Kaiwen Sun, Minghui Gong, Yang Yu, Minghui Yang, Yinong Jiang, Ying Zhang, Wei Song
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引用次数: 0
摘要
本研究旨在评估24小时尿醛固酮(UALD)对东北地区原发性醛固酮增多症(PA)的诊断准确性。共纳入423例高血压患者。经1:2倾向评分匹配(PSM)后,100例患者分为PA组,194例患者分为原发性高血压(EH)组。收集并分析临床特征及生化指标。生成受试者工作特征(ROC)曲线,计算曲线下面积(AUC),确定最佳诊断阈值。两组患者年龄差异无统计学意义(PA: 53.4±11.3岁,EH: 52.8±11.3岁,p < 0.05)。PA组24小时UALD的中位值显著更高(6.4 [3.7,13.9]μ g/24 h vs. 4.8 [2.5, 7.8] μ g/24 h, p < 0.05),且两组的UALD水平均随年龄增长而下降。最佳UALD临界值为11.4µg/24 h (AUC = 0.652,约登指数= 0.257)。对于55岁以上的患者,24小时尿醛固酮与肌酐比值(UACR)具有较好的诊断性能,最佳临界值为0.8µg/mmol/L (AUC = 0.695)。在华北地区,24小时UALD是一种很有希望的PA诊断指标,而24小时UACR可能会提高老年人的准确性。然而,需要进一步的研究来验证这些发现。
Diagnostic Accuracy of 24-Hour Urinary Aldosterone for Primary Aldosteronism in Northeast China
This study aimed to evaluate the diagnostic accuracy of 24-hour urinary aldosterone (UALD) for primary aldosteronism (PA) in Northeast China. A total of 423 patients with hypertension were consecutively enrolled. After 1:2 propensity score matching (PSM), 100 patients were classified into the PA group, and 194 patients were classified into the essential hypertension (EH) group. The clinical characteristics and biochemistry measurements were collected and analyzed. A receiver operating characteristic (ROC) curve was generated, and the area under the curve (AUC) was calculated to determine optimal diagnostic thresholds. No significant difference in age was observed between the groups (PA: 53.4 ± 11.3 years vs. EH: 52.8 ± 11.3 years, p > 0.05). The median 24-hour UALD was significantly greater in the PA group (6.4 [3.7, 13.9] µg/24 h vs. 4.8 [2.5, 7.8] µg/24 h, p < 0.05), with levels declining with age in both cohorts. The optimal UALD cutoff value was 11.4 µg/24 h (AUC = 0.652; Youden index = 0.257). For patients over 55 years, the 24-hour urinary aldosterone-to-creatinine ratio (UACR) showed superior diagnostic performance, with an optimal cutoff of 0.8 µg/mmol/L (AUC = 0.695). 24-Hour UALD was a promising diagnostic marker for PA in North China, whereas 24-hour UACR might increase accuracy in older populations. However, further studies are needed to validate these findings.
期刊介绍:
The Journal of Clinical Hypertension is a peer-reviewed, monthly publication that serves internists, cardiologists, nephrologists, endocrinologists, hypertension specialists, primary care practitioners, pharmacists and all professionals interested in hypertension by providing objective, up-to-date information and practical recommendations on the full range of clinical aspects of hypertension. Commentaries and columns by experts in the field provide further insights into our original research articles as well as on major articles published elsewhere. Major guidelines for the management of hypertension are also an important feature of the Journal. Through its partnership with the World Hypertension League, JCH will include a new focus on hypertension and public health, including major policy issues, that features research and reviews related to disease characteristics and management at the population level.