Endocrinol Metab.  2024 Dec;39(6):965-969. 10.3803/EnM.2024.1985.

Comparative Analysis of Liquid Chromatography-Tandem Mass Spectrometry and Radioimmunoassay in Determining Plasma Aldosterone Concentration and Plasma Renin Activity for Primary Aldosteronism Screening

• Kwon SY
• Kim KJ
• Lee SY
• Kim JH

• KMID: 2562724
• DOI: http://doi.org/10.3803/EnM.2024.1985

Abstract

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) accurately measures plasma aldosterone concentration (PAC), but its correlation with radioimmunoassay (RIA), equivalent RIA levels, and optimal cutoff for PAC and aldosterone-to-renin ratio (ARR) in primary aldosteronism (PA) screening have not been determined in a Korean population. Our study of 127 patients who underwent diagnostic testing for PA showed that the LC-MS/MS and RIA methods have good correlation, with a mean bias of 29.3% for PAC. An LC-MS/MS PAC level of 11.7 ng/dL was equivalent to an RIA PAC level of 15 ng/dL. Receiver operating characteristic curve analysis showed that an LC-MS/MS PAC level of 10.3 ng/dL and LC-MS/MS ARR level of 20.0 provided sensitivity of 73.1% with a specificity of 57.3% and sensitivity of 92.3% with a specificity of 14.7%, respectively. When the LC-MS/MS method is used for PA screening, an adjustment of cutoff values is necessary.

Keyword

Hyperaldosteronism; Aldosterone; Diagnosis; Chromatography, liquid; Tandem mass spectrometry; Radioimmunoassay

Figure

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  Fig. 1. Comparison of radioimmunoassay (RIA) and liquid chromatography-tandem mass spectrometry measurements of plasma aldosterone concentration (PAC) and plasma renin activity (PRA): Passing-Bablok regression analyses of (A) PAC and (B) PRA and Bland-Altman analyses of (C) PAC and (D) PRA. Essential hypertension (ET) is defined by liquid chromatography-tandem mass spectrometry (LC-MS/ MS) PAC as seated saline loading test ≤5.8 ng/dL; primary aldosteronism (PA) is defined by LC-MS/MS PAC as seated saline loading test >5.8 ng/dL (162 pmol/L). SD, standard deviation.

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