Academic Journal
CT-based body composition enhances prognostic performance of PASO score for surgical outcome in primary aldosteronism.
| Τίτλος: | CT-based body composition enhances prognostic performance of PASO score for surgical outcome in primary aldosteronism. |
|---|---|
| Συγγραφείς: | Lee S; Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea., Cho SJ; Division of Endocrinology and Metabolism, Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea., Park JA; Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea., Baek S; Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea., Rhee Y; Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea., Hong N; Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea. nkhong84@yuhs.ac. |
| Πηγή: | Hypertension research : official journal of the Japanese Society of Hypertension [Hypertens Res] 2026 Oct; Vol. 49 (10), pp. 2854-2863. Date of Electronic Publication: 2026 Aug 06. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Nature Publishing Group Country of Publication: England NLM ID: 9307690 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1348-4214 (Electronic) Linking ISSN: 09169636 NLM ISO Abbreviation: Hypertens Res Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2009- : London : Nature Publishing Group Original Publication: Toyonaka, Japan : The Society, c1992-2003 |
| Ιατρικοί όροι (MeSH): | Hyperaldosteronism*/surgery , Hyperaldosteronism*/diagnostic imaging , Body Composition*, Humans ; Female ; Tomography, X-Ray Computed ; Male ; Middle Aged ; Prognosis ; Adrenalectomy ; Treatment Outcome ; Adult ; Retrospective Studies ; Body Mass Index |
| Περίληψη: | Primary aldosteronism (PA), the most common cause of secondary hypertension, is associated with greater cardiovascular risk than essential hypertension. The Primary Aldosteronism Surgical Outcome (PASO) score incorporates body mass index (BMI) as one of its predictors and has demonstrated usefulness in predicting surgical outcomes. Computed tomography (CT)-derived body composition measures, particularly visceral fat area (VFA), have the potential to enhance the prediction of surgical outcomes in PA beyond the PASO score. We analyzed patients with PA who underwent unilateral adrenalectomy at Severance Hospital between January 2005 and December 2017. Body composition measures, including L3 VFA, skeletal muscle area, and L1 trabecular bone Hounsfield unit (HU), were manually annotated from preoperative CT. Surgical outcomes at 12 months were defined according to PASO criteria. Among a total of 165 patients (mean age 47.5 years, 60% women), complete, partial, and absent clinical success were observed in 67 (41%), 85 (51%), and 13 (8%) patients, respectively. Patients achieving complete success had a higher proportion of women, lower BMI, lower VFA, and higher bone HU. In multivariable models adjusted for clinical covariates including PASO score, both VFA and bone HU were independently associated with complete success (adjusted odds ratio [95% CI] per one SD increment: VFA, 0.62 [0.40-0.96]; bone HU, 1.84 [1.10-3.06]). Incorporating VFA and bone HU into the PASO-based model significantly improved discrimination for complete clinical success (AUC 0.76 vs. 0.66; p = 0.003). CT-derived VFA and bone HU enhanced the prognostic performance of the PASO score for clinical success after adrenalectomy in patients with PA. (© 2026. The Author(s), under exclusive licence to The Japanese Society of Hypertension.) |
| Competing Interests: | Compliance with ethical standards. Conflict of interest: All authors declare that this study was conducted without any commercial or financial relationships that could be construed as potential conflicts of interest. |
| References: | J Clin Endocrinol Metab. 2025 Aug 07;110(9):2453-2495. (PMID: 40658480) J Clin Endocrinol Metab. 2003 Jun;88(6):2399-403. (PMID: 12788834) Eur J Nucl Med Mol Imaging. 2026 Apr;53(5):3297-3309. (PMID: 41629417) Hypertens Res. 2023 May;46(5):1168-1170. (PMID: 36854727) Eur J Endocrinol. 2016 Dec;175(6):R265-R282. (PMID: 27412441) J Surg Res. 2012 Oct;177(2):241-7. (PMID: 22921664) Am J Physiol Heart Circ Physiol. 2004 Nov;287(5):H2023-6. (PMID: 15475529) Eur Heart J. 2018 Sep 1;39(33):3021-3104. (PMID: 30165516) Circulation. 2007 Jul 3;116(1):39-48. (PMID: 17576866) J Bone Metab. 2024 Nov;31(4):326-334. (PMID: 39701111) Sci Rep. 2021 May 26;11(1):11076. (PMID: 34040142) Eur J Endocrinol. 2022 Nov 22;187(6):S47-S58. (PMID: 36315466) J Bone Miner Res. 2011 Aug;26(8):1816-21. (PMID: 21472775) Am Surg. 2005 Oct;71(10):864-9. (PMID: 16468537) J Clin Endocrinol Metab. 2021 Jan 1;106(1):42-54. (PMID: 32717746) World J Surg. 2011 Nov;35(11):2422-7. (PMID: 21882028) J Clin Endocrinol Metab. 2008 Sep;93(9):3266-81. (PMID: 18552288) Korean J Intern Med. 2014 Mar;29(2):217-25. (PMID: 24648805) J Endocr Soc. 2018 Sep 17;2(11):1236-1245. (PMID: 30374468) Ann Surg. 2020 Dec;272(6):1125-1132. (PMID: 30672800) Sci Rep. 2022 Apr 6;12(1):5781. (PMID: 35388079) Obesity (Silver Spring). 2010 Nov;18(11):2191-8. (PMID: 20339361) Sci Rep. 2018 Jul 27;8(1):11369. (PMID: 30054580) Radiology. 2019 May;291(2):360-367. (PMID: 30912719) Endocrinol Metab (Seoul). 2021 Apr;36(2):401-412. (PMID: 33789036) Obesity (Silver Spring). 2010 May;18(5):884-9. (PMID: 20019678) PLoS One. 2016 Apr 04;11(4):e0153031. (PMID: 27043708) Ann Intern Med. 2013 Apr 16;158(8):588-95. (PMID: 23588747) Hypertension. 2021 Jun;77(6):1964-1973. (PMID: 33866798) Endocrinology. 2004 May;145(5):2273-82. (PMID: 14726444) |
| Contributed Indexing: | Keywords: Body composition; Implemental hypertension; Morning hypertension; Primary aldosteronism; Surgical outcome |
| Entry Date(s): | Date Created: 20260807 Date Completed: 20261005 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| DOI: | 10.1038/s41440-026-02735-0 |
| PMID: | 42562871 |
| Βάση Δεδομένων: | MEDLINE |
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