Academic Journal
Dexamethasone Nonsuppression in Primary Aldosteronism: Associations With Adrenal Imaging Findings.
| Τίτλος: | Dexamethasone Nonsuppression in Primary Aldosteronism: Associations With Adrenal Imaging Findings. |
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| Συγγραφείς: | Zhang XT; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Zeng QT; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Lin ZX; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Zhang HJ; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Wu MB; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Zhang H; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Wang R; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Shuai WL; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Zhang HC; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Yang J; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Xiong HL; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China., Dong YF; Department of Cardiovascular Medicine The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China.; Molecular Medicine of Jiangxi Key Laboratory The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 330006 China. |
| Πηγή: | Journal of the American Heart Association [J Am Heart Assoc] 2026 Oct 06; Vol. 15 (19), pp. e049591. Date of Electronic Publication: 2026 Sep 24. |
| Τύπος έκδοσης: | Journal Article; Observational Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford : Wiley-Blackwell |
| Ιατρικοί όροι (MeSH): | Hyperaldosteronism*/blood , Hyperaldosteronism*/diagnosis , Hyperaldosteronism*/epidemiology , Hyperaldosteronism*/diagnostic imaging , Dexamethasone*/administration & dosage , Hydrocortisone*/blood , Adrenal Glands*/diagnostic imaging , Glucocorticoids*/administration & dosage , Tomography, X-Ray Computed*, Biomarkers/blood ; Hypertension/etiology ; Hypertension/diagnosis ; Humans ; Female ; Male ; Middle Aged ; Prospective Studies ; Propensity Score ; Risk Factors ; Predictive Value of Tests ; Prevalence ; Logistic Models ; Aged ; Multivariate Analysis ; Adrenal Cortex Function Tests |
| Περίληψη: | Background: The 1-mg dexamethasone suppression test (DST) nonsuppression is increasingly recognized beyond adrenal incidentaloma, but its prevalence and clinical significance in patients evaluated for primary aldosteronism (PA) remain unclear, particularly in those without adrenal nodules. Methods: In this prospective observational study, consecutive patients with hypertension suspected of PA underwent standardized hormonal evaluation, including the 1-mg DST. DST nonsuppression was defined as post-DST serum cortisol >1.8 μg/dL in the absence of overt Cushing's syndrome. Patients were classified as non-PA or confirmed PA and further stratified by adrenal nodules status on computed tomography. Associations with DST nonsuppression were examined using multivariable logistic regression and propensity score-based analyses, with overlap weighting as the primary approach. Results: Among 883 patients who completed the 1-mg DST, DST nonsuppression was observed in 12.2%. Its prevalence showed an increasing pattern across groups, being lowest in individuals without PA, intermediate in patients with PA without adrenal nodules, and highest in those with adrenal nodules. Adrenal nodules were independently associated with DST nonsuppression (odds ratio, 2.68 [95% CI, 1.01-7.12]), with consistent findings across propensity score-based analyses. Among patients with PA without adrenal nodules, DST nonsuppression was associated with lower estimated glomerular filtration rate and a higher prevalence of chronic kidney disease. Conclusions: In the high-risk population with PA, DST nonsuppression was not randomly distributed across predefined groups and was independently associated with adrenal nodules. Even in the absence of adrenal nodules, DST nonsuppression was associated by less favorable renal markers, supporting its consistent association with clinical characteristics in patients with PA, rather than implying a distinct biochemical characteristic. |
| Contributed Indexing: | Keywords: DST nonsuppression; adrenal nodules; dexamethasone suppression test; hypertension; primary aldosteronism |
| Substance Nomenclature: | 7S5I7G3JQL (Dexamethasone) WI4X0X7BPJ (Hydrocortisone) 0 (Biomarkers) 0 (Glucocorticoids) |
| Entry Date(s): | Date Created: 20260925 Date Completed: 20261008 Latest Revision: 20261013 |
| Update Code: | 20261014 |
| DOI: | 10.1161/JAHA.126.049591 |
| PMID: | 42786607 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2047-9980 |
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| DOI: | 10.1161/JAHA.126.049591 |