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Dexamethasone Nonsuppression in Primary Aldosteronism: Associations With Adrenal Imaging Findings.

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Τίτλος: Dexamethasone Nonsuppression in Primary Aldosteronism: Associations With Adrenal Imaging Findings.
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
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  Data: Dexamethasone Nonsuppression in Primary Aldosteronism: Associations With Adrenal Imaging Findings.
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  Data: <searchLink fieldCode="AU" term="%22Zhang+XT%22">Zhang XT</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Zeng+QT%22">Zeng QT</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Lin+ZX%22">Lin ZX</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Zhang+HJ%22">Zhang HJ</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Wu+MB%22">Wu MB</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Zhang+H%22">Zhang H</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Wang+R%22">Wang R</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Shuai+WL%22">Shuai WL</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Zhang+HC%22">Zhang HC</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Yang+J%22">Yang J</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Xiong+HL%22">Xiong HL</searchLink>; 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.<br /><searchLink fieldCode="AU" term="%22Dong+YF%22">Dong YF</searchLink>; 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.
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  Data: <searchLink fieldCode="JN" term="%22101580524%22">Journal of the American Heart Association</searchLink> [J Am Heart Assoc] 2026 Oct 06; Vol. 15 (19), pp. e049591. <i>Date of Electronic Publication: </i>2026 Sep 24.
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  Data: <searchLink fieldCode="MM" term="%22Hyperaldosteronism%22">Hyperaldosteronism*</searchLink>/<searchLink fieldCode="MM" term="%22Hyperaldosteronism+blood%22">blood</searchLink> <br /><searchLink fieldCode="MM" term="%22Hyperaldosteronism%22">Hyperaldosteronism*</searchLink>/<searchLink fieldCode="MM" term="%22Hyperaldosteronism+diagnosis%22">diagnosis</searchLink> <br /><searchLink fieldCode="MM" term="%22Hyperaldosteronism%22">Hyperaldosteronism*</searchLink>/<searchLink fieldCode="MM" term="%22Hyperaldosteronism+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Hyperaldosteronism%22">Hyperaldosteronism*</searchLink>/<searchLink fieldCode="MM" term="%22Hyperaldosteronism+diagnostic+imaging%22">diagnostic imaging</searchLink> <br /><searchLink fieldCode="MM" term="%22Dexamethasone%22">Dexamethasone*</searchLink>/<searchLink fieldCode="MM" term="%22Dexamethasone+administration+%26+dosage%22">administration & dosage</searchLink> <br /><searchLink fieldCode="MM" term="%22Hydrocortisone%22">Hydrocortisone*</searchLink>/<searchLink fieldCode="MM" term="%22Hydrocortisone+blood%22">blood</searchLink> <br /><searchLink fieldCode="MM" term="%22Adrenal+Glands%22">Adrenal Glands*</searchLink>/<searchLink fieldCode="MM" term="%22Adrenal+Glands+diagnostic+imaging%22">diagnostic imaging</searchLink> <br /><searchLink fieldCode="MM" term="%22Glucocorticoids%22">Glucocorticoids*</searchLink>/<searchLink fieldCode="MM" term="%22Glucocorticoids+administration+%26+dosage%22">administration & dosage</searchLink> <br /><searchLink fieldCode="MM" term="%22Tomography%2C+X-Ray+Computed%22">Tomography, X-Ray Computed*</searchLink><br /><searchLink fieldCode="MH" term="%22Biomarkers%22">Biomarkers</searchLink>/<searchLink fieldCode="MH" term="%22Biomarkers+blood%22">blood</searchLink> ; <searchLink fieldCode="MH" term="%22Hypertension%22">Hypertension</searchLink>/<searchLink fieldCode="MH" term="%22Hypertension+etiology%22">etiology</searchLink> ; <searchLink fieldCode="MH" term="%22Hypertension%22">Hypertension</searchLink>/<searchLink fieldCode="MH" term="%22Hypertension+diagnosis%22">diagnosis</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Prospective+Studies%22">Prospective Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Propensity+Score%22">Propensity Score</searchLink> ; <searchLink fieldCode="MH" term="%22Risk+Factors%22">Risk Factors</searchLink> ; <searchLink fieldCode="MH" term="%22Predictive+Value+of+Tests%22">Predictive Value of Tests</searchLink> ; <searchLink fieldCode="MH" term="%22Prevalence%22">Prevalence</searchLink> ; <searchLink fieldCode="MH" term="%22Logistic+Models%22">Logistic Models</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%22">Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Multivariate+Analysis%22">Multivariate Analysis</searchLink> ; <searchLink fieldCode="MH" term="%22Adrenal+Cortex+Function+Tests%22">Adrenal Cortex Function Tests</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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.<br />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.<br />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.<br />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.
– Name: SubjectMinor
  Label: Contributed Indexing
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  Data: <i>Keywords: </i>DST nonsuppression; adrenal nodules; dexamethasone suppression test; hypertension; primary aldosteronism
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  Data: 7S5I7G3JQL (Dexamethasone)<br />WI4X0X7BPJ (Hydrocortisone)<br />0 (Biomarkers)<br />0 (Glucocorticoids)
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  Data: <i>Date Created: </i>20260925 <i>Date Completed: </i>20261008 <i>Latest Revision: </i>20261013
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  Data: 20261014
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  Data: 10.1161/JAHA.126.049591
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  Data: 42786607
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42786607
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        Value: 10.1161/JAHA.126.049591
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        Text: English
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        StartPage: e049591
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      – SubjectFull: Biomarkers blood
        Type: general
      – SubjectFull: Hypertension etiology
        Type: general
      – SubjectFull: Hypertension diagnosis
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      – SubjectFull: Hyperaldosteronism blood
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      – SubjectFull: Dexamethasone administration & dosage
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      – TitleFull: Dexamethasone Nonsuppression in Primary Aldosteronism: Associations With Adrenal Imaging Findings.
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              Text: 2026 Oct 06
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