Nakai Kazuki, Tsurutani Yuya, Irie Koki, Teruyama Kyoko, Suematsu Sachiko, Matsui Seishi, Makita Kohzoh, Saito Jun, Omura Masao, Nishikawa Tetsuo
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Kanagawa 222-0036, Japan.
Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
Endocr J. 2024 May 23;71(5):461-469. doi: 10.1507/endocrj.EJ23-0695. Epub 2024 Feb 28.
Plasma aldosterone concentration (PAC) was routinely measured using radioimmunoassay (RIA); however, the RIA kit was discontinued in March 2021 in Japan. This study examined PAC conversion in adrenal venous sampling (AVS) and AVS criteria when measured using chemiluminescent enzyme immunoassay (CLEIA). PAC of 415 adrenal venous blood samples from AVS (including segmental AVS) of 63 patients with primary aldosteronism was measured using RIA (Spac-S aldosterone kit; Fujirebio Inc.) and CLEIA (Lumipulse Presto Aldosterone; Fujirebio Inc.). PAC of 70 AVS samples was also measured using liquid chromatography-mass spectrometry (LC-MS/MS, ASKA Pharma Medical Co., Ltd.). PAC conversion formulas were determined for each AVS sample assay. PAC measured using CLEIA was significantly correlated with that measured using RIA (correlation coefficient = 0.971). The PAC conversion formula was PAC (CLEIA) = PAC (RIA) × 0.772 - 1,199 pg/mL. The PAC of 14,000 pg/mL in RIA was equivalent to 9,613 pg/mL in CLEIA. PAC measured using CLEIA was also correlated with that measured using LC-MS/MS, and the PAC conversion formula was PAC (CLEIA, pg/mL) = 0.97 × PAC (LC-MS/MS, pg/mL) + 211. The inter-assay coefficient of variability (CV) was 1.1-1.3% and intra-assay CV was 1.0-1.7%, measured using CLEIA. The PAC conversion formula for AVS samples was obtained using CLEIA and RIA, and the conversion formula was different from that for peripheral blood. PAC values measured by CLEIA showed preferable accuracy and high concordance with those measured by LC-MS/MS, even in AVS samples. The study outcomes are useful for interpreting AVS results using non-RIA measurement methods.
血浆醛固酮浓度（PAC）通常采用放射免疫分析法（RIA）进行测定；然而，该RIA试剂盒于2021年3月在日本停止生产。本研究探讨了在使用化学发光酶免疫分析法（CLEIA）测定时，肾上腺静脉采血（AVS）中的PAC转换情况以及AVS标准。使用RIA（Spac-S醛固酮试剂盒；富士瑞必欧株式会社）和CLEIA（Lumipulse Presto醛固酮；富士瑞必欧株式会社）对63例原发性醛固酮增多症患者的415份AVS（包括节段性AVS）肾上腺静脉血样本的PAC进行了测定。还使用液相色谱-质谱联用技术（LC-MS/MS，ASKA制药医疗株式会社）对70份AVS样本的PAC进行了测定。确定了每个AVS样本检测方法的PAC转换公式。使用CLEIA测定的PAC与使用RIA测定的PAC显著相关（相关系数 = 0.971）。PAC转换公式为PAC（CLEIA）= PAC（RIA）×0.772 - 1199 pg/mL。RIA中14000 pg/mL的PAC相当于CLEIA中的9613 pg/mL。使用CLEIA测定的PAC也与使用LC-MS/MS测定的PAC相关，PAC转换公式为PAC（CLEIA，pg/mL）= 0.97×PAC（LC-MS/MS，pg/mL）+ 211。使用CLEIA测量时，批间变异系数（CV）为1.1 - 1.3%，批内CV为1.0 - 1.7%。使用CLEIA和RIA获得了AVS样本的PAC转换公式，该转换公式与外周血的不同。即使在AVS样本中，使用CLEIA测量的PAC值也显示出较好的准确性，并且与使用LC-MS/MS测量的值高度一致。该研究结果有助于使用非RIA测量方法解释AVS结果。
