Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan.
Product Planning, Fujirebio Inc., Tokyo, Japan.
Sci Rep. 2024 Oct 29;14(1):26040. doi: 10.1038/s41598-024-75645-1.
The transition from radioimmunoassay (RIA) to chemiluminescent enzyme immunoassay (CLEIA) for plasma aldosterone concentration (PAC) assays has raised concerns over its impact on primary aldosteronism (PA) diagnosis. This study investigated the correlation between PAC and renin values using RIA, CLEIA, and liquid chromatography/mass spectrometry/mass spectrometry (LC-MS/MS), established cutoff values for PA diagnosis using the aldosterone-to-renin ratio (ARR) with PAC_CLEIA, and assessed the differences in PAC values by measuring weak mineralocorticoids (WMs). This retrospective study evaluated 312 serum PAC samples using RIA, CLEIA, and LC-MS/MS, and analyzed 315 plasma renin samples. Method correlations were assessed through Passing-Bablok regression. Receiver operating characteristic curves determined ARR cutoffs for PA diagnosis. WMs were quantified to evaluate their impact on ΔPAC (RIA-LC-MS/MS) through multiple regression analysis. PAC_CLEIA and PAC_LC-MS/MS values were highly correlated. ARRs derived from PAC_RIAs demonstrated more false positives and lower specificity than ARRs using PAC_CLEIA or PAC_LC-MS/MS. WMs significantly influenced ΔPAC in both the PA and non-PA groups. ARRs using PAC_CLEIA are valuable for determining PA cutoffs in clinical practice. The transition to PAC using CLEIA may enhance PA detection rates. WMs were found to interfere with PAC measurements in the RIA method, affecting outcomes.
从放射免疫分析（RIA）到化学发光酶免疫分析（CLEIA）检测血浆醛固酮浓度（PAC）的转变引起了人们对其对原发性醛固酮增多症（PA）诊断影响的关注。本研究使用 RIA、CLEIA 和液相色谱/质谱/质谱（LC-MS/MS）研究了 PAC 和肾素值之间的相关性，使用 PAC_CLEIA 建立了醛固酮与肾素比值（ARR）用于 PA 诊断的截止值，并通过测量弱盐皮质激素（WMs）评估了 PAC 值的差异。这项回顾性研究使用 RIA、CLEIA 和 LC-MS/MS 评估了 312 个血清 PAC 样本，并分析了 315 个血浆肾素样本。通过 Passing-Bablok 回归评估方法相关性。接收者操作特征曲线确定 ARR 用于 PA 诊断的截止值。通过多元回归分析评估 WM 对 ΔPAC（RIA-LC-MS/MS）的影响，以定量 WM。PAC_CLEIA 和 PAC_LC-MS/MS 值高度相关。与使用 PAC_CLEIA 或 PAC_LC-MS/MS 的 ARR 相比，PAC_RIA 衍生的 ARRs 显示出更多的假阳性和较低的特异性。WM 对 PA 和非 PA 组的 ΔPAC 均有显著影响。在临床实践中，使用 PAC_CLEIA 的 ARR 有助于确定 PA 的截止值。向 CLEIA 检测 PAC 的转变可能会提高 PA 的检出率。WM 被发现会干扰 RIA 方法中的 PAC 测量，从而影响结果。
