TY - JOUR
T1 - Aldosterone regulation in primary aldosteronism
T2 - differences between adenoma and bilateral hyperplasia
AU - Mantero, F.
AU - Gion, M.
AU - Armanini, D.
AU - Opocher, G.
PY - 1976
Y1 - 1976
N2 - The diurnal patterns of plasma aldosterone, plasma renin activity (PRA), cortisol and adrenocorticotrophic hormone (ACTH) in the supine and in the upright position have been studied in 14 patients with primary aldosteronism, 5 with adenoma and 9 with bilateral hyperplasia. Blood samples were drawn at intervals from 6 hr to 30 min. Supine patients with an adenoma showed marked diurnal variations of aldosterone, with maximal values at 08.00 hr and minimal values at 18.00 hr and secretory spurts beginning after 02.00 hr. Plasma cortisol paralleled aldosterone, and ACTH seemed to anticipate aldosterone and cortisol variations; PRA remained unchanged. In patients with hyperplasia, aldosterone was significantly lower than in the adenoma group at 08.00 hr, and its decline during the day was less marked; fluctuations rather than secretory episodes were seen. After patients assumed the upright posture, aldosterone remained unchanged or decreased in patients with adenoma, whereas it significantly increased in hyperplasia; PRA remained low, although a slight increment was seen in the latter group. The different response of aldosterone in the 2 groups was not modified by the administration of propranolol, apparently excluding a renin dependent mechanism. On the other hand, dexamethasone seemed to affect the response of aldosterone to the upright posture in both groups; in adenoma there was a slight but significant increase, and in hyperplasia the usual rise was partially suppressed. It is concluded that ACTH has a predominant role in regulating aldosterone secretion in primary aldosteronism due to adenoma, whereas its action in bilateral hyperplasia is only permissive.
AB - The diurnal patterns of plasma aldosterone, plasma renin activity (PRA), cortisol and adrenocorticotrophic hormone (ACTH) in the supine and in the upright position have been studied in 14 patients with primary aldosteronism, 5 with adenoma and 9 with bilateral hyperplasia. Blood samples were drawn at intervals from 6 hr to 30 min. Supine patients with an adenoma showed marked diurnal variations of aldosterone, with maximal values at 08.00 hr and minimal values at 18.00 hr and secretory spurts beginning after 02.00 hr. Plasma cortisol paralleled aldosterone, and ACTH seemed to anticipate aldosterone and cortisol variations; PRA remained unchanged. In patients with hyperplasia, aldosterone was significantly lower than in the adenoma group at 08.00 hr, and its decline during the day was less marked; fluctuations rather than secretory episodes were seen. After patients assumed the upright posture, aldosterone remained unchanged or decreased in patients with adenoma, whereas it significantly increased in hyperplasia; PRA remained low, although a slight increment was seen in the latter group. The different response of aldosterone in the 2 groups was not modified by the administration of propranolol, apparently excluding a renin dependent mechanism. On the other hand, dexamethasone seemed to affect the response of aldosterone to the upright posture in both groups; in adenoma there was a slight but significant increase, and in hyperplasia the usual rise was partially suppressed. It is concluded that ACTH has a predominant role in regulating aldosterone secretion in primary aldosteronism due to adenoma, whereas its action in bilateral hyperplasia is only permissive.
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M3 - Article
C2 - 192515
AN - SCOPUS:0017182537
VL - 51
SP - 329
EP - 332
JO - Clinical Science and Molecular Medicine
JF - Clinical Science and Molecular Medicine
SN - 0301-0538
IS - Sup. 3
ER -