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Tytuł:
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Random 'spot' urinary metanephrines compared with 24-h-urinary and plasma results in phaeochromocytomas and paragangliomas.
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Autorzy:
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Sbardella E; Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK.; Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
Maunsell Z; Department of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
May CJH; Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK.
Tadman M; Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK.
James T; Department of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Jafar-Mohammadi B; Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK.
Isidori AM; Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
Grossman AB; Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK.
Shine B; Department of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
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Źródło:
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European journal of endocrinology [Eur J Endocrinol] 2020 Aug; Vol. 183 (2), pp. 129-139.
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Typ publikacji:
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Comparative Study; Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2023- : Oxford : Oxford University Press
Original Publication: Oslo, Norway : Scandinavian University Press, c1994-
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MeSH Terms:
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Adrenal Gland Neoplasms/*urine
Metanephrine/*blood
Metanephrine/*urine
Paraganglioma/*urine
Pheochromocytoma/*urine
Adolescent ; Adrenal Gland Neoplasms/blood ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Area Under Curve ; Chromatography, High Pressure Liquid ; Creatinine/blood ; Creatinine/urine ; Dopamine/analogs & derivatives ; Dopamine/blood ; Dopamine/urine ; Female ; Humans ; Male ; Mass Spectrometry ; Middle Aged ; Normetanephrine/blood ; Normetanephrine/urine ; Paraganglioma/blood ; Pheochromocytoma/blood ; ROC Curve ; Reference Values ; Retrospective Studies ; Sex Factors ; Young Adult
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Substance Nomenclature:
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0J45DE6B88 (Normetanephrine)
5001-33-2 (Metanephrine)
AYI8EX34EU (Creatinine)
JCH2767EDP (3-methoxytyramine)
VTD58H1Z2X (Dopamine)
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Entry Date(s):
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Date Created: 20200516 Date Completed: 20200701 Latest Revision: 20220415
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Update Code:
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20240105
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DOI:
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10.1530/EJE-19-0809
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PMID:
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32413848
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Background: In patients with phaeochromocytomas or paragangliomas (PPGLs), 24-h urine collections for metanephrines (uMNs) are cumbersome.
Objective: To evaluate the diagnostic utility of ratios to creatinine of 'spot' uMNs.
Methods: Concentrations of uMNs and plasma metanephrines (pMNs) were measured by HPLC-mass-spectrometry. We retrospectively compared correlations of 24-h-urine output and ratio to creatinine in historical specimens and prospectively assessed 24-h and contemporaneous spot urines and, where possible, pMNs. Using trimmed log-transformed values, we derived reference intervals based on age and sex for spot urines. We used multiples of upper limit of normal (ULNs) to compare areas under curves (AUCs) for receiver-operator characteristic curves of individual, and sum and product of, components.
Results: In 3143 24-h-urine specimens on 2416 patients, the correlation coefficients between the ratios and outputs of metanephrine, normetanephrine and 3-methoxytyramine in 24-h urines were 0.983, 0.905 and 0.875, respectively. In 96 patients, the correlations between plasma concentrations, urine output and ratios in spot specimens were similar to those for raw output or ratios in 24-h specimens. Of the 160 patients with PPGLs, the CIs for AUCs for individual metabolites overlapped for all four types of measurement, as did those for the sum of the multiple ULNs although these were slightly higher (AUC for spot urine: 0.838 (0.529-1), plasma: 0.929 (0.874-0.984) and output: 0.858 (0.764-0.952)).
Conclusions: Ratios of fractionated metanephrines to creatinine in spot urine samples appear to have a similar diagnostic power to other measurements. The ease of spot urine collection may facilitate diagnosis and follow-up of PPGLs through improved patient compliance.
