Urinary excretion of 19-noraldosterone, 18, 19-dihydroxycorticosterone and 18-hydroxy-19-norcorticosterone in patients with aldosterone-producing adenoma or idiopathic hyperaldosteronism

Abstract

Urinary excretion of 19-noraldosterone. 18, 19-dihydroxycorticosterone (18, 19(OH)2-B), 18-hydroxy-19-norcorticosterone (18-OH-19-nor-B), 18-hydroxycorticosterone (18-OH-B), 18-hydroxycortisol (18-OH-F) and aldosterone were measured in 25 patients with primary aldosteronism, 16 with an aldosterone-producing adenoma and 9 with idiopathic hyperaldosteronism. In patients with idiopathic hyperaldosteronism, urinary 19-noraldosterone (207±51 pmol/day), 18, 19(OH)2-B (21±4.2 nmol/day) and 18-OH-19-nor-B (879±21 3 pmol/day) levels were lower but not significantly different from 19-noraldosterone (263±56 pmol/day), 18, 19(OH)2-B (40±8.7 nmol/day) and 18-OH-19-nor-B (1322±267 pmol/day) seen in patients with aldosterone-producing adenoma. Urinary aldosterone did not differ significantly between patients with idiopathic hyperaldosteronism and those with aldosterone-producing adenoma. Both urinary 18-OH-B and 18-OH-F excretion were significantly higher in aldosterone-producing adenoma (39±5.2 nmol/day, 1660±318 nmol/day, respectively) compared with patients with idiopathic hyperaldosteronism (19±3.3 nmol/day, 541±93 nmol/day. respectively) (p<0.05). Though urinary 18-OH-F and 18-OH-B concentrations were useful markers, the mineralocorticoid steroids which we can only now measure, 19-noraldosterone, 18, 19(OH)2-B and 18-OH-19-nor-B, could not be used to distinguish the two subsets of primary aldosteronism.