Aldosterone Suppression by Dexamethasone in Patients With KCNJ5-Mutated Aldosterone-Producing Adenoma

The Journal of Clinical Endocrinology and Metabolism
Kosuke InoueTetsuo Nishikawa

Abstract

Aldosterone biosynthesis is regulated principally by ACTH and gene mutations as well as by angiotensin II and serum potassium. In addition, previous studies have reported the potential effects of KCNJ5 mutations in aldosterone-producing adenoma (APA) on cardiovascular diseases. However, responsiveness to ACTH in APAs according to potassium inwardly rectifying channel, subfamily J, member 5 (KCNJ5) mutations remains unknown. To investigate KCNJ5 genotype-specific differences in aldosterone biosynthesis in response to ACTH stimulation. A cross-sectional study through retrieval of clinical records. One hundred forty-one patients aged ≥20 years with APA were examined. Associations between KCNJ5 mutations and clinical parameters reflecting the renin-angiotensin system [saline infusion test (SIT)] and ACTH pathways [dexamethasone suppression test (DST)]. KCNJ5 mutations were detected in 107 cases. In the crude comparison, patients with mutations in KCNJ5 had higher plasma aldosterone concentrations (PACs) both at baseline and after the SIT. PAC after the DST showed a significant inverse association with KCNJ5 genotypes after controlling for age, sex, tumor size, and PAC after the SIT. Immunohistochemical analysis of 101 cases reveale...Continue Reading

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Citations

Dec 19, 2019·Journal of Hypertension·Troy H PuarPeng C Kek
Aug 14, 2019·The Journal of Clinical Endocrinology and Metabolism·Taweesak WannachaleeAdina F Turcu
Feb 26, 2021·The Journal of Clinical Endocrinology and Metabolism·Christina TatsiConstantine A Stratakis
May 1, 2021·Biomedicines·Kiyotaka ItchoMasayasu Yoneda
Jun 13, 2021·The Journal of Clinical Endocrinology and Metabolism·Yuta TezukaAdina F Turcu

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