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Erlic, Z.* ; Reel, P.* ; Reel, S.* ; Amar, L.* ; Pecori, A.* ; Larsen, C.K.* ; Tetti, M.* ; Pamporaki, C.* ; Prehn, C. ; Adamski, J. ; Prejbisz, A.* ; Ceccato, F.* ; Scaroni, C.* ; Kroiss, M.* ; Dennedy, M.C.* ; Deinum, J.* ; Langton, K.* ; Mulatero, P.* ; Reincke, M.* ; Lenzini, L.* ; Gimenez-Roqueplo, A.P.* ; Assié, G.* ; Blanchard, A.* ; Zennaro, M.C.* ; Jefferson, E.* ; Beuschlein, F.*

Targeted metabolomics as a tool in discriminating endocrine from primary hypertension.

J. Clin. Endocrinol. Metab. 106, 1111-1128 (2021)
Verlagsversion DOI
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
CONTEXT: Identification of patients with endocrine forms of hypertension (EHT) (primary hyperaldosteronism [PA], pheochromocytoma/paraganglioma [PPGL] and Cushing syndrome [CS]) provides the basis to implement individualized therapeutic strategies. Targeted metabolomics (TM) have revealed promising results in profiling cardiovascular diseases and endocrine conditions associated with hypertension. OBJECTIVE: Use TM to identify distinct metabolic patterns between primary hypertension (PHT) and EHT and test its discriminating ability. DESIGN: Retrospective analyses of PHT and EHT patients from a European multicentre study (ENSAT-HT). TM was performed on stored blood samples using liquid chromatography mass spectrometry. To identify discriminating metabolites a "classical approach" (CA) (performing a series of univariate and multivariate analyses) and a "machine learning approach" (MLA) (using Random Forest) were used. PATIENTS: The study included 282 adult patients (52% female; mean age 49 years) with proven PHT (n=59) and EHT (n=223 with 40 CS, 107 PA and 76 PPGL), respectively. RESULTS: From 155 metabolites eligible for statistical analyses, 31 were identified discriminating between PHT and EHT using the CA and 27 using the MLA, of which 15 metabolites (C9, C16, C16:1, C18:1, C18:2, arginine, aspartate, glutamate, ornithine, spermidine, lysoPCaC16:0, lysoPCaC20:4, lysoPCaC24:0, PCaeC42:0, SM C18:1, SM C20:2) were found by both approaches. The ROC curve built on the top 15 metabolites from the CA provided an area under the curve (AUC) of 0.86, which was similar to the performance of the 15 metabolites from MLA (AUC 0.83). CONCLUSIONS: TM identifies distinct metabolic pattern between PHT and EHT providing promising discriminating performance.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Cushing Syndrome ; Arterial Hypertension ; Pheochromocytoma ; Primary Aldosteronism ; Screening ; Targeted Metabolomics; Amino-acid-metabolism; Primary Aldosteronism; Oxidative Stress; Cardiovascular Events; Prevalence; Diagnosis; Management; Society; Pheochromocytoma; Manifestations
ISSN (print) / ISBN 0021-972X
e-ISSN 1945-7197
Quellenangaben Band: 106, Heft: 4, Seiten: 1111-1128 Artikelnummer: , Supplement: ,
Verlag Endocrine Society
Verlagsort Bethesda, Md.
Begutachtungsstatus Peer reviewed
Institut(e) Molekulare Endokrinologie und Metabolismus (MEM)
Förderungen Deutsche Forschungsgemeinschaft
Clinical Research Priority Program of the University of Zurich
European Union's Horizon 2020 research and innovation program