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Chinese normotensive and essential hypertensive reference intervals for plasma aldosterone and renin activity by liquid chromatography-tandem mass spectrometry

  • Jenny Yeuk-Ki Cheng EMAIL logo , Felix Chi-Kin Wong , Edith Wing-Kar Chow , Wendy Wan-Hang Lau , Kitty Kit-Ting Cheung , Timothy Hua-Tse Cheng , Teresa Kam-Chi Tsui , Alan Shek-Lun Chan , Clara Wai-Shan Lo and Chung-Shun Ho
Published/Copyright: August 4, 2022

Abstract

Objectives

The renin-angiotensin-aldosterone system (RAAS) regulates blood pressure. Plasma renin activities (PRA) and plasma aldosterone concentrations (PAC) are biomarkers related to RAAS. Liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based measurements for PRA and PAC have become popular. Method-specific reference intervals (RIs) are required.

Methods

Routine PRA and PAC services in a Hong Kong teaching hospital were based on LC-MS/MS methods. PRA and PAC RIs were developed for normotensive subjects and essential hypertensive (EH) patients. Healthy volunteers were recruited to establish normotensive RIs. PRA and PAC results of hypertensive patients with urine aldosterone tests for primary aldosteronism (PA) screening were retrieved from the laboratory information system. Patients without PA were included. Patients with secondary hypertension and patients on medications affecting the RAAS were excluded. The central 95% RIs were established based on the recommendations of the Clinical and Laboratory Standards Institute guideline C28-A3.

Results

PRA and PAC of 170 normotensive volunteers and 362 EH patients were analysed. There was no sex-specific difference in PRA and PAC for normotensive and EH reference subjects. Differences for PRA and PAC were noted between normotensive subjects aged below 45 and their older counterparts. However, such a difference was only identified for PRA but not PAC in EH patients. Age-specific RIs were established accordingly.

Conclusions

This study presented age-specific LC-MS/MS RIs of PRA and PAC for both normotensive and EH populations for local Chinese in Hong Kong.


Corresponding author: Jenny Yeuk-Ki Cheng, Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30–32 Ngan Shing Street, Statin, NT, Hong Kong, Phone: +(852) 5569 9723, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study has been approved by The Chinese University of Hong Kong–New Territories East Cluster Clinical Research Ethics Committee.

References

1. Freel, E. Mechanisms of hypertension: the expanding role of aldosterone. J Am Soc Nephrol 2004;15:1993–2001. https://doi.org/10.1097/01.asn.0000132473.50966.14.Search in Google Scholar PubMed PubMed Central

2. Hannemann, A, Wallaschofski, H. Prevalence of primary aldosteronism in patient’s cohorts and in population-based studies-a review of the current literature. Horm Metab Res Horm Stoffwechselforschung Horm Metab 2012;44:157–62. https://doi.org/10.1055/s-0031-1295438.Search in Google Scholar PubMed

3. Monticone, S, Losano, I, Tetti, M, Buffolo, F, Veglio, F, Mulatero, P. Diagnostic approach to low-renin hypertension. Clin Endocrinol 2018;89:385–96. https://doi.org/10.1111/cen.13741.Search in Google Scholar PubMed

4. Dorrian, CA, Toole, BJ, Alvarez-Madrazo, S, Kelly, A, Connell, JMC, Wallace, AM. A screening procedure for primary aldosteronism based on the diasorin liaison (R) automated chemiluminescent immunoassay for direct renin. Ann Clin Biochem 2010;47:195–9. https://doi.org/10.1258/acb.2010.009230.Search in Google Scholar PubMed

5. Gruson, D, Maisin, D, Lison, P, Maiter, D, Persu, A. Two-site automated chemiluminescent assay for measurement of immunoreactive renin. Biomarkers 2011;16:605–9. https://doi.org/10.3109/1354750x.2011.614015.Search in Google Scholar

6. Campbell, DJ, Nussberger, J, Stowasser, M, Danser, AHJ, Morganti, A, Frandsen, E, et al.. Activity assays and immunoassays for plasma renin and prorenin: information provided and precautions necessary for accurate measurement. Clin Chem 2009;55:867–77. https://doi.org/10.1373/clinchem.2008.118000.Search in Google Scholar PubMed

7. Carter, S, Owen, LJ, Kerstens, MN, Dullaart, RPF, Keevil, BG. A liquid chromatography tandem mass spectrometry assay for plasma renin activity using online solid-phase extraction. Ann Clin Biochem 2012;49:570–9. https://doi.org/10.1258/acb.2012.011186.Search in Google Scholar PubMed

8. Owen, LJ, Adaway, J, Morris, K, Lockhart, S, Keevil, BG. A widely applicable plasma renin activity assay by LC-MS/MS with offline solid phase extraction. Ann Clin Biochem 2014;51:409–11. https://doi.org/10.1177/0004563214524558.Search in Google Scholar PubMed

9. Bystrom, CE, Salameh, W, Reitz, R, Clarke, NJ. Plasma renin activity by LC-MS/MS: development of a prototypical clinical assay reveals a subpopulation of human plasma samples with substantial peptidase activity. Clin Chem 2010;56:1561–9. https://doi.org/10.1373/clinchem.2010.146449.Search in Google Scholar PubMed

10. Cyr, MS, Sancho, JM, Melby, JC. Quantitation of plasma aldosterone by radioimmunoassay. Clin Chem 1972;18:1395–402. https://doi.org/10.1093/clinchem/18.11.1395.Search in Google Scholar

11. Schirpenbach, C. Automated chemiluminescence-immunoassay for aldosterone during dynamic testing: comparison to radioimmunoassays with and without extraction steps. Clin Chem 2006;52:1749–55. https://doi.org/10.1373/clinchem.2006.068502.Search in Google Scholar PubMed

12. Owen, LJ, Keevil, BG. Supported liquid extraction as an alternative to solid phase extraction for LC-MS/MS aldosterone analysis? Ann Clin Biochem Int J Biochem Lab Med 2013;50:489–91. https://doi.org/10.1177/0004563213480758.Search in Google Scholar PubMed

13. Turpeinen, U, Hämäläinen, E, Stenman, UH. Determination of aldosterone in serum by liquid chromatography–tandem mass spectrometry. J Chromatogr B 2008;862:113–8. https://doi.org/10.1016/j.jchromb.2007.11.005.Search in Google Scholar PubMed

14. Van Der Gugten, JG, Dubland, J, Liu, HF, Wang, A, Joseph, C, Holmes, DT. Determination of serum aldosterone by liquid chromatography and tandem mass spectrometry: a liquid–liquid extraction method for the ABSCIEX API-5000 mass spectrometry system. J Clin Pathol 2012;65:457–62. https://doi.org/10.1136/jclinpath-2011-200564.Search in Google Scholar PubMed

15. Yamashita, K, Okuyama, M, Nakagawa, R, Honma, S, Satoh, F, Morimoto, R, et al.. Development of sensitive derivatization method for aldosterone in liquid chromatography-electrospray ionization tandem mass spectrometry of corticosteroids. J Chromatogr A 2008;1200:114–21. https://doi.org/10.1016/j.chroma.2008.05.034.Search in Google Scholar PubMed

16. Hinchliffe, E, Carter, S, Owen, LJ, Keevil, BG. Quantitation of aldosterone in human plasma by ultra high performance liquid chromatography tandem mass spectrometry. J Chromatogr B 2013;913–914:19–23. https://doi.org/10.1016/j.jchromb.2012.11.013.Search in Google Scholar PubMed

17. Ceglarek, U, Kortz, L, Leichtle, A, Fiedler, GM, Kratzsch, J, Thiery, J. Rapid quantification of steroid patterns in human serum by on-line solid phase extraction combined with liquid chromatography–triple quadrupole linear ion trap mass spectrometry. Clin Chim Acta 2009;401:114–8. https://doi.org/10.1016/j.cca.2008.11.022.Search in Google Scholar PubMed

18. Guo, T, Taylor, RL, Singh, RJ, Soldin, SJ. Simultaneous determination of 12 steroids by isotope dilution liquid chromatography-photospray ionization tandem mass spectrometry. Clin Chim Acta 2006;372:76–82. https://doi.org/10.1016/j.cca.2006.03.034.Search in Google Scholar PubMed

19. Eisenhofer, G, Kurlbaum, M, Peitzsch, M, Constantinescu, G, Remde, H, Schulze, M, et al.. The saline infusion test for primary aldosteronism: implications of immunoassay inaccuracy. J Clin Endocr Metab 2021;107:e2027–36. https://doi.org/10.1210/clinem/dgab924.Search in Google Scholar PubMed PubMed Central

20. Knudsen, C, Adelborg, K, Søndergaard, E, Parkner, T. Biotin interference in routine IDS-iSYS immunoassays for aldosterone, renin, insulin-like growth factor 1, growth hormone and bone alkaline phosphatase. Scand J Clin Lab Investig 2021;82:6–11. https://doi.org/10.1080/00365513.2021.2003854.Search in Google Scholar PubMed

21. PetitClerc, C, Solberg, H. Approved recommendation (1987) on the theory of reference values. Part 2. Selection of individuals for the production of reference values. Clin Chim Acta 1987;170:S1–1. https://doi.org/10.1016/0009-8981(87)90150-1.Search in Google Scholar

22. Gibbons, S, Field, H, Fairhurst, A, Fleming, A, Ford, C, Williams, EL, et al.. Clinical evaluation of assays for plasma renin activity and aldosterone measurement by liquid chromatography–tandem mass spectrometry. J Appl Lab Med 2020;6:668–78. https://doi.org/10.1093/jalm/jfaa177.Search in Google Scholar PubMed

23. Xu, W, Yu, Q, Chen, F, Qin, J, Pan, B, Guo, W, et al.. Method development and clinical application assessment of plasma renin activity (PRA) by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Fudan Univ J Med Sci 2019;46:70–8.Search in Google Scholar

24. Le Goff, C, Gonzalez-Antuña, A, Peeters, S, Fabregat-Cabello, N, Van Der Gugten, JG, Vroonen, L, et al.. Migration from RIA to LC-MS/MS for aldosterone determination: implications for clinical practice and determination of plasma and urine reference range intervals in a cohort of healthy Belgian subjects. Clin Mass Spectrom 2018;9:7–17. https://doi.org/10.1016/j.clinms.2018.06.002.Search in Google Scholar

25. Tan, X, Li, F, Wang, X, Wang, Y. Quantitation and clinical evaluation of plasma aldosterone by ultra-performance liquid chromatography–mass spectrometry. J Chromatogr A 2020;1609:460456. https://doi.org/10.1016/j.chroma.2019.460456.Search in Google Scholar PubMed

26. Meunier, C, Blondelle, D, Faure, P, Baguet, JP, Le Goff, C, Chabre, O, et al.. Development and validation of a method using supported liquid extraction for aldosterone determination in human plasma by LC-MS/MS. Clin Chim Acta 2015;447:8–15. https://doi.org/10.1016/j.cca.2015.05.007.Search in Google Scholar PubMed

27. Lin, W, Yao, Z, Li, Y, Liao, Z, Xiao, J, Chen, Y, et al.. Developing an ultra-performance liquid chromatography-tandem mass spectrometry for detecting aldosterone in human plasma. J Clin Lab Anal 2021;35:e24029. https://doi.org/10.1002/jcla.24029.Search in Google Scholar PubMed PubMed Central

28. Taylor, PJ, Cooper, DP, Gordon, RD, Stowasser, M. Measurement of aldosterone in human plasma by semiautomated HPLC-tandem mass spectrometry. Clin Chem 2009;55:1155–62. https://doi.org/10.1373/clinchem.2008.116004.Search in Google Scholar PubMed

29. Lo, C, Tsui, T, Ma, R, Chan, M, Ho, C. Quantitation of plasma angiotensin II in healthy Chinese subjects by a validated liquid chromatography tandem mass spectrometry method. Biomed Chromatogr 2022;36:e5318. https://doi.org/10.1002/bmc.5318.Search in Google Scholar PubMed

30. Zeng, W, Chu, T, Ho, C, Lo, C, Chan, A, Kong, A, et al.. Lack of effects of renin-angiotensin-aldosterone system Activity and beta-adrenoceptor pathway polymorphisms on the response to bisoprolol in hypertension. Front Cardiovasc Med 2022;9:842875. https://doi.org/10.3389/fcvm.2022.842875.10.3389/fcvm.2022.842875Search in Google Scholar PubMed PubMed Central

31. Lahti, A, Hyltoft Petersen, P, Boyd, J, Rustad, P, Laake, P, Solberg, H. Partitioning of nongaussian-distributed biochemical reference data into subgroups. Clin Chem 2004;50:891–900.https://doi.org/10.1373/clinchem.2003.027953.Search in Google Scholar PubMed

32. Clinical and Laboratory Standards Institute. Defining, establishing, and verifying reference intervals in the clinical laboratory; Approved guideline-Third Edition. In: CLSI document EP28-A3c. Wayne, PA: Clinical and Laboratory Standards Institute; 2010:8–12 pp.Search in Google Scholar

33. Horn, PS, Pesce, AJ, Copeland, BE. A robust approach to reference interval estimation and evaluation. Clin Chem 1998;44:622–31. https://doi.org/10.1093/clinchem/44.3.622.Search in Google Scholar

34. Rehan, M, Raizman, JE, Cavalier, E, Don-Wauchope, AC, Holmes, DT. Laboratory challenges in primary aldosteronism screening and diagnosis. Clin Biochem 2015;48:377–87. https://doi.org/10.1016/j.clinbiochem.2015.01.003.Search in Google Scholar PubMed

35. Nanba, K, Vaidya, A, Rainey, W. Aging and adrenal aldosterone production. Hypertension 2018;71:218–23. https://doi.org/10.1161/hypertensionaha.117.10391.Search in Google Scholar PubMed PubMed Central

36. Nanba, K, Vaidya, A, Williams, GH, Zheng, I, Else, T, Rainey, WE. Age-related autonomous aldosteronism. Circulation 2017;136:347–55. https://doi.org/10.1161/circulationaha.117.028201.Search in Google Scholar

37. Deng, L, Xiong, Z, Li, H, Lei, X, Cheng, L. Analytical validation and investigation on reference intervals of aldosterone and renin in Chinese han population by using fully automated chemiluminescence immunoassays. Clin Biochem 2018;56:89–94. https://doi.org/10.1016/j.clinbiochem.2018.04.016.Search in Google Scholar PubMed

38. Fanelli, F, Cantù, M, Temchenko, A, Mezzullo, M, Lindner, J, Peitzsch, M, et al.. Report from the HarmoSter study: impact of calibration on comparability of LC-MS/MS measurement of circulating cortisol, 17OH-progesterone and aldosterone. Clin Chem Lab Med 2022;60:726–39. https://doi.org/10.1515/cclm-2021-1028.Search in Google Scholar PubMed

39. Alnazer, R, Veldhuizen, G, de Leeuw, P. The effect of age, bmi, and sex on aldosterone, renin and the aldosterone-to-renin ratio in essential hypertensives. J Hypertens 2021;39(1 Suppl):e223. https://doi.org/10.1097/01.hjh.0000746964.72170.92.Search in Google Scholar

40. Funder, JW, Carey, RM, Mantero, F, Murad, MH, Reincke, M, Shibata, H, et al.. The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline. J Clin Endocr Metab 2016;101:1889–916. https://doi.org/10.1210/jc.2015-4061.Search in Google Scholar PubMed

41. Yin, Y, Yu, S, Qiu, L. Establishment of a rapid and simple liquid chromatography tandem mass spectrometry method for measuring aldosterone in urine. Clin Chim Acta 2019;493:84–90. https://doi.org/10.1016/j.cca.2019.03.109.Search in Google Scholar

Received: 2022-04-04
Accepted: 2022-07-13
Published Online: 2022-08-04
Published in Print: 2022-09-27

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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