Table 3.
Hormonal differences between patients with KCNJ5-mutatated vs other APAs
| KCNJ5 (N = 27) | No KCNJ5(N = 12) | |||||||
|---|---|---|---|---|---|---|---|---|
| Steroid (nmol/L) | Morning | Midnight | CST | DST | Morning | Midnight | CST | DST |
| 18OHF | 3.27 [2.24-4.59] | 1.83 [1.15-3.55] | 5.19 [3.82-8.42] | 1.15 [0.51-2.24] | 2.15 [1.87-2.63]a | 0.57 [0.46-0.85]c | 4.24 [3.60-5.32] | 0.37 [0.31, 0.50]c |
| 18oxoF | 0.26 [0.15-0.39] | 0.17 [0.10-0.33] | 0.45 [0.26-0.69] | 0.10 [0.05-0.18] | 0.02 [0.02-0.09]d | 0.01 [0.00-0.02]d | 0.07 [0.05-0.19]d | 0.02 [0.01, 0.03]d |
| Aldo | 0.41 [0.29-0.51] | 0.27 [0.17-0.49] | 1.13 [0.79-1.65] | 0.20 [0.11-0.36] | 0.45 [0.33-0.56] | 0.30 [0.16-0.39] | 1.03 [0.65-1.21] | 0.40 [0.26, 0.50]a |
| 18OHB | 1.63 [0.86-2.01] | 0.81 [0.44-1.28] | 5.65 [3.82-8.09] | 0.43 [0.37-0.86] | 1.08 [0.87-1.46] | 0.59 [0.34-0.71] | 4.50 [3.41-5.90] | 0.62 [0.34, 0.80] |
| B | 6.05 [3.53-7.95] | 1.91 [1.27-2.65] | 70.2 [52.6-84.3] | 0.79 [0.64-1.03] | 4.13 [2.93-5.88] | 0.87 [0.75-1.59]a | 52.2 [38.2-60.0]b | 0.47 [0.37, 0.61]c |
| DOC | 0.21 [0.17-0.35] | 0.15 [0.11-0.24] | 1.50 [1.02-2.00] | 0.11 [0.08-0.16] | 0.15 [0.14-0.23] | 0.10 [0.05-0.11]a | 1.00 [0.73-1.40] | 0.09 [0.03, 0.11] |
| Cortisol | 251 [191-335] | 76 [50-123] | 639 [583-728] | 29 [20-43] | 227 [171-330] | 54 [42-78] | 592 [547-684] | 24 [20, 27] |
| E | 50 [42-59] | 17 [12-25] | 60 [52-69] | 6 [5-8] | 51 [44-56] | 12 [9-20] | 53 [46-64] | 5 [4, 6] |
| 11dF | 0.08 [0.07-0.12] | 0.04 [0.03-0.07] | 0.66 [0.53-0.80] | 0.02 [0.02-0.27] | 0.09 [0.06-0.13] | 0.03 [0.02-0.05] | 0.61 [0.52-0.72] | 0.01 [0.01, 0.02] |
| 17OHP4 | 0.19 [0.05-0.28] | 0.18 [0.04-0.32] | 0.67 [0.46-0.92] | 0.07 [0.02-0.27] | 0.18 [0.13-0.29] | 0.17 [0.09-0.27] | 0.73 [0.57-1.04] | 0.18 [0.12, 0.25] |
| Prog | 0.24 [0.19-0.32] | 0.22 [0.14-0.39] | 1.19 [0.84-2.39] | 0.20 [0.13-0.22] | 0.16 [0.11-0.25] | 0.15 [0.10-0.20] | 1.00 [0.79-1.71] | 0.17 [0.08, 0.21] |
| T | 1.07 [0.57-14.5] | 1.14 [0.41-14.5] | 1.49 [0.79-14.4] | 0.89 [0.33-16.0] | 12.7 [10.2-16.7] | 12.1 [8.8-16.4] | 13.0 [10.1-15.6] | 15.5 [9.8, 19.7] |
| A4 | 2.11 [1.31-2.72] | 1.36 [0.98-1.93] | 4.17 [3.46-6.10] | 1.16 [0.76-1.69] | 1.75 [1.56-2.24] | 1.16 [0.98-1.23] | 3.68 [3.27-4.39] | 0.99 [0.79, 1.12] |
| 11OHT | 0.49 [0.35-0.75] | 0.21 [0.15-0.28] | 0.58 [0.42-0.73] | 0.13 [0.09-0.16] | 0.49 [0.34-0.62] | 0.25 [0.18-0.34] | 0.62 [0.51-0.71] | 0.13 [0.12, 0.18] |
| 11KT | 0.92 [0.69-1.43] | 0.49 [0.31-0.67] | 0.80 [0.70-1.29] | 0.20 [0.17-0.26] | 0.88 [0.66-1.33] | 0.44 [0.39-0.52] | 0.69 [0.58-1.06] | 0.21 [0.17, 0.27] |
| 11OHA4 | 4.71 [3.18-12.3] | 2.06 [1.05-4.10] | 15.1 [9.1-22.0] | 0.76 [0.49-1.23] | 4.87 [2.45-9.92] | 1.07 [0.82-2.87] | 11.3 [8.3-14.4] | 0.56 [0.35, 0.78] |
| 11KA4 | 0.94 [0.77-2.30] | 0.45 [0.29-0.73] | 1.69 [1.05-2.51] | 0.19 [0.15-0.25] | 0.98 [0.44-1.68] | 0.31 [0.25-0.56] | 1.56 [0.91-1.82] | 0.19 [0.14, 0.26] |
All variables are shown as median with interquartile ranges. Among 40 APA cases, 1 case had no available adrenal tissue for research. The “No KCNJ5” group includes: 6 CACNA1D-mutated, 1 ATP1A1-mutated, 2 ATP2B3-mutated, and 1 CTNNB1-mutated APA cases and 2 APAs with no known mutations.
Abbreviations: 11dF, 11-deoxycortisol; 11KA4, 11-ketoandrostenedione; 11KT, 11-ketotestosterone; 11OHA4, 11ß-hydroxyandrostenedione; 11OHT, 11ß-hydroxytestosterone; 17OHP4, 17α-hydroxyprogesterone; 18OHB, 18-hydroxycorticosterone; 18OHF, 18-hydroxycortisol; 18oxoF, 18-oxocortisol; A4, androstenedione; Aldo, aldosterone; APA, aldosterone-producing adenoma; B, corticosterone; CST, cosyntropin stimulation test; DOC, 11-deoxycorticosterone; DST, 1 mg dexamethasone suppression test; E, cortisone; Prog, progesterone; T, testosterone.
The Mann-Whitney U test was used to compare steroid concentrations in the same condition between the 2 groups: compared with the KCNJ5 group;
a P < 0.05;
b P < 0.01;
c P < 0.005;
d P < 0.001.