Diagnostic Accuracy of Salivary Metanephrines in Pheochromocytomas and Paragangliomas.

BACKGROUND: Measurements of plasma free metanephrines are recommended for diagnosing pheochromocytomas and paragangliomas (PPGL). Metanephrines can be detected in saliva with LC-MS/ MS with sufficient analytical sensitivity and precision. Because collecting saliva is noninvasive and less cumbersome...

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Publicado en:Clinical Chemistry Vol. 67; no. 8; pp. 1090 - 1098
Autores principales: Eijkelenkamp, Karin, Osinga, Thamara E., van Faassen, Martijn, Kema, Ido P., Kerstens, Michiel N., Pacak, Karel, Sluiter, Wim J., Links, Thera P., van der Horst-Schrivers, Anouk N. A.
Formato: Journal Article
Publicado: Oxford University Press / USA Aug2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2021
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      pub: Oxford University Press / USA
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        atl: Diagnostic Accuracy of Salivary Metanephrines in Pheochromocytomas and Paragangliomas.
      aug:
        au:
          Eijkelenkamp, Karin
          Osinga, Thamara E.
          van Faassen, Martijn
          Kema, Ido P.
          Kerstens, Michiel N.
          Pacak, Karel
          Sluiter, Wim J.
          Links, Thera P.
          van der Horst-Schrivers, Anouk N. A.
        affil: Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
      sug:
      ab: BACKGROUND: Measurements of plasma free metanephrines are recommended for diagnosing pheochromocytomas and paragangliomas (PPGL). Metanephrines can be detected in saliva with LC-MS/ MS with sufficient analytical sensitivity and precision. Because collecting saliva is noninvasive and less cumbersome than plasma or urine sampling, we assessed the diagnostic accuracy of salivary metanephrines in diagnosing PPGL. METHODS: This 2-center study included 118 healthy participants (44 men; mean age: 33 years (range: 19-74 years)), 44 patients with PPGL, and 54 patients suspected of PPGL. Metanephrines were quantified in plasma and saliva using LC-MS/MS. Diagnostic accuracy; correlation between plasma and salivary metanephrines; and potential factors influencing salivary metanephrines, including age, sex, and posture during sampling, were assessed. RESULTS: Salivary metanephrines were significantly higher in patients with PPGL compared with healthy participants (metanephrine (MN): 0.19 vs 0.09 nmol/L, P<0.001; normetanephrine (NMN): 2.90 vs 0.49 nmol/L, P<0.001). The diagnostic sensitivity and specificity of salivary metanephrines were 89% and 87%, respectively. Diagnostic accuracy of salivary metanephrines was 88%, with an area under the ROC curve of 0.880. We found a significant correlation between plasma and salivary metanephrines (Pearson correlation coefficient: MN, 0.86, P<0.001; NMN, 0.83, P<0.001). Salivary NMN concentrations were higher when collected in a seated position compared with supine (P<0.001) and increased with age (P<0.001). CONCLUSIONS: Salivary metanephrines are a promising tool in the biochemical diagnosis of PPGL. Salivary metanephrines correlate with plasma free metanephrines and are increased in patients with PPGL. At this time, however, salivary metanephrines cannot replace measurement of plasma free metanephrines.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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