Morning Plasma Aldosterone Predicts the Subtype of Primary Aldosteronism Independant of Sodium Intake
Bibliographic record
Abstract
The objective of the present study was to assess the potential predictive value of supine morning plasma aldosterone concentration, a component of the postural stimulation test (PST), in distinguishing aldosterone-producing adenoma (APA) from idiopathic adrenal hyperplasia (IAH) in a series of 61 patients with confirmed primary aldosteronism (PAL). The reproducibility of the PST was also tested under conditions of both normal- and high-sodium intake. Twenty-seven patients had surgery-confirmed unique APA. Thirty-four patients were classified as IAH and treated medically. Morning plasma aldosterone values were significantly higher in patients with APA compared to those with IAH (p < 0.01) on both diets. Using the receiver-operating characteristic (ROC) curve analysis, it was observed that the cutoff values in the highest (>900 pmol/L or 32 ng/dl) and lowest (<300 pmol/L or 11 ng/dl) range of the morning plasma aldosterone measurements were predictive of the subtype diagnosis in about 50% of PAL cases (31 of 61 patients). The sensitivity, specificity, and accuracy of the PST were >70% on both sodium diets. The PST was also reproducible irrespective of sodium intake. Moreover, one of its components, the supine morning plasma aldosterone, can be used as an indicator for the subtype diagnosis in about half of PAL patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".