Endocrine Abstracts

Introduction: After the introduction of the Endocrine Society Guideline 2008, the disease recognition rate in Southern Thailand becomes dramatically noticeable. However, the prevalence rate of primary aldosteronism (PA) in this region is still unknown and aldosterone-renin ratio screening (ARR) is not widely available.

Objective: i) to identify the prevalence rate of PA among patients who had ARR screening, ii) to identify predictive factors for the PA diagnosis

Materials and methods: All patients who underwent the aldosterone-renin ratio (ARR) test, during January 2011 to December 2016 were selected from the electronic database. Eligible cases were including the patients aged over 15 years old who had both of plasma aldosterone concentration and plasma renin activity.

Results: Total 420 cases were enrolled. The overall prevalence rate is 16.7%. The predictive factors are age<60 years old (OR 4.77, 95% CI: 2.12–10.75), BMI<25 kg/m² (OR 1.97, 95% CI: 1.03–3.77), DM (OR 0.25, 95% CI: 0.09–0.74), anti-hypertensive agents>3 (OR 5.21, 95%CI: 2.56–10.62), serum sodium≥141 mmol/l (OR 3.55, 95%CI: 1.68–7.50), and serum potassium <3.5 mmol/l (OR 9.15, 95%CI: 4.75–17.61). The predictive scoring system is generated by their coefficients which the AUC of the ROC curve is 0.865. A total score of >4 has the most acceptable negative predictive value (sensitivity, 0.971; specificity, 0.483; NPV, 0.988; PPV, 0.273, test prevalence 59.29%).

Conclusion: The prevalence rate of PA in the clinical practice was established. The predicting factors for PA were identified and the total score of less than 4 from the predictive scoring system indicated that ARR screening was not required.