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REVIEW article
Front. Endocrinol.
Sec. Adrenal Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1548344
This article is part of the Research Topic Enhancing Adrenal Tumor Diagnostics: Biomarkers and Molecular Mechanisms View all 10 articles
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Primary aldosteronism is the most common cause of secondary hypertension, yet most cases remain unrecognized and left without optimal treatment. The diagnostic inertia may be attributed to the lack of specific symptoms, insufficient awareness among physicians, still conflicting indications for screening for primary aldosteronism and first and foremost challenging diagnostics. This review describes the current challenges of biochemical diagnostics of primary aldosteronism, including screening, case confirmation and subtyping. It also discusses immunoassays widely used in assessment of suspected autonomous aldosterone secretion -recent advances in the field and limitations of the method in comparison to the gold standard -liquid chromatography -tandem mass spectrometry. The review focuses on the application of novel "omics" strategies in the diagnostics of primary aldosteronism. Steroidomics and proteomics offer a possibility to simultaneously assess steroids and protein/peptides on a large scale. This multianalyte approach in comparison to the selective quantification of a chosen compound has been proved useful in the diagnostics of primary aldosteronism. It also offers a unique insight into the individual characteristics, underlying mechanisms and even reflects the genetic alterations of primary aldosteronism cases. The "omics" techniques are associated with large amounts of generated data, the interpretation of which may be troublesome and often necessitates the use of artificial intelligence.The novel advances in the biochemical diagnostics of primary aldosteronism, including "omics" techniques, presented in this review may help to address the most emerging problems, increase the number of diagnosed patients and facilitate the choice of an optimal treatment.
Keywords: primary aldosteronism, Hypertension, Adrenal tumor, Aldosterone, Steroidomics, Proteomics, immunoassays, biomarkers
Received: 19 Dec 2024; Accepted: 07 Mar 2025.
Copyright: © 2025 Szatko, Toboła, Falhammar, Zgliczyński and Glinicki. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Alicja Szatko, EndoLab Laboratory, Centre of Postgraduate Medical Education, Warsaw, Poland
Piotr Glinicki, EndoLab Laboratory, Centre of Postgraduate Medical Education, Warsaw, Poland
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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