Influence of various confounding variables and storage conditions on metanephrine and normetanephrine levels in plasma

Summary Objective  Measurements of plasma free metanephrines have been advocated as first‐line tests for phaeochromocytoma. The aim of the study was to assess the impact of potential confounding variables. Design  Comparative study between 2008 and 2009. Subjects  Hundred and eighty healthy subjects...

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Published inClinical endocrinology (Oxford) Vol. 73; no. 2; pp. 153 - 160
Main Authors Deutschbein, Timo, Unger, Nicole, Jaeger, Andrea, Broecker-Preuss, Martina, Mann, Klaus, Petersenn, Stephan
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.08.2010
Blackwell
Wiley Subscription Services, Inc
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Online AccessGet full text
ISSN0300-0664
1365-2265
1365-2265
DOI10.1111/j.1365-2265.2009.03761.x

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Abstract Summary Objective  Measurements of plasma free metanephrines have been advocated as first‐line tests for phaeochromocytoma. The aim of the study was to assess the impact of potential confounding variables. Design  Comparative study between 2008 and 2009. Subjects  Hundred and eighty healthy subjects. Measurements  The effects of age, BMI, gender, menstrual cycle (sampling every 2 days), time of day (sampling every 2 h), venepunture (0, 15, 30, 60, 90 and 120 min), physical exercise (0, 15 and 30 min), coffee (0 and 60 min), breakfast (0 and 60 min) and various body positions (standing and supine rest, each 0 and 120 min) were evaluated. In addition, whole blood and plasma samples were stored at 4 °C or at 22 °C for 0, 1, 3, 24 and 72 h. Plasma free metanephrines were measured using radioimmunoassay (LDN). Results  While metanephrine was significantly influenced by sex and age, BMI and sex were significant predictors of normetanephrine. Coffee (+20%) and food (+8%) elevated normetanephrine significantly (P < 0·05), while metanephrine remained stable. Physical exercise increased metanephrine (+82%) as well as normetanephrine (+84%) significantly (P < 0·005). Supine rest significantly decreased both metanephrine (−34%) and normetanephrine (−19%) when compared to standing rest (P < 0·01). Metanephrine and normetanephrine were not significantly influenced by time of day, menstrual cycle or venepuncture. When plasma samples were stored at 4 °C, metanephrine and normetanephrine were stable for 72 h. Conclusions  Physical exercise may lead to relevant changes in metanephrine and normetanephrine and should therefore be avoided prior to sampling. Although effects of age, sex and BMI were small, these variables should be considered when interpreting biochemical results. Blood should be taken in the supine position, and samples should be immediately centrifuged and stored at 4 °C to improve stability.
AbstractList Measurements of plasma free metanephrines have been advocated as first-line tests for phaeochromocytoma. The aim of the study was to assess the impact of potential confounding variables. Comparative study between 2008 and 2009. Hundred and eighty healthy subjects. The effects of age, BMI, gender, menstrual cycle (sampling every 2 days), time of day (sampling every 2 h), venepunture (0, 15, 30, 60, 90 and 120 min), physical exercise (0, 15 and 30 min), coffee (0 and 60 min), breakfast (0 and 60 min) and various body positions (standing and supine rest, each 0 and 120 min) were evaluated. In addition, whole blood and plasma samples were stored at 4 degrees C or at 22 degrees C for 0, 1, 3, 24 and 72 h. Plasma free metanephrines were measured using radioimmunoassay (LDN). While metanephrine was significantly influenced by sex and age, BMI and sex were significant predictors of normetanephrine. Coffee (+20%) and food (+8%) elevated normetanephrine significantly (P < 0.05), while metanephrine remained stable. Physical exercise increased metanephrine (+82%) as well as normetanephrine (+84%) significantly (P < 0.005). Supine rest significantly decreased both metanephrine (-34%) and normetanephrine (-19%) when compared to standing rest (P < 0.01). Metanephrine and normetanephrine were not significantly influenced by time of day, menstrual cycle or venepuncture. When plasma samples were stored at 4 degrees C, metanephrine and normetanephrine were stable for 72 h. Physical exercise may lead to relevant changes in metanephrine and normetanephrine and should therefore be avoided prior to sampling. Although effects of age, sex and BMI were small, these variables should be considered when interpreting biochemical results. Blood should be taken in the supine position, and samples should be immediately centrifuged and stored at 4 degrees C to improve stability.
Measurements of plasma free metanephrines have been advocated as first-line tests for phaeochromocytoma. The aim of the study was to assess the impact of potential confounding variables.OBJECTIVEMeasurements of plasma free metanephrines have been advocated as first-line tests for phaeochromocytoma. The aim of the study was to assess the impact of potential confounding variables.Comparative study between 2008 and 2009.DESIGNComparative study between 2008 and 2009.Hundred and eighty healthy subjects.SUBJECTSHundred and eighty healthy subjects.The effects of age, BMI, gender, menstrual cycle (sampling every 2 days), time of day (sampling every 2 h), venepunture (0, 15, 30, 60, 90 and 120 min), physical exercise (0, 15 and 30 min), coffee (0 and 60 min), breakfast (0 and 60 min) and various body positions (standing and supine rest, each 0 and 120 min) were evaluated. In addition, whole blood and plasma samples were stored at 4 degrees C or at 22 degrees C for 0, 1, 3, 24 and 72 h. Plasma free metanephrines were measured using radioimmunoassay (LDN).MEASUREMENTSThe effects of age, BMI, gender, menstrual cycle (sampling every 2 days), time of day (sampling every 2 h), venepunture (0, 15, 30, 60, 90 and 120 min), physical exercise (0, 15 and 30 min), coffee (0 and 60 min), breakfast (0 and 60 min) and various body positions (standing and supine rest, each 0 and 120 min) were evaluated. In addition, whole blood and plasma samples were stored at 4 degrees C or at 22 degrees C for 0, 1, 3, 24 and 72 h. Plasma free metanephrines were measured using radioimmunoassay (LDN).While metanephrine was significantly influenced by sex and age, BMI and sex were significant predictors of normetanephrine. Coffee (+20%) and food (+8%) elevated normetanephrine significantly (P < 0.05), while metanephrine remained stable. Physical exercise increased metanephrine (+82%) as well as normetanephrine (+84%) significantly (P < 0.005). Supine rest significantly decreased both metanephrine (-34%) and normetanephrine (-19%) when compared to standing rest (P < 0.01). Metanephrine and normetanephrine were not significantly influenced by time of day, menstrual cycle or venepuncture. When plasma samples were stored at 4 degrees C, metanephrine and normetanephrine were stable for 72 h.RESULTSWhile metanephrine was significantly influenced by sex and age, BMI and sex were significant predictors of normetanephrine. Coffee (+20%) and food (+8%) elevated normetanephrine significantly (P < 0.05), while metanephrine remained stable. Physical exercise increased metanephrine (+82%) as well as normetanephrine (+84%) significantly (P < 0.005). Supine rest significantly decreased both metanephrine (-34%) and normetanephrine (-19%) when compared to standing rest (P < 0.01). Metanephrine and normetanephrine were not significantly influenced by time of day, menstrual cycle or venepuncture. When plasma samples were stored at 4 degrees C, metanephrine and normetanephrine were stable for 72 h.Physical exercise may lead to relevant changes in metanephrine and normetanephrine and should therefore be avoided prior to sampling. Although effects of age, sex and BMI were small, these variables should be considered when interpreting biochemical results. Blood should be taken in the supine position, and samples should be immediately centrifuged and stored at 4 degrees C to improve stability.CONCLUSIONSPhysical exercise may lead to relevant changes in metanephrine and normetanephrine and should therefore be avoided prior to sampling. Although effects of age, sex and BMI were small, these variables should be considered when interpreting biochemical results. Blood should be taken in the supine position, and samples should be immediately centrifuged and stored at 4 degrees C to improve stability.
Objective  Measurements of plasma free metanephrines have been advocated as first‐line tests for phaeochromocytoma. The aim of the study was to assess the impact of potential confounding variables. Design  Comparative study between 2008 and 2009. Subjects  Hundred and eighty healthy subjects. Measurements  The effects of age, BMI, gender, menstrual cycle (sampling every 2 days), time of day (sampling every 2 h), venepunture (0, 15, 30, 60, 90 and 120 min), physical exercise (0, 15 and 30 min), coffee (0 and 60 min), breakfast (0 and 60 min) and various body positions (standing and supine rest, each 0 and 120 min) were evaluated. In addition, whole blood and plasma samples were stored at 4 °C or at 22 °C for 0, 1, 3, 24 and 72 h. Plasma free metanephrines were measured using radioimmunoassay (LDN). Results  While metanephrine was significantly influenced by sex and age, BMI and sex were significant predictors of normetanephrine. Coffee (+20%) and food (+8%) elevated normetanephrine significantly ( P  < 0·05), while metanephrine remained stable. Physical exercise increased metanephrine (+82%) as well as normetanephrine (+84%) significantly ( P  < 0·005). Supine rest significantly decreased both metanephrine (−34%) and normetanephrine (−19%) when compared to standing rest ( P  < 0·01). Metanephrine and normetanephrine were not significantly influenced by time of day, menstrual cycle or venepuncture. When plasma samples were stored at 4 °C, metanephrine and normetanephrine were stable for 72 h. Conclusions  Physical exercise may lead to relevant changes in metanephrine and normetanephrine and should therefore be avoided prior to sampling. Although effects of age, sex and BMI were small, these variables should be considered when interpreting biochemical results. Blood should be taken in the supine position, and samples should be immediately centrifuged and stored at 4 °C to improve stability.
Summary Objective Measurements of plasma free metanephrines have been advocated as first-line tests for phaeochromocytoma. The aim of the study was to assess the impact of potential confounding variables. Design Comparative study between 2008 and 2009. Subjects Hundred and eighty healthy subjects. Measurements The effects of age, BMI, gender, menstrual cycle (sampling every 2 days), time of day (sampling every 2 h), venepunture (0, 15, 30, 60, 90 and 120 min), physical exercise (0, 15 and 30 min), coffee (0 and 60 min), breakfast (0 and 60 min) and various body positions (standing and supine rest, each 0 and 120 min) were evaluated. In addition, whole blood and plasma samples were stored at 4 °C or at 22 °C for 0, 1, 3, 24 and 72 h. Plasma free metanephrines were measured using radioimmunoassay (LDN). Results While metanephrine was significantly influenced by sex and age, BMI and sex were significant predictors of normetanephrine. Coffee (+20%) and food (+8%) elevated normetanephrine significantly (P < 0·05), while metanephrine remained stable. Physical exercise increased metanephrine (+82%) as well as normetanephrine (+84%) significantly (P < 0·005). Supine rest significantly decreased both metanephrine (-34%) and normetanephrine (-19%) when compared to standing rest (P < 0·01). Metanephrine and normetanephrine were not significantly influenced by time of day, menstrual cycle or venepuncture. When plasma samples were stored at 4 °C, metanephrine and normetanephrine were stable for 72 h. Conclusions Physical exercise may lead to relevant changes in metanephrine and normetanephrine and should therefore be avoided prior to sampling. Although effects of age, sex and BMI were small, these variables should be considered when interpreting biochemical results. Blood should be taken in the supine position, and samples should be immediately centrifuged and stored at 4 °C to improve stability. [PUBLICATION ABSTRACT]
Summary Objective  Measurements of plasma free metanephrines have been advocated as first‐line tests for phaeochromocytoma. The aim of the study was to assess the impact of potential confounding variables. Design  Comparative study between 2008 and 2009. Subjects  Hundred and eighty healthy subjects. Measurements  The effects of age, BMI, gender, menstrual cycle (sampling every 2 days), time of day (sampling every 2 h), venepunture (0, 15, 30, 60, 90 and 120 min), physical exercise (0, 15 and 30 min), coffee (0 and 60 min), breakfast (0 and 60 min) and various body positions (standing and supine rest, each 0 and 120 min) were evaluated. In addition, whole blood and plasma samples were stored at 4 °C or at 22 °C for 0, 1, 3, 24 and 72 h. Plasma free metanephrines were measured using radioimmunoassay (LDN). Results  While metanephrine was significantly influenced by sex and age, BMI and sex were significant predictors of normetanephrine. Coffee (+20%) and food (+8%) elevated normetanephrine significantly (P < 0·05), while metanephrine remained stable. Physical exercise increased metanephrine (+82%) as well as normetanephrine (+84%) significantly (P < 0·005). Supine rest significantly decreased both metanephrine (−34%) and normetanephrine (−19%) when compared to standing rest (P < 0·01). Metanephrine and normetanephrine were not significantly influenced by time of day, menstrual cycle or venepuncture. When plasma samples were stored at 4 °C, metanephrine and normetanephrine were stable for 72 h. Conclusions  Physical exercise may lead to relevant changes in metanephrine and normetanephrine and should therefore be avoided prior to sampling. Although effects of age, sex and BMI were small, these variables should be considered when interpreting biochemical results. Blood should be taken in the supine position, and samples should be immediately centrifuged and stored at 4 °C to improve stability.
Author Mann, Klaus
Jaeger, Andrea
Deutschbein, Timo
Broecker-Preuss, Martina
Petersenn, Stephan
Unger, Nicole
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  surname: Petersenn
  fullname: Petersenn, Stephan
  organization: Department of Endocrinology and Division of Laboratory Research, University of Duisburg-Essen, Essen, Germany
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Issue 2
Keywords Metadrenaline
Metanephrine
Storage
Normetanephrine
Conservation
Confounding factor
Endocrinology
Blood plasma
Language English
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References Raber, W., Raffesberg, W., Waldhausl, W. et al. (2003) Exercise induces excessive normetanephrine responses in hypertensive diabetic patients. European Journal of Clinical Investigation, 33, 480-487.
Robertson, D., Johnson, G.A., Robertson, R.M. et al. (1979) Comparative assessment of stimuli that release neuronal and adrenomedullary catecholamines in man. Circulation, 59, 637-643.
Pacak, K., Linehan, W.M., Eisenhofer, G. et al. (2001) Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Annals of Internal Medicine, 134, 315-329.
Eisenhofer, G., Goldstein, D.S., Walther, M.M. et al. (2003) Biochemical diagnosis of pheochromocytoma: how to distinguish true- from false-positive test results. Journal of Clinical Endocrinology and Metabolism 88, 2656-2666.
Eisenhofer, G. (1994) Plasma normetanephrine for examination of extraneuronal uptake and metabolism of noradrenaline in rats. Naunyn-Schmiedebergs Archives of Pharmacology, 349, 259-269.
De Jong, W.H., Eisenhofer, G., Post, W.J. et al. (2009) Dietary influences on plasma and urinary metanephrines: implications for diagnosis of catecholamine-producing tumors. Journal of Clinical Endocrinology and Metabolism, 94, 2841-2849.
Willemsen, J.J., Ross, H.A., Lenders, J.W. et al. (2007) Stability of urinary fractionated metanephrines and catecholamines during collection, shipment, and storage of samples. Clinical Chemistry, 53, 268-272.
Roden, M. (2002) How to detect pheochromocytomas?--the diagnostic relevance of plasma free metanephrines. Wiener Klinische Wochenschrift, 114, 246-251.
Boomsma, F., Alberts, G., Van Eijk, L. et al. (1993) Optimal collection and storage conditions for catecholamine measurements in human plasma and urine. Clinical Chemistry, 39, 2503-2508.
Young Jr, W.F. (2007) Clinical practice. The incidentally discovered adrenal mass. New England Journal of Medicine, 356, 601-610.
Sawka, A.M., Gafni, A., Thabane, L. et al. (2004) The economic implications of three biochemical screening algorithms for pheochromocytoma. Journal of Clinical Endocrinology and Metabolism, 89, 2859-2866.
Willemsen, J.J., Sweep, C.G., Lenders, J.W. et al. (2003) Stability of plasma free metanephrines during collection and storage as assessed by an optimized HPLC method with electrochemical detection. Clinical Chemistry, 49, 1951-1953.
Weise, M., Merke, D.P., Pacak, K. et al. (2002) Utility of plasma free metanephrines for detecting childhood pheochromocytoma. Journal of Clinical Endocrinology and Metabolism, 87, 1955-1960.
Grossman, A., Pacak, K., Sawka, A. et al. (2006) Biochemical diagnosis and localization of pheochromocytoma: can we reach a consensus? Annals of the New York Academy of Sciences, 1073, 332-347.
Martignoni, E., Blandini, F., Melzi d'Eril, G.V. et al. (1993) The influence of gender in the evaluation of platelet and plasma catecholamines. Life Sciences, 52, 1995-2004.
Cameron, O.G., Curtis, G.C., Zelnik, T. et al. (1987) Circadian fluctuation of plasma epinephrine in supine humans. Psychoneuroendocrinology, 12, 41-51.
Eisenhofer, G., Lenders, J.W., Linehan, W.M. et al. (1999) Plasma normetanephrine and metanephrine for detecting pheochromocytoma in von Hippel-Lindau disease and multiple endocrine neoplasia type 2. New England Journal of Medicine, 340, 1872-1879.
Sawka, A.M., Thabane, L., Gafni, A. et al. (2005) Measurement of fractionated plasma metanephrines for exclusion of pheochromocytoma: can specificity be improved by adjustment for age? BMC Endocrine Disorders, 5, 1.
Williams, P.D., Puddey, I.B., Beilin, L.J. et al. (1993) Genetic influences on plasma catecholamines in human twins. Journal of Clinical Endocrinology and Metabolism, 77, 794-799.
Lenders, J.W., Pacak, K., Walther, M.M. et al. (2002) Biochemical diagnosis of pheochromocytoma: which test is best? JAMA, 287, 1427-1434.
Eisenhofer, G., Friberg, P., Pacak, K. et al. (1995) Plasma metadrenalines: do they provide useful information about sympatho-adrenal function and catecholamine metabolism? Clinical Science, 88, 533-542.
Sawka, A.M., Jaeschke, R., Singh, R.J. et al. (2003) A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. Journal of Clinical Endocrinology and Metabolism, 88, 553-558.
Pillai, D., Ross, H.A., Kratzsch, J. et al. (2009) Proficiency test of plasma free and total metanephrines: report from a study group. Clinical Chemistry and Laboratory Medicine, 47, 786-790.
Raber, W., Raffesberg, W., Bischof, M. et al. (2000) Diagnostic efficacy of unconjugated plasma metanephrines for the detection of pheochromocytoma. Archives of Internal Medicine, 160, 2957-2963.
Sawka, A.M., Prebtani, A.P., Thabane, L. et al. (2004) A systematic review of the literature examining the diagnostic efficacy of measurement of fractionated plasma free metanephrines in the biochemical diagnosis of pheochromocytoma. BMC Endocrine Disorders, 4, 2.
Eisenhofer, G., Keiser, H., Friberg, P. et al. (1998) Plasma metanephrines are markers of pheochromocytoma produced by catechol-O-methyltransferase within tumors. Journal of Clinical Endocrinology and Metabolism, 83, 2175-2185.
Bracken, R.M., Linnane, D.M. & Brooks, S. (2009) Plasma catecholamine and nephrine responses to brief intermittent maximal intensity exercise. Amino Acids, 36, 209-217.
Eisenhofer, G. (2003) Editorial: biochemical diagnosis of pheochromocytoma--is it time to switch to plasma-free metanephrines? Journal of Clinical Endocrinology and Metabolism, 88, 550-552.
Lenders, J.W., Keiser, H.R., Goldstein, D.S. et al. (1995) Plasma metanephrines in the diagnosis of pheochromocytoma. Annals of Internal Medicine, 123, 101-109.
Lenders, J.W., Willemsen, J.J., Eisenhofer, G. et al. (2007) Is supine rest necessary before blood sampling for plasma metanephrines? Clinical Chemistry, 53, 352-354.
Robertson, D., Frolich, J.C., Carr, R.K. et al. (1978) Effects of caffeine on plasma renin activity, catecholamines and blood pressure. New England Journal of Medicine, 298, 181-186.
2009; 47
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1999; 340
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1978; 298
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2003; 33
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2001; 134
1993; 39
2009; 94
1993; 77
2002; 287
1995; 88
2002; 87
1993; 52
2000; 160
2005; 5
2003; 49
1995; 123
2006; 1073
1994; 349
2003; 88
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References_xml – reference: Eisenhofer, G., Goldstein, D.S., Walther, M.M. et al. (2003) Biochemical diagnosis of pheochromocytoma: how to distinguish true- from false-positive test results. Journal of Clinical Endocrinology and Metabolism 88, 2656-2666.
– reference: Eisenhofer, G., Lenders, J.W., Linehan, W.M. et al. (1999) Plasma normetanephrine and metanephrine for detecting pheochromocytoma in von Hippel-Lindau disease and multiple endocrine neoplasia type 2. New England Journal of Medicine, 340, 1872-1879.
– reference: Lenders, J.W., Pacak, K., Walther, M.M. et al. (2002) Biochemical diagnosis of pheochromocytoma: which test is best? JAMA, 287, 1427-1434.
– reference: Raber, W., Raffesberg, W., Bischof, M. et al. (2000) Diagnostic efficacy of unconjugated plasma metanephrines for the detection of pheochromocytoma. Archives of Internal Medicine, 160, 2957-2963.
– reference: Cameron, O.G., Curtis, G.C., Zelnik, T. et al. (1987) Circadian fluctuation of plasma epinephrine in supine humans. Psychoneuroendocrinology, 12, 41-51.
– reference: Robertson, D., Johnson, G.A., Robertson, R.M. et al. (1979) Comparative assessment of stimuli that release neuronal and adrenomedullary catecholamines in man. Circulation, 59, 637-643.
– reference: Sawka, A.M., Prebtani, A.P., Thabane, L. et al. (2004) A systematic review of the literature examining the diagnostic efficacy of measurement of fractionated plasma free metanephrines in the biochemical diagnosis of pheochromocytoma. BMC Endocrine Disorders, 4, 2.
– reference: Pacak, K., Linehan, W.M., Eisenhofer, G. et al. (2001) Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Annals of Internal Medicine, 134, 315-329.
– reference: Young Jr, W.F. (2007) Clinical practice. The incidentally discovered adrenal mass. New England Journal of Medicine, 356, 601-610.
– reference: Williams, P.D., Puddey, I.B., Beilin, L.J. et al. (1993) Genetic influences on plasma catecholamines in human twins. Journal of Clinical Endocrinology and Metabolism, 77, 794-799.
– reference: Willemsen, J.J., Sweep, C.G., Lenders, J.W. et al. (2003) Stability of plasma free metanephrines during collection and storage as assessed by an optimized HPLC method with electrochemical detection. Clinical Chemistry, 49, 1951-1953.
– reference: Grossman, A., Pacak, K., Sawka, A. et al. (2006) Biochemical diagnosis and localization of pheochromocytoma: can we reach a consensus? Annals of the New York Academy of Sciences, 1073, 332-347.
– reference: Eisenhofer, G., Keiser, H., Friberg, P. et al. (1998) Plasma metanephrines are markers of pheochromocytoma produced by catechol-O-methyltransferase within tumors. Journal of Clinical Endocrinology and Metabolism, 83, 2175-2185.
– reference: Boomsma, F., Alberts, G., Van Eijk, L. et al. (1993) Optimal collection and storage conditions for catecholamine measurements in human plasma and urine. Clinical Chemistry, 39, 2503-2508.
– reference: Roden, M. (2002) How to detect pheochromocytomas?--the diagnostic relevance of plasma free metanephrines. Wiener Klinische Wochenschrift, 114, 246-251.
– reference: Sawka, A.M., Thabane, L., Gafni, A. et al. (2005) Measurement of fractionated plasma metanephrines for exclusion of pheochromocytoma: can specificity be improved by adjustment for age? BMC Endocrine Disorders, 5, 1.
– reference: Raber, W., Raffesberg, W., Waldhausl, W. et al. (2003) Exercise induces excessive normetanephrine responses in hypertensive diabetic patients. European Journal of Clinical Investigation, 33, 480-487.
– reference: Robertson, D., Frolich, J.C., Carr, R.K. et al. (1978) Effects of caffeine on plasma renin activity, catecholamines and blood pressure. New England Journal of Medicine, 298, 181-186.
– reference: De Jong, W.H., Eisenhofer, G., Post, W.J. et al. (2009) Dietary influences on plasma and urinary metanephrines: implications for diagnosis of catecholamine-producing tumors. Journal of Clinical Endocrinology and Metabolism, 94, 2841-2849.
– reference: Lenders, J.W., Willemsen, J.J., Eisenhofer, G. et al. (2007) Is supine rest necessary before blood sampling for plasma metanephrines? Clinical Chemistry, 53, 352-354.
– reference: Lenders, J.W., Keiser, H.R., Goldstein, D.S. et al. (1995) Plasma metanephrines in the diagnosis of pheochromocytoma. Annals of Internal Medicine, 123, 101-109.
– reference: Eisenhofer, G., Friberg, P., Pacak, K. et al. (1995) Plasma metadrenalines: do they provide useful information about sympatho-adrenal function and catecholamine metabolism? Clinical Science, 88, 533-542.
– reference: Sawka, A.M., Gafni, A., Thabane, L. et al. (2004) The economic implications of three biochemical screening algorithms for pheochromocytoma. Journal of Clinical Endocrinology and Metabolism, 89, 2859-2866.
– reference: Pillai, D., Ross, H.A., Kratzsch, J. et al. (2009) Proficiency test of plasma free and total metanephrines: report from a study group. Clinical Chemistry and Laboratory Medicine, 47, 786-790.
– reference: Sawka, A.M., Jaeschke, R., Singh, R.J. et al. (2003) A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. Journal of Clinical Endocrinology and Metabolism, 88, 553-558.
– reference: Martignoni, E., Blandini, F., Melzi d'Eril, G.V. et al. (1993) The influence of gender in the evaluation of platelet and plasma catecholamines. Life Sciences, 52, 1995-2004.
– reference: Willemsen, J.J., Ross, H.A., Lenders, J.W. et al. (2007) Stability of urinary fractionated metanephrines and catecholamines during collection, shipment, and storage of samples. Clinical Chemistry, 53, 268-272.
– reference: Bracken, R.M., Linnane, D.M. & Brooks, S. (2009) Plasma catecholamine and nephrine responses to brief intermittent maximal intensity exercise. Amino Acids, 36, 209-217.
– reference: Eisenhofer, G. (1994) Plasma normetanephrine for examination of extraneuronal uptake and metabolism of noradrenaline in rats. Naunyn-Schmiedebergs Archives of Pharmacology, 349, 259-269.
– reference: Weise, M., Merke, D.P., Pacak, K. et al. (2002) Utility of plasma free metanephrines for detecting childhood pheochromocytoma. Journal of Clinical Endocrinology and Metabolism, 87, 1955-1960.
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  year: 2002
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  article-title: How to detect pheochromocytomas?‐‐the diagnostic relevance of plasma free metanephrines
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  article-title: Comparative assessment of stimuli that release neuronal and adrenomedullary catecholamines in man
  publication-title: Circulation
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  year: 2007
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  article-title: Is supine rest necessary before blood sampling for plasma metanephrines?
  publication-title: Clinical Chemistry
– volume: 298
  start-page: 181
  year: 1978
  end-page: 186
  article-title: Effects of caffeine on plasma renin activity, catecholamines and blood pressure
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– volume: 1073
  start-page: 332
  year: 2006
  end-page: 347
  article-title: Biochemical diagnosis and localization of pheochromocytoma: can we reach a consensus?
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  article-title: Proficiency test of plasma free and total metanephrines: report from a study group
  publication-title: Clinical Chemistry and Laboratory Medicine
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  article-title: Utility of plasma free metanephrines for detecting childhood pheochromocytoma
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– volume: 349
  start-page: 259
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  year: 2005
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– volume: 39
  start-page: 2503
  year: 1993
  ident: e_1_2_8_30_2
  article-title: Optimal collection and storage conditions for catecholamine measurements in human plasma and urine
  publication-title: Clinical Chemistry
  doi: 10.1093/clinchem/39.12.2503
– ident: e_1_2_8_6_2
  doi: 10.1001/archinte.160.19.2957
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Snippet Summary Objective  Measurements of plasma free metanephrines have been advocated as first‐line tests for phaeochromocytoma. The aim of the study was to assess...
Objective  Measurements of plasma free metanephrines have been advocated as first‐line tests for phaeochromocytoma. The aim of the study was to assess the...
Measurements of plasma free metanephrines have been advocated as first-line tests for phaeochromocytoma. The aim of the study was to assess the impact of...
Summary Objective Measurements of plasma free metanephrines have been advocated as first-line tests for phaeochromocytoma. The aim of the study was to assess...
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StartPage 153
SubjectTerms Adolescent
Adrenal Gland Neoplasms - blood
Adrenal Gland Neoplasms - diagnosis
Adult
Biological and medical sciences
Blood Chemical Analysis - methods
Blood Chemical Analysis - statistics & numerical data
Blood Specimen Collection - methods
Blood Specimen Collection - statistics & numerical data
Confounding Factors (Epidemiology)
Endocrinopathies
Exercise - physiology
Feeding Behavior - physiology
Female
Fundamental and applied biological sciences. Psychology
Humans
Male
Medical sciences
Menstrual Cycle - blood
Menstrual Cycle - metabolism
Menstrual Cycle - physiology
Metanephrine - blood
Metanephrine - metabolism
Middle Aged
Normetanephrine - blood
Normetanephrine - metabolism
Pheochromocytoma - blood
Pheochromocytoma - diagnosis
Vertebrates: endocrinology
Young Adult
Title Influence of various confounding variables and storage conditions on metanephrine and normetanephrine levels in plasma
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https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1365-2265.2009.03761.x
https://www.ncbi.nlm.nih.gov/pubmed/20039892
https://www.proquest.com/docview/1545888149
https://www.proquest.com/docview/734032030
Volume 73
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