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 in | Clinical endocrinology (Oxford) Vol. 73; no. 2; pp. 153 - 160 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
01.08.2010
Blackwell Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
ISSN | 0300-0664 1365-2265 1365-2265 |
DOI | 10.1111/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. |
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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 |
Author_xml | – sequence: 1 givenname: Timo surname: Deutschbein fullname: Deutschbein, Timo organization: Department of Endocrinology and Division of Laboratory Research, University of Duisburg-Essen, Essen, Germany – sequence: 2 givenname: Nicole surname: Unger fullname: Unger, Nicole organization: Department of Endocrinology and Division of Laboratory Research, University of Duisburg-Essen, Essen, Germany – sequence: 3 givenname: Andrea surname: Jaeger fullname: Jaeger, Andrea organization: Department of Endocrinology and Division of Laboratory Research, University of Duisburg-Essen, Essen, Germany – sequence: 4 givenname: Martina surname: Broecker-Preuss fullname: Broecker-Preuss, Martina organization: Department of Endocrinology and Division of Laboratory Research, University of Duisburg-Essen, Essen, Germany – sequence: 5 givenname: Klaus surname: Mann fullname: Mann, Klaus organization: Department of Endocrinology and Division of Laboratory Research, University of Duisburg-Essen, Essen, Germany – sequence: 6 givenname: Stephan surname: Petersenn fullname: Petersenn, Stephan organization: Department of Endocrinology and Division of Laboratory Research, University of Duisburg-Essen, Essen, Germany |
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Keywords | Metadrenaline Metanephrine Storage Normetanephrine Conservation Confounding factor Endocrinology Blood plasma |
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(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. 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(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. 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(e_1_2_8_9_2) 2002; 114 e_1_2_8_14_2 e_1_2_8_15_2 e_1_2_8_31_2 e_1_2_8_10_2 e_1_2_8_11_2 e_1_2_8_32_2 |
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. – reference: 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. – volume: 52 start-page: 1995 year: 1993 end-page: 2004 article-title: The influence of gender in the evaluation of platelet and plasma catecholamines publication-title: Life Sciences – volume: 134 start-page: 315 year: 2001 end-page: 329 article-title: Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma publication-title: Annals of Internal Medicine – volume: 114 start-page: 246 year: 2002 end-page: 251 article-title: How to detect pheochromocytomas?‐‐the diagnostic relevance of plasma free metanephrines publication-title: Wiener Klinische Wochenschrift – volume: 88 start-page: 550 year: 2003 end-page: 552 article-title: Editorial: biochemical diagnosis of pheochromocytoma‐‐is it time to switch to plasma‐free metanephrines? publication-title: Journal of Clinical Endocrinology and Metabolism – volume: 83 start-page: 2175 year: 1998 end-page: 2185 article-title: Plasma metanephrines are markers of pheochromocytoma produced by catechol‐O‐methyltransferase within tumors publication-title: Journal of Clinical Endocrinology and Metabolism – volume: 123 start-page: 101 year: 1995 end-page: 109 article-title: Plasma metanephrines in the diagnosis of pheochromocytoma publication-title: Annals of Internal Medicine – volume: 49 start-page: 1951 year: 2003 end-page: 1953 article-title: Stability of plasma free metanephrines during collection and storage as assessed by an optimized HPLC method with electrochemical detection publication-title: Clinical Chemistry – volume: 356 start-page: 601 year: 2007 end-page: 610 article-title: Clinical practice. The incidentally discovered adrenal mass publication-title: New England Journal of Medicine – volume: 59 start-page: 637 year: 1979 end-page: 643 article-title: Comparative assessment of stimuli that release neuronal and adrenomedullary catecholamines in man publication-title: Circulation – volume: 53 start-page: 352 year: 2007 end-page: 354 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 publication-title: New England Journal of Medicine – volume: 1073 start-page: 332 year: 2006 end-page: 347 article-title: Biochemical diagnosis and localization of pheochromocytoma: can we reach a consensus? publication-title: Annals of the New York Academy of Sciences – volume: 47 start-page: 786 year: 2009 end-page: 790 article-title: Proficiency test of plasma free and total metanephrines: report from a study group publication-title: Clinical Chemistry and Laboratory Medicine – volume: 88 start-page: 2656 year: 2003 end-page: 2666 article-title: Biochemical diagnosis of pheochromocytoma: how to distinguish true‐ from false‐positive test results publication-title: Journal of Clinical Endocrinology and Metabolism – volume: 39 start-page: 2503 year: 1993 end-page: 2508 article-title: Optimal collection and storage conditions for catecholamine measurements in human plasma and urine publication-title: Clinical Chemistry – volume: 287 start-page: 1427 year: 2002 end-page: 1434 article-title: Biochemical diagnosis of pheochromocytoma: which test is best? publication-title: JAMA – volume: 12 start-page: 41 year: 1987 end-page: 51 article-title: Circadian fluctuation of plasma epinephrine in supine humans publication-title: Psychoneuroendocrinology – volume: 87 start-page: 1955 year: 2002 end-page: 1960 article-title: Utility of plasma free metanephrines for detecting childhood pheochromocytoma publication-title: Journal of Clinical Endocrinology and Metabolism – volume: 349 start-page: 259 year: 1994 end-page: 269 article-title: Plasma normetanephrine for examination of extraneuronal uptake and metabolism of noradrenaline in rats publication-title: Naunyn-Schmiedebergs Archives of Pharmacology – volume: 5 start-page: 1 year: 2005 article-title: Measurement of fractionated plasma metanephrines for exclusion of pheochromocytoma: can specificity be improved by adjustment for age? publication-title: BMC Endocrine Disorders – volume: 53 start-page: 268 year: 2007 end-page: 272 article-title: Stability of urinary fractionated metanephrines and catecholamines during collection, shipment, and storage of samples publication-title: Clinical Chemistry – volume: 340 start-page: 1872 year: 1999 end-page: 1879 article-title: Plasma normetanephrine and metanephrine for detecting pheochromocytoma in von Hippel‐Lindau disease and multiple endocrine neoplasia type 2 publication-title: New England Journal of Medicine – volume: 77 start-page: 794 year: 1993 end-page: 799 article-title: Genetic influences on plasma catecholamines in human twins publication-title: Journal of Clinical Endocrinology and Metabolism – volume: 94 start-page: 2841 year: 2009 end-page: 2849 article-title: Dietary influences on plasma and urinary metanephrines: implications for diagnosis of catecholamine‐producing tumors publication-title: Journal of Clinical Endocrinology and Metabolism – volume: 36 start-page: 209 year: 2009 end-page: 217 article-title: Plasma catecholamine and nephrine responses to brief intermittent maximal intensity exercise publication-title: Amino Acids – volume: 33 start-page: 480 year: 2003 end-page: 487 article-title: Exercise induces excessive normetanephrine responses in hypertensive diabetic patients publication-title: European Journal of Clinical Investigation – volume: 89 start-page: 2859 year: 2004 end-page: 2866 article-title: The economic implications of three biochemical screening algorithms for pheochromocytoma publication-title: Journal of Clinical Endocrinology and Metabolism – volume: 88 start-page: 553 year: 2003 end-page: 558 article-title: A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24‐hour urinary metanephrines and catecholamines publication-title: Journal of Clinical Endocrinology and Metabolism – volume: 4 start-page: 2 year: 2004 article-title: A systematic review of the literature examining the diagnostic efficacy of measurement of fractionated plasma free metanephrines in the biochemical diagnosis of pheochromocytoma publication-title: BMC Endocrine Disorders – volume: 160 start-page: 2957 year: 2000 end-page: 2963 article-title: Diagnostic efficacy of unconjugated plasma metanephrines for the detection of pheochromocytoma publication-title: Archives of Internal Medicine – volume: 88 start-page: 533 year: 1995 end-page: 542 article-title: Plasma metadrenalines: do they provide useful information about sympatho‐adrenal function and catecholamine metabolism? publication-title: Clinical Science – ident: e_1_2_8_10_2 doi: 10.1210/jc.2002-030005 – ident: e_1_2_8_24_2 doi: 10.1007/s00726-008-0049-2 – ident: e_1_2_8_29_2 doi: 10.1373/clinchem.2006.076489 – ident: e_1_2_8_28_2 doi: 10.1210/jc.2009-0303 – ident: e_1_2_8_20_2 doi: 10.1016/0024-3205(93)90684-U – ident: e_1_2_8_31_2 doi: 10.1373/clinchem.2006.075218 – ident: e_1_2_8_14_2 doi: 10.1056/NEJMcp065470 – ident: e_1_2_8_17_2 doi: 10.1042/cs0880533 – ident: e_1_2_8_26_2 doi: 10.1056/NEJM197801262980403 – ident: e_1_2_8_11_2 doi: 10.1210/jc.2002-021251 – ident: e_1_2_8_16_2 doi: 10.1186/1472-6823-5-1 – ident: e_1_2_8_4_2 doi: 10.1056/NEJM199906173402404 – volume: 114 start-page: 246 year: 2002 ident: e_1_2_8_9_2 article-title: How to detect pheochromocytomas?‐‐the diagnostic relevance of plasma free metanephrines publication-title: Wiener Klinische Wochenschrift – ident: e_1_2_8_3_2 doi: 10.1210/jcem.83.6.4870 – ident: e_1_2_8_7_2 doi: 10.7326/0003-4819-134-4-200102200-00016 – ident: e_1_2_8_21_2 doi: 10.1016/0306-4530(87)90021-7 – ident: e_1_2_8_19_2 doi: 10.1210/jc.77.3.794 – ident: e_1_2_8_13_2 doi: 10.1186/1472-6823-4-2 – ident: e_1_2_8_12_2 doi: 10.1210/jc.2003-031127 – ident: e_1_2_8_22_2 doi: 10.1161/01.CIR.59.4.637 – ident: e_1_2_8_8_2 doi: 10.1001/jama.287.11.1427 – ident: e_1_2_8_2_2 doi: 10.1196/annals.1353.038 – ident: e_1_2_8_18_2 doi: 10.1210/jc.87.5.1955 – ident: e_1_2_8_25_2 doi: 10.1007/BF00169292 – ident: e_1_2_8_5_2 doi: 10.7326/0003-4819-123-2-199507150-00004 – ident: e_1_2_8_23_2 doi: 10.1046/j.1365-2362.2003.01155.x – ident: e_1_2_8_27_2 doi: 10.1210/jc.2002-021913 – ident: e_1_2_8_15_2 doi: 10.1515/CCLM.2009.162 – ident: e_1_2_8_32_2 doi: 10.1373/clinchem.2003.023135 – 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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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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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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