FRI133 Diagnosis Of Liquorice Induced Hypertension By Mass Spectrometry - A Simpler And Less Expensive Method

Disclosure: Á.D. Árnason: None. B.B. Sigurdsson: None. E. Cook: None. M. Þorsteinsdóttir: None. S. Wallerstedt: None. H.A. Sigurjonsdottir: None. Background: The diagnosis of liquorice induced hypertension (LIH) has been confirmed by measuring the urinary ratio of free cortisol/cortisone by gas chromatography. The aim of this study was to evaluate if analysis of this ratio in serum (Q(S)) is as sensitive and selective compared to analysis of the urinary ratio (Q(U)) using mass spectrometry (LC-MS/MS) and if the analysis of serum GA (glycyrrhetinic acid) correlates to the ratio of Q(S) in order to diagnose LIH. Methods: We included 125 individuals, 117 normotensive (NT) and 8 hypertensive (HT). Mean age was 31.6 years for the whole group (W), 31.1 years for NT, 39 years for HT, 31.1 years for men (n=72) and 32.2 years for women (n=53). The study was prospective and double blind, participants consuming 150 mg of capsuled GA daily for 2 weeks (n= 62) or placebo (n=63). Highly selective and sensitive validated inhouse LC-MS/MS method, able to measure both serum and urine samples, was used to quantify free cortisol and cortisone. An additional validated in-house method was used to quantify serum 18β-GA. Mean values with standard deviation of Q(S), Q(U) and serum GA was obtained for W and the subgroups. The mean difference (mdiff) in Q(S), Q(U) and serum GA before and after GA intake (or placebo) was evaluated with Wilcoxon test and correlation by Spearman correlation test. Results: For W the mdiff for Q(S) was 0.936 (±3.19, p<0.001) and for Q(U) it was 0.214 (±0.493, p<0.001), Q(S) and Q(U) correlated (p<0.001, rho=0,605). For NT the mdiff for Q(S) was 0.877 (±3.22, p<0.001) and for Q(U) it was 0.203 (±0.498, p<0.001), Qs and Q(U) correlated (p<0.001 and rho=0.610). For HT the mdiff for Q(S) and Q(U) was not significant. For men the mdiff for Q(S) was 1.30 (±2.85, p<0.001) and for Q(U) it was 0.241 (±0.474, p<0.001), Q(S) and Q(U) correlated (p<0.001, rho=0.635). For women the mdiff of Q(S) was 0.446 (±3.58, p=0.00816) and for Q(U) it was 0.176 (±0.520, p=0.0360), Qs and Q(U) correlated (p<0.001, rho=0.477).The mdiff for GA for W was 6.78x10(5) (±1.04x10(6), p<0.001), for the NT the mdiff in GA was 6.50x10(5) (±1.00x10(6), p<0.001), for HT it was not significant. For men it was 7.18x10(5) (±9.15x10(5), p<0.001) and for women it was 6.24x10(5)(±1.19x10(6), p=0.0140). There was a positive linear relationship between the mdiff of Q(S) and GA and Q(U) and GA, for all groups (p<0,05). Conclusions: We conclude that the new inhouse LC-MS/MS method is a sensitive and reliable method to evaluate Qs, Qu and serum GA. Further, this new inhouse method is a reliable method to diagnose LIH. Presentation: Friday, June 16, 2023