Association Between Urinary Catecholamine Excretion and Urine Volume

Michael Haap; Friedemann Blaschka; Rainer Lehmann; Annika Hoyer; Karsten Müssig

doi:10.1055/a-0926-3532

Hormone and Metabolic Research, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Horm Metab Res 2019; 51(08): 531-538
DOI: 10.1055/a-0926-3532

Endocrine Care

Association Between Urinary Catecholamine Excretion and Urine Volume

Michael Haap

¹Department of Internal Medicine, Medical Intensive Care Unit, University of Tübingen, Tübingen, Germany

²Department of Internal Medicine, Endocrinology und Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, Germany

,

Friedemann Blaschka

²Department of Internal Medicine, Endocrinology und Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, Germany

,

Rainer Lehmann

²Department of Internal Medicine, Endocrinology und Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, Germany

⁴German Center for Diabetes Research (DZD), München-Neuherberg, Germany

,

Annika Hoyer

³Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany

⁴German Center for Diabetes Research (DZD), München-Neuherberg, Germany

,

Karsten Müssig

⁴German Center for Diabetes Research (DZD), München-Neuherberg, Germany

⁵Division of Endocrinology und Diabetology, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

⁶Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany

› Institutsangaben

Abstract

Several confounders must be considered in the evaluation of urinary catecholamine excretion. However, literature is contradictory about potential confounders. The aim of the present study was to assess correlations between catecholamine excretion and anthropometric or clinical parameters with special attention to urine volume. A total of 967 24-h urinary catecholamine measurements were performed in 593 patients for diagnostic purposes. The indication for urine examination was suspicion of secondary hypertension, phaeochromocytoma, or paraganglioma. From the patients examined, 57% were females and 43% were males. The patients’ age ranged between 15 and 87 years with a median [Q1; Q3] of 51 [39; 62] years. Seventy-eight percent of the patients suffered from hypertension. Seventy percent of patients took one or more antihypertensive drugs. The most commonly used drugs were ACE inhibitors (43%), while α-blockers (15%) were the least used drugs. Urinary excretion was between 500 and 11 950 ml/24 h with a median of 2200 [1600; 2685] ml/24 h. The median body mass index (BMI) was 26.7 [24.0; 30.4] kg/m². The excretion of all catecholamines was greater in men than in women (all p<0.0001). Epinephrine (p=0.0026), dopamine (p<0.0001), and metanephrine (p=0.0106) excretion decreased with age. BMI was associated with urinary excretion of dopamine (p<0.0001), norepinephrine (p=0.0026), normetanephrine (p<0.0001), and homovanillylmandelic acid (HVMA; p=0.0251). Urine volume correlated with urinary dopamine (p=0.0127), metanephrine (p<0.0001), normetanephrine (p=0.0070), and HVMA (p<0.0028) excretion. In addition to the established associations between urinary catecholamine excretion and age, gender, and BMI in the present study, urinary catecholamine excretion correlated also with urine volume.

Key words

epinephrine - norepinephrine - dopamine - homovanillylmandelic acid - metanephrine - normetanephrine - vanillylmandelic acid - pheochromocytoma - paraganglioma

Volltext

Referenzen

References
1 Beard CM, Sheps SG, Kurland LT. et al. Occurrence of pheochromocytoma in Rochester, Minnesota, 1950 through 1979. Mayo Clin Proc 1983; 58: 802-804
2 Pacak K, Linehan WM, Eisenhofer G. et al. Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann Intern Med 2001; 134: 315-329
3 Eisenhofer G, Keiser H, Friberg P. et al. Plasma metanephrines are markers of pheochromocytoma produced by catechol-O-methyltransferase within tumors. J Clin Endocrinol Metab 1998; 83: 2175-2185
4 Unger N, Pitt C, Schmidt IL. et al. Diagnostic value of various biochemical parameters for the diagnosis of pheochromocytoma in patients with adrenal mass. Eur J Endocrinol 2006; 154: 409-417
5 Eisenhofer G, Lenders JW, Pacak K. Choice of biochemical test for diagnosis of pheochromocytoma: Validation of plasma metanephrines. Curr Hypertens Rep 2002; 4: 250-255
6 Eisenhofer G, Lenders JW, Linehan WM. et al. Plasma normetanephrine and metanephrine for detecting pheochromocytoma in von Hippel-Lindau disease and multiple endocrine neoplasia type 2. N Engl J Med 1999; 340: 1872-1879
7 Lenders JW, Pacak K, Walther MM. et al. Biochemical diagnosis of pheochromocytoma: Which test is best?. JAMA 2002; 287: 1427-1434
8 Lenders JW, Duh QY, Eisenhofer G. et al. Pheochromocytoma and paraganglioma: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014; 99: 1915-1942
9 Jenner DA, Harrison GA, Prior IA. et al. 24-h catecholamine excretion: Relationships with age and weight. Clin Chim Acta 1987; 164: 17-25
10 Gerlo EA, Schoors DF, Dupont AG. Age- and sex-related differences for the urinary excretion of norepinephrine, epinephrine, and dopamine in adults. Clin Chem 1991; 37: 875-878
11 Olsson T, Viitanen M, Hagg E. et al. Catecholamine excretion in old age. Aging (Milano) 1991; 3: 263-268
12 Jenner DA, Harrison GA, Prior IA. et al. Inter-population comparisons of catecholamine excretion. Ann Hum Biol 1987; 14: 1-9
13 Mericq MV, Cutler Jr GB. High fluid intake increases urine free cortisol excretion in normal subjects. J Clin Endocrinol Metab 1998; 83: 682-684
14 Müssig K, Remer T, Fritsche A. et al. Urinary free cortisone, but not cortisol, is associated with urine volume in severe obesity. Steroids 2009; 74: 742-745
15 Peaston RT, Weinkove C. Measurement of catecholamines and their metabolites. Ann Clin Biochem 2004; 41: 17-38
16 Smedes F, Kraak JC, Poppe H. Simple and fast solvent extraction system for selective and quantitative isolation of adrenaline, noradrenaline and dopamine from plasma and urine. J Chromatogr 1982; 231: 25-39
17 Bicker J, Fortuna A, Alves G, Falcao A. Liquid chromatographic methods for the quantification of catecholamines and their metabolites in several biological samples--a review. Anal Chim Acta 2013; 768: 12-34
18 Ross GA, Newbould EC, Thomas J. et al. Plasma and 24 h-urinary catecholamine concentrations in normal and patient populations. Ann Clin Biochem 1993; 30 (Pt 1) 38-44
19 Thomas L. Phäochromozytom, Paragangliom, Neuroblastom. In Thomas L. (ed) Labor und Diagnose : Indikation und Bewertung von Laborbefunden für die medizinische Diagnostik. 8th Edition Frankfurt/Main: TH-Books Verlagsgesellschaft; 2012: 1769-1778
20 Kawano Y, Kawasaki T, Kawazoe N. et al. Circadian variations of urinary dopamine, norepinephrine, epinephrine and sodium in normotensive and hypertensive subjects. Nephron 1990; 55: 277-282
21 Von Euler US, Hellner-Bjorkman S, Orwen I. Diurnal variations in the excretion of free and conjugated noradrenaline and adrenaline in urine from healthy subjects. Acta Physiol Scand Suppl 1955; 33: 10-16
22 Hoeldtke RD, Martin WR. Urine volume and catecholamine excretion. J Lab Clin Med 1970; 75: 166-174
23 De Schaepdryver AF, Leroy JG. Urine volume and catecholamine excretion in man. Acta Cardiol 1961; 16: 631-638
24 Boren DR, Henry DP, Selkurt EE. et al. Renal modulation of urinary catecholamine excretion during volume expansion in the dog. Hypertension 1980; 2: 383-389
25 Hathaway PW, Brehm ML, Clapp JR. et al. Urine flow, catecholamines, and blood pressure. The variability of response of normal human subjects in a relaxed laboratory setting. Psychosom Med 1969; 31: 20-30
26 Lakatua DJ, Nicolau GY, Bogdan C. et al. Chronobiology of catecholamine excretion in different age groups. Prog Clin Biol Res 1987; 227B: 31-50
27 Dalmaz Y, Peyrin L, Sann L. et al. Age-related changes in catecholamine metabolites of human urine from birth to adulthood. J Neural Transm 1979; 46: 153-174
28 Moyer TP, Jiang NS, Tyce GM. et al. Analysis for urinary catecholamines by liquid chromatography with amperometric detection: Methodology and clinical interpretation of results. Clin Chem 1979; 25: 256-263
29 Premel-Cabic A, Turcant A, Allain P. Normal reference intervals for free catecholamines and their acid metabolites in 24-h urines from children, as determined by liquid chromatography with amperometric detection. Clin Chem 1986; 32: 1585-1587
30 Descovich GC, Montalbetti N, Kuhl JF. et al. Age and catecholamine rhythms. Chronobiologia 1974; 1: 163-171
31 Brown MJ, Allison DJ. Renal conversion of plasma DOPA to urine dopamine. Br J Clin Pharmacol 1981; 12: 251-253
32 Chugh G, Pokkunuri I, Asghar M. Renal dopamine and angiotensin II receptor signaling in age-related hypertension. Am J Physiol Renal Physiol 2013; 304: F1-F7
33 Armando I, Nowicki S, Aguirre J. et al. A decreased tubular uptake of dopa results in defective renal dopamine production in aged rats. Am J Physiol 1995; 268: F1087-F1092
34 Vieira-Coelho MA, Hussain T, Kansra V. et al. Aging, high salt intake, and renal dopaminergic activity in Fischer 344 rats. Hypertension 1999; 34: 666-672
35 Choudhury D, Levi M. Kidney aging – inevitable or preventable?. Nat Rev Nephrol 2011; 7: 706-717
36 Pestana M, Jardim H, Correia F. et al. Renal dopaminergic mechanisms in renal parenchymal diseases and hypertension. Nephrol Dial Transplant 2001; 16 (Suppl 1): 53-59
37 Quelhas-Santos J, Soares-Silva I, Fernandes-Cerqueira C. et al. Plasma and urine renalase levels and activity during the recovery of renal function in kidney transplant recipients. Exp Biol Med (Maywood) 2014; 239: 502-508
38 Zhang MZ, Harris RC. Antihypertensive mechanisms of intra-renal dopamine. Curr Opin Nephrol Hypertens 2015; 24: 117-122
39 Pestana M, Jardim H, Serrao P. et al. Reduced urinary excretion of dopamine and metabolites in chronic renal parenchymal disease. Kidney Blood Press Res 1998; 21: 59-65
40 Müssig K, Häring HU, Schleicher ED. Pseudopheochromocytoma in Parkinson's disease. Eur J Intern Med 2008; 19: 151-152
41 Davidson DF. Elevated urinary dopamine in adults and children. Ann Clin Biochem 2005; 42: 200-207
42 Asghar M, Tayebati SK, Lokhandwala MF. et al. Potential dopamine-1 receptor stimulation in hypertension management. Curr Hypertens Rep 2011; 13: 294-302
43 Felder RA, Jose PA. Mechanisms of disease: the role of GRK4 in the etiology of essential hypertension and salt sensitivity. Nat Clin Pract Nephrol 2006; 2: 637-650
44 Zeng C, Jose PA. Dopamine receptors: Important antihypertensive counterbalance against hypertensive factors. Hypertension 2011; 57: 11-17
45 Amano A, Tsunoda M, Aigaki T. et al. Age-related changes of dopamine, noradrenaline and adrenaline in adrenal glands of mice. Geriatr Gerontol Int 2013; 13: 490-496
46 Ito Y, Fujimoto Y, Obara T. The role of epinephrine, norepinephrine, and dopamine in blood pressure disturbances in patients with pheochromocytoma. World J Surg 1992; 16: 759-763 discussion 763–754
47 Bravo EL, Tarazi RC, Gifford RW. et al. Circulating and urinary catecholamines in pheochromocytoma. Diagnostic and pathophysiologic implications. N Engl J Med 1979; 301: 682-686
48 Ernsberger P, Koletsky RJ, Kilani A. et al. Effects of weight cycling on urinary catecholamines: Sympathoadrenal role in refeeding hypertension. J Hypertens 1998; 16: 2001-2005
49 Coulson JM. The relationship between blood pressure variability and catecholamine metabolites: a pilot study. J Hum Hypertens 2015; 29: 50-52
50 Lee ZS, Critchley JA, Tomlinson B. et al. Urinary epinephrine and norepinephrine interrelations with obesity, insulin, and the metabolic syndrome in Hong Kong Chinese. Metabolism 2001; 50: 135-143
51 Macdonald IA, Lake DM. An improved technique for extracting catecholamines from body fluids. J Neurosci Methods 1985; 13: 239-248
52 Paffenbarger Jr. RS, Hyde RT, Wing AL. et al. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med 1986; 314: 605-613
53 Saprunova MM. [Daily catecholamine excretion in children suffering from constitutional, exogenous obesity]. Vopr Pitan 1980; 18-20
54 Young JB, Troisi RJ, Weiss ST. et al. Relationship of catecholamine excretion to body size, obesity, and nutrient intake in middle-aged and elderly men. Am J Clin Nutr 1992; 56: 827-834
55 Linnoila M, Oliver J, Adinoff B. et al. High correlations of norepinephrine, dopamine, and epinephrine and their major metabolite excretion rates. Arch Gen Psychiatry 1988; 45: 701-704
56 Reynolds V, Jenner DA, Palmer CD. et al. Catecholamine excretion rates in relation to life-styles in the male population of Otmoor, Oxfordshire. Ann Hum Biol 1981; 8: 197-209
57 Horky K, Marek J, Kopecka J. et al. Influence of age on orthostatic changes in plasma renin activity and urinary catecholamines in man. Physiol Bohemoslov 1975; 24: 481-488
58 Landsberg L, Troisi R, Parker D. et al. Obesity, blood pressure, and the sympathetic nervous system. Ann Epidemiol 1991; 1: 295-303
59 Troisi RJ, Weiss ST, Parker DR. et al. Relation of obesity and diet to sympathetic nervous system activity. Hypertension 1991; 17: 669-677
60 Johnston JL, Leiter LA, Burrow GN. et al. Excretion of urinary catecholamine metabolites in anorexia nervosa: effect of body composition and energy intake. Am J Clin Nutr 1984; 40: 1001-1006
61 Young JB, Landsberg L. Diet-induced changes in sympathetic nervous system activity: possible implications for obesity and hypertension. J Chronic Dis 1982; 35: 879-886
62 Krieger DR, Landsberg L. Mechanisms in obesity-related hypertension: role of insulin and catecholamines. Am J Hypertens 1988; 1: 84-90
63 Bell BB, Rahmouni K. Leptin as a Mediator of Obesity-Induced Hypertension. Curr Obes Rep 2016; 5: 397-404
64 Corry DB, Tuck ML. Obesity, hypertension, and sympathetic nervous system activity. Curr Hypertens Rep 1999; 1: 119-126

Zusatzmaterial

Supplementary Material