Ferric reducing antioxidant power (FRAP)
The plasma and urine FRAP was significantly decreased in all study subgroups: incidentaloma (-55%, p < 0.0001; -46%, p < 0.0001) pheochromocytoma (-54%, p < 0.0001; -41%, p < 0.0001) and Cushing’s/Conn’s adenoma (-53%, p < 0.0001; -37%, p < 0.0001) as compared to the controls (Fig. 2D, 2E). However, there were no differences between the study groups in the plasma/urine index of FRAP (Fig. 2F).
In the controls, plasma TAC correlated highly positively with urine TAC (R = 0.981, p < 0.0001), plasma DPPH (R = 0.886, p < 0.0001) and plasma FRAP (R = 0.945, p < 0.0001), as well as negatively with plasma OSI (R=-0.724, p < 0.0001). Plasma OSI was associated positively with urine OSI (R = 0.541, p < 0.0001), and negatively with plasma DPPH (R=-0.573, p < 0.0001) and plasma FRAP (R=-0.604, p < 0.0001). The positive associations were between plasma DPPH and plasma FRAP (R = 0.858, p < 0.0001), plasma DPPH and urine DPPH (R = 0.797, p < 0.0001), plasma FRAP and urine FRAP (R = 0.775, p < 0.0001), urine TAC and urine DPPH (R = 0.838, P < 0.0001), urine TAC and urine FRAP (R = 0.812, p < 0.0001), urine TOS and urine OSI (R = 0.904, p < 0.0001), and urine DPPH and urine FRAP (R = 0.702, p < 0.0001). We observed negative correlation between plasma TOS and plasma DPPH (R=-0.291, p = 0.024), urine TAC and urine OSI (R=-0.63, p < 0.0001), urine TAC and urine TOS (R=-0.308, p = 0.017), urine TOS and urine FRAP (R=-0.27, p = 0.037), urine OSI and urine DPPH (R=-0.444, p < 0.0001), as well as urine OSI and urine FRAP (R=-0.52, p < 0.0001). Moreover, BMI correlated positively with cortisol (R = 0.415, p = 0.023), and negatively with urine TOS (R=-0.481, p = 0.007) and urine OSI (R=-0.435, p = 0.016). Plasma FRAP was positively associated with glucose (R = 0.4, p = 0.035), while normethanephrine correlated positively with cortisol (R = 0.282, p = 0.029) and methanephrine (R = 0.854, p < 0.0001). Plasma UA correlated positively with plasma TPC (R = 0.713, p < 0.0001), plasma and urine TAC (R = 0.879, p < 0.0001; R = 0.889, p < 0.0001), plasma and urine DDPH (R = 0.852, p < 0.0001; R = 0.779, p < 0.0001), plasma and urine FRAP (R = 0.832, p < 0.0001; R = 0.705, p < 0.0001), and negatively with plasma and urine OSI (R=-0.608, p < 0.0001; R=-0.504, p < 0.0001). Plasma TPC was associated positively with TAC (R = 0.77, p < 0.0001; R = 0.779, p < 0.0001), DDPH (R = 0.645, p < 0.0001; R = 0.618, p < 0.0001), FRAP (R = 0.772, p < 0.0001; R = 0.632, p < 0.0001), and negatively with plasma and urine OSI (R=-0.6, p < 0.0001; R=-0.506) (Fig. 3A).
In incidentaloma patients, plasma TAC was associated positively with plasma DPPH (R = 0.712, p = 0.001), plasma FRAP (R = 0.714, p = 0.001) and urine TAC (R = 0.943, p < 0.0001), as well as negatively with plasma OSI (R=-0.866, p < 0.0001). The positive correlations were between plasma TOS and plasma OSI (R = 0.733, p < 0.0001), plasma OSI and urine OSI (R = 0.613, p = 0.005), plasma FRAP and urine FRAP (R = 0.759, p < 0.0001), urine TAC and urine DPPH (R = 0.697, p = 0.001), urine TAC and urine FRAP (R = 0.84, p < 0.0001), urine TOS and urine OSI (R = 0.594, p = 0.006), as well as urine DPHA and urine FRAP (R = 0.563, p = 0.015). Whereas, we found negative associations between plasma TOS and plasma DPPH (R=-0.498, p = 0.025), plasma OSI and plasma DPPH (R=-0.844, p < 0.0001), plasma OSI and plasma FRAP (R=-0.493, p = 0.032), as well as urine TAC and urine OSI (R=-0.553, p = 0.011). Further on, plasma TOS negatively correlated with normethanephrine (R=-0.448, p = 0.048). We observed positive correlations between cortisol and methanephrine (R = 0.485, p = 0.03), cortisol and urine OSI (R = 0.496, p = 0.026), methanephrine and normethanephrine (R = 0.781, p < 0.0001), methanephrine and aldosterone (R = 0.529, p = 0.017), as well as normethanephrine and aldosterone (R = 0.483, p = 0.031) (Fig. 3B).
In pheochromocytoma subgroup, plasma TAC correlated positively with plasma DPPH (R = 0.815, p < 0.0001), plasma FRAP (R = 0.61, p = 0.004) and urine TAC (R = 0.973, p < 0.0001), whereas negatively plasma OSI (R=-0.711, p < 0.0001). We found positive associations between plasma TOS and plasma OSI (R = 0.494, p = 0.027), plasma DPPH and urine DPPH (R = 0.451, p = 0.046), plasma FRAP and urine FRAP (R = 0.458, p = 0.049), urine TAC and urine DPPH (R = 0.639, p = 0.002), urine TAC and urine FRAP (R = 0.835, p < 0.0001). Methanephrine was associated positively with normethanephrine (R = 0.631, p = 0.003), plasma and urine TAC (R = 0.877, p < 0.0001; R = 0.83, P < 0.0001), DPPH (R = 0.633, p = 0.003; R = 0.76, p < 0.0001), and FRAP (R = 0.511, p = 0.021; R = 0.515, p = 0.024). We observed that normethanephrine correlated positively with plasma and urine TAC (R = 0.698, p = 0.001; R = 0.657, p = 0.002), plasma DPPH (R = 0.586, p = 0.007) and urine FRAP (R = 0.54, p = 0.017), as well as negatively with plasma OSI (R=-0.525, p-0.017). The negative correlation was also between plasma OSI and plasma DPPH (R=-0.869, p < 0.0001). Plasma UA was positively associated with urine FRAP (R = 0.521, p = 0.027) and negatively with plasma OSI (R=-0.465, p = 0.045). We observed positive correlation between plasma TPC and urine DPPH (R = 0.462, p = 0.047) (Fig. 3C).
In Cushing’s/Conn’s adenoma patients, plasma TAC highly positively correlated with plasma DPPH (R = 0.637, p = 0.002), plasma FRAP (R = 0.782, p < 0.0001) and urine TAC (R = 0.956, p < 0.0001). The positive correlations were between plasma DPPH and plasma FRAP (R = 0.58, p = 0.007), plasma DPPH and urine DPPH (R = 0.674, p = 0.001), plasma FRAP and urine FRAP (R = 0.516, p = 0.02), urine TAC and urine DPPH (R = 0.852, p < 0.0001), urine TAC and urine FRAP (R = 0.527, p = 0.017), urine TOS and urine OSI (R = 0.821, p < 0.0001), and urine DPPH and urine FRAP (R = 0.469, p = 0.037). Additionally, plasma DPPH was associated negatively with cortisol (R=-0.569, p = 0.009), whereas methanephrine positively with normethanephrine (R = 0.457, p = 0.043). We found positive correlation between plasma UA and normethanephrine (R = 0.522, p = 0.018) (Fig. 3D).