{"title":"Comparison of the clinical significance of lymphocyte-based inflammatory indices between the two major subtypes of primary aldosteronism.","authors":"Daisuke Watanabe, Satoshi Morimoto, Noriko Morishima, Atsuhiro Ichihara","doi":"10.1007/s12020-025-04193-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Primary aldosteronism (PA) can be classified into aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) and is related to chronic inflammatory diseases. We compared lymphocyte-based inflammatory indices among patients with APA, IHA and essential hypertension (EH), and investigated the relationships between these indices and background factors in patients with PA.</p><p><strong>Methods: </strong>A total of 186 patients (39 with APA, 48 with IHA, and 99 with blood-pressure-matched EH) were retrospectively included. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated as lymphocyte-based inflammatory indices.</p><p><strong>Results: </strong>Lymphocyte count was lower in the APA group than in the IHA and EH groups. NLR and PLR were significantly higher in the APA group than in the IHA and EH groups. In the APA group, NLR correlated positively with plasma aldosterone concentration after the saline infusion test, while in the IHA group, NLR correlated positively with body mass index and negatively with flow-mediated dilation. Lymphocyte-based inflammatory indices did not differ significantly between KCNJ5-mutant and wild-type groups. NLR, MLR, and PLR remained unchanged from baseline to 1 week after adrenalectomy (ADX), but a cut-off baseline MLR of 0.18 was predictive of complete clinical success after ADX (sensitivity, 0.8095; specificity, 0.7222; area under the curve, 0.719).</p><p><strong>Conclusion: </strong>Lymphocyte-based inflammatory indices showed distinct patterns in patients with APA and IHA. This study provides a better understanding of the implications of complete blood cell counts in patients with PA.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12020-025-04193-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Primary aldosteronism (PA) can be classified into aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) and is related to chronic inflammatory diseases. We compared lymphocyte-based inflammatory indices among patients with APA, IHA and essential hypertension (EH), and investigated the relationships between these indices and background factors in patients with PA.
Methods: A total of 186 patients (39 with APA, 48 with IHA, and 99 with blood-pressure-matched EH) were retrospectively included. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated as lymphocyte-based inflammatory indices.
Results: Lymphocyte count was lower in the APA group than in the IHA and EH groups. NLR and PLR were significantly higher in the APA group than in the IHA and EH groups. In the APA group, NLR correlated positively with plasma aldosterone concentration after the saline infusion test, while in the IHA group, NLR correlated positively with body mass index and negatively with flow-mediated dilation. Lymphocyte-based inflammatory indices did not differ significantly between KCNJ5-mutant and wild-type groups. NLR, MLR, and PLR remained unchanged from baseline to 1 week after adrenalectomy (ADX), but a cut-off baseline MLR of 0.18 was predictive of complete clinical success after ADX (sensitivity, 0.8095; specificity, 0.7222; area under the curve, 0.719).
Conclusion: Lymphocyte-based inflammatory indices showed distinct patterns in patients with APA and IHA. This study provides a better understanding of the implications of complete blood cell counts in patients with PA.
期刊介绍:
Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology.
Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted.
Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.