Comparison of Neutrophil/Lymphocyte and Platelet/Lymphocyte ratios of cases with adrenal adenoma diagnosed with primary hyperaldosteronism and cases with nonfunctional adrenal adenoma

Comparison of Neutrophil/Lymphocyte and Platelet/Lymphocyte ratios of cases with adrenal adenoma diagnosed with primary hyperaldosteronism and cases with nonfunctional adrenal adenoma. Objective: Primary hyperaldosteronism (PH) is an endocrinological disease associated with increased systemic inflammation. This study aimed to compare the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients diagnosed with PH during the investigation of adrenal adenomas with those in a control group of patients with adrenal adenomas but without any hormone secretion. Materials and Methods: The study included patients diagnosed with myelipoma, adrenal adenoma, and adrenal hyperplasia who were evaluated at the Karadeniz Technical University Faculty of Medicine Internal Medicine Polyclinics between 2014 and 2024. Patients with an aldosterone/renin ratio (ARO) of 75 and above and patients with an aldosterone level of 10 ng/dL and above in the saline infusion test were evaluated as having hyperaldosteronism. Demographic characteristics of the patients, laboratory data and clinical features at the time of diagnosis, and selected diagnostic and treatment methods were retrospectively examined. Results: In our study, 62.3% of the patients were female and 37.7% were male. The mean age of the patients at the time of diagnosis was 56.86 years. The patients had various comorbidities at the time of diagnosis. The mean plasma aldosterone concentration (PAC) at the time of diagnosis was 17.44 ± 0.61 ng/dL, mean plasma renin activity (PRA) was 2.98 ± 0.26 ng/ml/h, and mean ARO was 28.82 ± 3.53. The patients' mean glucose was 106.73 ± 2.10 mg/dl, mean creatinine was 0.79 ± 0.07 mg/dl, mean ALT was 22.13 ± 1.33 U/L, mean sodium was 144.06 ± 5.04 mmol/L, mean potassium was 4.32 ± 0.02 mEq/L, mean WBC was 7.43 ± 0.14 µL, mean hemoglobin (Hgb) was 13.58 ± 0.09 g/dL, mean neutrophil was 4.41 ± 0.11 µL, mean platelet (PLT) was 251.49 ± 4.64 µL, and mean lymphocyte was 3.26 ± 1.02 µL. Of the patients with adrenal adenoma, 22.7% were functional and 77.2% were non-functional. There were statistically significant differences in potassium, hemoglobin, ALT and lymphocyte values between the PH and non-PH groups (p values <0.001; 0.004; <0.005; 0.004, respectively). NLR and PLR levels, which are indicators of systemic inflammation in patients diagnosed with PH, were compared with non-functioning patients. While the mean NLR was 2.617 ± 0.201 in the PD group, this value was approximately 0.47 lower in the non-functional group. This difference was found to be statistically significant (p = 0.040), indicating that PD may be associated with systemic inflammation. The mean value of NLR in PD patients was 135.09 ± 5.66, approximately 32 units higher than in the non-functional group. However, this difference was not found to be statistically significant (p = 0.052). Conclusion: Our study demonstrates that PH may have an effect not only on electrolyte and blood pressure regulation but also on the inflammatory response. It is thought that biomarkers such as NLR, which are cheap, widely available and provide rapid results, may have a supportive role in the diagnosis of PH. The findings emphasize that early diagnosis is critical in preventing target organ damage and comorbid disease development, and show that NLR can be considered as a helpful tool in clinical decision-making processes. Keywords: Adrenal adenoma, Adrenal hyperplasia, Adrenal mass and hypertension, Aldosterone-producing adenoma, Primary hyperaldosteronism, Secondary hypertension