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Title: | A Multicenter Study of Neutrophil-to-Lymphocyte Ratio in Primary Aldosteronism. | Authors: | Shen J.;Li Q.;Young M.J.;Fuller P.J.;Yang J. ;Lim Y.Y.;Hoo J.;Chee M.R.;Hu J.;Libianto R. | Monash Health Department(s): | Endocrinology | Institution: | (Libianto, Shen, Young, Fuller, Yang) Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia (Libianto, Shen, Fuller, Yang) Department of Endocrinology, Monash Health, Clayton, VIC, Australia (Libianto, Chee, Hoo, Lim, Young, Yang) Department of Medicine, Monash University, Clayton, VIC, Australia (Hu, Li) Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Young) Cardiovascular Endocrinology Laboratory, Baker Heart and Diabetes Institute, Prahan, VIC, Australia | Issue Date: | 16-Feb-2021 | Copyright year: | 2020 | Publisher: | Endocrine Society | Place of publication: | United Kingdom | Publication information: | Journal of the Endocrine Society. 4 (12) (pp 1-9), 2020. Date of Publication: 01 Dec 2020. | Journal: | Journal of the Endocrine Society | Abstract: | Background: Hypertensive patients with primary aldosteronism (PA) have a higher risk of cardiovascular complications than those with blood pressure-matched essential hypertension. The excess cardiovascular consequences of PA can be attributed to the proinflammatory effect of excessive aldosterone and mineralocorticoid receptor activation in a range of peripheral tissues and cell types. The neutrophil-to-lymphocyte ratio (NLR) is a widely available marker of inflammation which has been shown to predict cardiovascular outcome in the general population. This study aims to evaluate the use of NLR as a potential biomarker of PA and PA severity. Method(s): Patients with PA (n = 355) were identified from 2 large PA databases in Australia and China, while controls (n = 222) were patients with hypertension who were referred for assessment but did not meet the diagnostic criteria for PA. The NLR was retrospectively collected from routine full blood examination, prior to commencement of targeted treatment for PA. Result(s): The NLR did not differ between PA patients and hypertensive controls (median 2.3 and 2.4, P = 0.563). However, among patients with PA, the NLR was positively correlated with baseline and post-saline aldosterone levels (r = 0.22 and P < 0.001 for both) and negatively correlated with serum potassium (r = -0.15, P = 0.006). Furthermore, in a logistic regression analysis of data from patients with PA, the NLR predicted the presence of comorbid chronic kidney disease (CKD) (defined as estimated glomerular filtration rate <60 mL/min/1.73m2) with an odds ratio of 1.5 (P = 0.003). Conclusion(s): While the NLR did not distinguish PA from controls, it was a marker of PA severity, being associated with aldosterone concentration as well as the presence of CKD. A prospective study is needed to further clarify the role of NLR in predicting end-organ damage associated with PA.Copyright © 2020 The Author(s). | DOI: | http://monash.idm.oclc.org/login?url= http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1210/jendso/bvaa153 |
ISSN: | 2472-1972 (electronic) | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/27296 | Type: | Article | Subjects: | male measurement *neutrophil lymphocyte ratio plasma renin activity potassium blood level *primary hyperaldosteronism/di [Diagnosis] priority journal retrospective study transthoracic echocardiography aldosterone/ec [Endogenous Compound] alpha adrenergic receptor blocking agent/dt [Drug Therapy] angiotensin receptor antagonist/dt [Drug Therapy] antihypertensive agent/dt [Drug Therapy] beta adrenergic receptor blocking agent/dt [Drug Therapy] biological marker/ec [Endogenous Compound] calcium channel blocking agent/dt [Drug Therapy] dihydropyridine/dt [Drug Therapy] dipeptidyl carboxypeptidase inhibitor/dt [Drug Therapy] diuretic agent/dt [Drug Therapy] hydralazine/dt [Drug Therapy] mineralocorticoid receptor/ec [Endogenous Compound] moxonidine/dt [Drug Therapy] potassium/ec [Endogenous Compound] prazosin/dt [Drug Therapy] renin/ec [Endogenous Compound] immunoassay analyzer DiaSorin Liaison analyzer multicenter study adult aldosterone blood level article Australia blood examination cerebrovascular accident China chronic kidney failure comorbidity controlled study coronary artery disease diabetes mellitus essential hypertension estimated glomerular filtration rate female heart left ventricle hypertrophy human *hypertension/dt [Drug Therapy] laboratory test logistic regression analysis major clinical study coronary artery disease diabetes mellitus essential hypertension estimated glomerular filtration rate female heart left ventricle hypertrophy human *hypertension / *drug therapy laboratory test logistic regression analysis major clinical study male measurement multicenter study *neutrophil lymphocyte ratio plasma renin activity potassium blood level *primary hyperaldosteronism / *diagnosis priority journal Article transthoracic echocardiography aldosterone blood level adult retrospective study Australia blood examination cerebrovascular accident China chronic kidney failure comorbidity controlled study |
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