Lam Hung-Bun, Yang Po-Sheng, Chien Ming-Nan, Lee Jie-Jen, Chao Li-Fen, Cheng Shih-Ping
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan.
Arch Med Sci. 2019 Jul;15(4):880-886. doi: 10.5114/aoms.2018.74758. Epub 2018 Mar 28.
Primary hyperparathyroidism (PHPT) is associated with adverse cardiovascular outcomes which may result from an increase in systemic inflammation. Previously we have shown that serum parathyroid hormone (PTH) levels are independently associated with inflammatory indicators. The neutrophil-to-lymphocyte ratio (NLR) is an inexpensive, widely available marker of inflammation. In the present study, we aimed to assess the longitudinal changes in NLR before and after parathyroidectomy.
This retrospective study included 95 patients diagnosed with PHPT who underwent parathyroidectomy between 2006 and 2016. Follow-up complete blood counts were available in 31 patients.
At diagnosis, 43 (45%) patients presented with overt clinical symptoms and had higher serum calcium and PTH levels. Preoperative NLR was positively correlated with total white blood cell count ( = 0.001), serum calcium ( = 0.001), and PTH level ( = 0.013). The NLR was not associated with sex, age, comorbidities, or parathyroid weight. Among patients who were cured of PHPT, the median NLR decreased from 2.26 to 1.77 after parathyroidectomy ( = 0.037). There was no difference in hemoglobin, total white blood cells, or platelet count before and after surgery.
We found a positive correlation of preoperative NLR with calcium and PTH levels in PHPT patients. After curative parathyroidectomy, NLR modestly decreased without changes in other hematological parameters.
原发性甲状旁腺功能亢进症（PHPT）与不良心血管结局相关，这可能是由全身炎症增加所致。此前我们已经表明，血清甲状旁腺激素（PTH）水平与炎症指标独立相关。中性粒细胞与淋巴细胞比值（NLR）是一种廉价且广泛可用的炎症标志物。在本研究中，我们旨在评估甲状旁腺切除术前和术后NLR的纵向变化。
这项回顾性研究纳入了95例在2006年至2016年间接受甲状旁腺切除术的PHPT确诊患者。31例患者有随访时的全血细胞计数结果。
在诊断时，43例（45%）患者出现明显临床症状，且血清钙和PTH水平较高。术前NLR与白细胞总数（ = 0.001）、血清钙（ = 0.001）和PTH水平（ = 0.013）呈正相关。NLR与性别、年龄、合并症或甲状旁腺重量无关。在治愈的PHPT患者中，甲状旁腺切除术后NLR中位数从2.26降至1.77（ = 0.037）。手术前后血红蛋白、白细胞总数或血小板计数无差异。
我们发现PHPT患者术前NLR与钙和PTH水平呈正相关。根治性甲状旁腺切除术后，NLR适度下降，其他血液学参数无变化。
