Szydełko Joanna, Szydełko-Gorzkowicz Magdalena, Matyjaszek-Matuszek Beata
Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland.
Department of Obstetrics and Perinatology, Independent Public Clinical Hospital No. 4 in Lublin, Jaczewskiego 8, 20-954 Lublin, Poland.
J Clin Med. 2021 Sep 3;10(17):3997. doi: 10.3390/jcm10173997.
Acromegaly is a rare disease caused by overproduction of growth hormone (GH) by a pituitary adenoma, and consequently increased insulin-like growth factor 1 (IGF-1) concentration. The GH/IGF-1 axis and immune cells interactions are hypothesized to be involved in subclinical inflammation. This retrospective study aimed to investigate the differences in neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR) ratios, and systemic immune-inflammation index (SII) in GH-secreting adenomas compared with non-functioning pituitary adenomas (NFPAs) concerning clinical and radiological findings. After evaluation of 665 patients with pituitary tumors, 62 individuals with newly diagnosed acromegaly and 134 with NFPAs were enrolled in the analysis. The control group consisted of 120 healthy individuals. Fifty-eight patients with acromegaly were re-evaluated after medical or surgical therapies. NLR, PLR, SII values, and neutrophil count were significantly higher ( ≤ 0.001), whereas lymphocyte count was lower in acromegaly than in NFPAs ( = 0.001). No significant differences between NFPAs and controls were observed in analyzed ratios. Higher preoperative NLR, PLR, SII values were found in patients who failed to achieve a cure with surgery ( < 0.05). Although NLR, PLR, and SII values were significantly higher in acromegaly, these indices cannot be used to discriminate GH-secreting pituitary tumors from NFPAs. Treatment of acromegaly decreased the value of NLR and SII, but it requires further studies to consolidate the real clinical role of these inflammation-related ratios.
肢端肥大症是一种罕见疾病,由垂体腺瘤过度分泌生长激素(GH)引起,进而导致胰岛素样生长因子1(IGF-1)浓度升高。据推测,GH/IGF-1轴与免疫细胞的相互作用参与了亚临床炎症。这项回顾性研究旨在调查与无功能垂体腺瘤(NFPA)相比,生长激素分泌型腺瘤患者在中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)以及全身免疫炎症指数(SII)方面在临床和影像学表现上的差异。在评估了665例垂体肿瘤患者后,62例新诊断的肢端肥大症患者和134例NFPA患者被纳入分析。对照组由120名健康个体组成。58例肢端肥大症患者在接受药物或手术治疗后进行了重新评估。肢端肥大症患者的NLR、PLR、SII值和中性粒细胞计数显著更高(≤0.001),而淋巴细胞计数低于NFPA患者(=0.001)。在分析的比值中,未观察到NFPA与对照组之间存在显著差异。手术未能治愈的患者术前NLR、PLR、SII值更高(<0.05)。尽管肢端肥大症患者的NLR、PLR和SII值显著更高,但这些指标不能用于区分生长激素分泌型垂体肿瘤与NFPA。肢端肥大症的治疗降低了NLR和SII值,但需要进一步研究来巩固这些炎症相关比值的实际临床作用。