The International Journal of Romanian Society of Endocrinology / Registered in 1938

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January - March 2019, Volume 15, Issue 1

Toraman A, Aras F, Hekimsoy Z, Kursat S

Is There a Relationship between Parathyroid Hormone and Neutrophil Lymphocyte Ratio or Platelet Lymphocyte Ratio?

Acta Endo (Buc) 2019, 15 (1): 96-101
doi: 10.4183/aeb.2019.96

Context. Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are recent prognostic markers associated with inflammation in many diseases such as chronic kidney disease (CKD), malignancies, myocardial infarction. Objective. In this study, we investigated the relationship between NLR-PLR and parathyroid hormone (PTH) and vitamin D in patients with high PTH levels. Design. The patients with high PTH levels in Nephrology and Endocrinolgy Outpatient clinics were evaluated retrospectively. Subjects and methods. The medical records of the patients were examined and clinical data, including demographic details, clinical and laboratory findings, treatment and follow-up data were obtained. NLR and PLR were calculated. Serum creatinine, calcium, phosphorus, magnesium, lipid levels, calcium phosphorus product, PTH and vitamin D values were investigated. The relationship between NLR-PLR and laboratory parameters, GFR (MDRD-GFR), PTH and vitamin D were investigated. Results. 48 male and 253 female patients were enrolled in this study. The mean age was 57.57±13.28. NLR correlated negatively with albumin, hemoglobin, vitamin D, calcium and cholesterol and it positively correlated with creatinine and PTH. Multiple regression analysis showed that main determinants of NLR were PTH, albumin, LDLcholesterol, hemoglobin and gender. Conclusions. In this study NLR and PLR correlated negatively with hemoglobin and cholesterol. Positive correlation between NLR and creatinine could be explained by increased degrees of inflammation associated with more pronounced degrees of renal dysfunction. The impact of PTH on NLR was independent of GFR. In multiple regression model this suggests that PTH could be a pro-inflammatory parameter independent of the degree of renal dysfunction.

Keywords: Hyperparathyroidism, neutrophil lymphocyte ratio, platelet lymphocyte ratio, inflammation, chronic kidney disease.

Correspondence: Aysun Toraman MD, “Celal Bayar” University, “Hafsa Sultan” Hospital, Dept. of Nephrology, Manisa, 45110, Turkey, E-mail: