{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:17:57Z","timestamp":1792685877889,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":45,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Peking University First Hospital","award":["2019CR22"],"award-info":[{"award-number":["2019CR22"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p><jats:italic>Objective<\/jats:italic>. Assessing excess adrenal hormones is important in patients with adrenal mass. Current screening tests for excess cortisol hormones are complex, so it cannot be done sometimes due to the limited medical resources. The aim of the study was to evaluate whether the neutrophil\u2010lymphocyte ratio (NLR) can be used as an initial screening biomarker for Cushing\u2019s syndrome (CS) in patients with an adrenal mass. <jats:italic>Methods<\/jats:italic>. This retrospective study included a total of 185 patients with CS and 185 patients with nonfunctional adrenal adenoma (matched 1\u2009:\u20091 by sex, body mass index, and discharge date). The NLR was compared between the two groups. The association between NLR and serum and urinary cortisol concentrations was analyzed, and an NLR cut\u2010off value for CS screening was calculated. <jats:italic>Results<\/jats:italic>. NLR (3.38 (2.33, 5.45) vs. 2.13 (1.74, 3.00), <jats:italic>P<\/jats:italic> &lt; 0.001) was significantly higher in the CS group than in the nonfunctional adenoma group. In CS patients, the NLR was positively associated with serum cortisol concentrations at 8\u2009am, with 24\u2010hour urine free cortisol and with serum cortisol after a 1\u2009mg dexamethasone suppression test (<jats:italic>P<\/jats:italic> &lt; 0.001 each). An NLR cut\u2010off of 2.2 had a sensitivity of 80.0% and a specificity of 54.05%. The weighted Youden index for the NLR was similar to that of the 24\u2010hour urine free cortisol and late\u2010night serum cortisol tests, which are recommended initial tests for CS diagnosis. <jats:italic>Conclusion<\/jats:italic>. The NLR may be useful for initial screening for CS among patients with an adrenal mass as an easy and convenient marker.<\/jats:p>","DOI":"10.1155\/2021\/6635594","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T03:11:27Z","timestamp":1613531487000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Neutrophil\u2010Lymphocyte Ratio as an Initial Screening Biomarker for Differential Diagnosis of Cushing\u2019s Syndrome from Nonfunctional Adenoma in Patients with an Adrenal 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