{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:15:26Z","timestamp":1793333726549,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>Inflammatory biomarkers, such as absolute neutrophil and lymphocyte counts, neutrophil-to-lymphocyte ratio (NLR), platelet (PLT)-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR), are associated with the progression and development of several disorders. Although patients with Cushing syndrome (CS) have immunosuppression with altered leucocyte counts, the profile of the inflammatory biomarkers in these patients has not been extensively studied.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Design<\/jats:title>\n<jats:p>We compared a panel of inflammatory biomarkers in patients with active endogenous CS (<jats:italic>n<\/jats:italic> of complete blood count (CBC) reports\u2009=\u2009319) and eucortisolemic subjects of similar age, gender and BMI (<jats:italic>n<\/jats:italic> of CBC reports\u2009=\u200993). Patients were divided into two age groups (6\u201312 years at the time of CBC and &gt;12 years at the time of CBC) based on age differences in normal reference ranges.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Patients with CS had higher NLR vs controls (6\u201312 years: 2.47 (1.86, 3.32) vs 1.35 (1.11, 2.27), <jats:italic>P<\/jats:italic>\u2009 &lt; 0.0001; &gt;12 years: 3.00 (2.23\u20134.17) vs 1.80 (1.23\u20132.31), <jats:italic>P<\/jats:italic>\u2009 &lt; 0.0001). Similarly, absolute neutrophil and lymphocyte counts, MLR and PLR differed between patients with CS and controls. The inflammatory biomarkers correlated with indices of cortisol secretion, such as midnight serum cortisol, 24-h urinary free cortisol and morning cortisol. On receiver operating characteristic analysis, NLR showed high area under the curve (AUC) (6\u201312 years: cutoff of 1.72 had AUC: 0.77, &gt;12 years: cutoff of 2.35 had AUC: 0.81).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>We conclude that multiple inflammatory biomarkers differed between patients with CS and controls suggesting substantial effects of hypercortisolemia on the immune system.<\/jats:p>\n<\/jats:sec>","DOI":"10.1530\/eje-21-1199","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T19:23:13Z","timestamp":1645039393000},"page":"503-510","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-7","source":"Crossref","is-referenced-by-count":17,"title":["Inflammatory biomarkers in the evaluation of pediatric endogenous Cushing syndrome"],"prefix":"10.1093","volume":"186","author":[{"given":"Rachel","family":"Wurth","sequence":"first","affiliation":[{"name":"1Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Rescigno","sequence":"additional","affiliation":[{"name":"1Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsi","family":"Flippo","sequence":"additional","affiliation":[{"name":"1Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantine A","family":"Stratakis","sequence":"additional","affiliation":[{"name":"1Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland, USA"},{"name":"2Human Genetics & Precision Medicine, IMBB, FORTH, Heraklion, Crete, Greece"},{"name":"2Human Genetics & Precision Medicine, IMBB, FORTH, Heraklion, Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2882-4584","authenticated-orcid":true,"given":"Christina","family":"Tatsi","sequence":"additional","affiliation":[{"name":"1Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/186\/4\/EJE-21-1199.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/downloadpdf\/journals\/eje\/186\/4\/EJE-21-1199.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:17:40Z","timestamp":1676391460000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/186\/4\/503\/6852988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,1]]},"references-count":0,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.1530\/eje-21-1199","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,1]]}}}