Inflammatory and nutritional indices in patients with pheochromocytoma

Belma Özlem Tural Balsak; Muzaffer Deniz; Narin Nasıroğlu İmga; Neslihan Çuhacı Seyrek; Oya Topaloğlu; Reyhan Ersoy; Bekir Çakır

Inflammatory and nutritional indices in patients with pheochromocytoma

Abstract

Aims: Pheochromocytoma is characterized by catecholamine excess, which may influence immune regulation and metabolic pathways. However, the relationship between catecholamine activity, systemic inflammation, and immune-nutritional status remains incompletely understood. This study aimed to evaluate inflammatory and nutritional indices in patients with pheochromocytoma and to investigate their association with tumor size and plasma metanephrine levels. Methods: In this retrospective study, 39 patients with pheochromocytoma were compared with 24 age-, sex-, and body mass index-matched healthy control subjects. Complete blood count parameters and inflammation-based indices, including neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score, were analyzed. Correlation analyses were performed to assess the relationships between inflammatory indices, plasma metanephrine levels, and tumor size. Results: Patients with pheochromocytoma had significantly higher WBC, neutrophil, and platelet counts than controls. SII was significantly elevated, whereas NLR, CONUT, and PNI did not differ between groups. Fasting glucose levels were higher in the pheochromocytoma group, while lipid parameters were comparable. Correlation analyses demonstrated PNI was negatively correlated with both tumor size and plasma metanephrine levels. SII showed positive correlations with NLR and PNI, and CONUT was positively correlated with NLR. Conclusion: Pheochromocytoma is associated with systemic inflammatory activation, as reflected by elevated leukocyte parameters and increased SII. Although overall nutritional indices were not significantly altered, the inverse association between PNI and tumor burden suggests that catecholamine excess may adversely affect immune-nutritional status. These findings highlight the complex immune-metabolic interplay in pheochromocytoma.

Keywords

References

Lenders JW, Duh QY, Eisenhofer G, et al. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(6):1915-1942. doi:10.1210/jc.2014-1498
Zuber SM, Kantorovich V, Pacak K. Hypertension in pheochromocytoma: characteristics and treatment. Endocrinol Metab Clin North Am. 2011; 40(2):295-vii. doi:10.1016/j.ecl.2011.02.002
Zhang W, Yu J, Chen Y, et al. Glucose disorders in patients with pheochromocytoma/paraganglioma: profile and influence effects in a large cohort with 705 patients. Endocr Pract. 2025;31(3):269-277. doi:10. 1016/j.eprac.2024.11.004
Zhang W, Zhou Y, Cui Y, et al. An in-depth exploration of the catecholamine and dyslipidemia relationship in pheochromocytoma and paraganglioma patients: a large Chinese cohort study. Endocrine. 2025;89(2):595-602. doi:10.1007/s12020-025-04277-w
Pongratz G, Straub RH. The sympathetic nervous response in inflammation. Arthritis Res Ther. 2014;16(6):504. doi:10.1186/s13075-014-0504-2
Bergmann M, Sautner T. Immunomodulatory effects of vasoactive catecholamines. Wien Klin Wochenschr. 2002;114(17-18):752-761.
Zheng K, Liu X, Ji W, Lu J, Cui J, Li W. The efficacy of different inflammatory markers for the prognosis of patients with malignant tumors. J Inflamm Res. 2021;14:5769-5785. doi:10.2147/JIR.S334941
Yang R, Chang Q, Meng X, Gao N, Wang W. Prognostic value of Systemic immune-inflammation index in cancer: a meta-analysis. J Cancer. 2018;9(18):3295-3302. doi:10.7150/jca.25691

Details

Primary Language

English

Subjects

Endocrinology

Journal Section

Research Article

Authors

Belma Özlem Tural Balsak ^*
0000-0002-1348-7706
Türkiye

Muzaffer Deniz
0000-0002-8905-3955
Türkiye

Narin Nasıroğlu İmga
0000-0001-8013-230X
Türkiye

Neslihan Çuhacı Seyrek
0000-0003-1042-3640
Türkiye

Oya Topaloğlu
0000-0003-2501-935X
Türkiye

Reyhan Ersoy
0000-0002-7437-1176
Türkiye

Bekir Çakır
0000-0001-7526-8827
Türkiye

Publication Date

May 22, 2026

Submission Date

March 1, 2026

Acceptance Date

April 9, 2026

Published in Issue

Year 2026 Volume: 8 Number: 3

IZ

https://izlik.org/JA72EX82XC

Cite

RIS / Bibtex

APA

Tural Balsak, B. Ö., Deniz, M., Nasıroğlu İmga, N., Çuhacı Seyrek, N., Topaloğlu, O., Ersoy, R., & Çakır, B. (2026). Inflammatory and nutritional indices in patients with pheochromocytoma. Anatolian Current Medical Journal, 8(3), 442-447. https://izlik.org/JA72EX82XC

AMA

1.Tural Balsak BÖ, Deniz M, Nasıroğlu İmga N, et al. Inflammatory and nutritional indices in patients with pheochromocytoma. Anatolian Curr Med J / ACMJ / acmj. 2026;8(3):442-447. https://izlik.org/JA72EX82XC

Chicago

Tural Balsak, Belma Özlem, Muzaffer Deniz, Narin Nasıroğlu İmga, et al. 2026. “Inflammatory and Nutritional Indices in Patients With Pheochromocytoma”. Anatolian Current Medical Journal 8 (3): 442-47. https://izlik.org/JA72EX82XC.

EndNote

Tural Balsak BÖ, Deniz M, Nasıroğlu İmga N, Çuhacı Seyrek N, Topaloğlu O, Ersoy R, Çakır B (May 1, 2026) Inflammatory and nutritional indices in patients with pheochromocytoma. Anatolian Current Medical Journal 8 3 442–447.

IEEE

[1]B. Ö. Tural Balsak et al., “Inflammatory and nutritional indices in patients with pheochromocytoma”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 3, pp. 442–447, May 2026, [Online]. Available: https://izlik.org/JA72EX82XC

ISNAD

Tural Balsak, Belma Özlem - Deniz, Muzaffer - Nasıroğlu İmga, Narin - Çuhacı Seyrek, Neslihan - Topaloğlu, Oya - Ersoy, Reyhan - Çakır, Bekir. “Inflammatory and Nutritional Indices in Patients With Pheochromocytoma”. Anatolian Current Medical Journal 8/3 (May 1, 2026): 442-447. https://izlik.org/JA72EX82XC.

JAMA

1.Tural Balsak BÖ, Deniz M, Nasıroğlu İmga N, Çuhacı Seyrek N, Topaloğlu O, Ersoy R, Çakır B. Inflammatory and nutritional indices in patients with pheochromocytoma. Anatolian Curr Med J / ACMJ / acmj. 2026;8:442–447.

MLA

Tural Balsak, Belma Özlem, et al. “Inflammatory and Nutritional Indices in Patients With Pheochromocytoma”. Anatolian Current Medical Journal, vol. 8, no. 3, May 2026, pp. 442-7, https://izlik.org/JA72EX82XC.

Vancouver

1.Belma Özlem Tural Balsak, Muzaffer Deniz, Narin Nasıroğlu İmga, Neslihan Çuhacı Seyrek, Oya Topaloğlu, Reyhan Ersoy, Bekir Çakır. Inflammatory and nutritional indices in patients with pheochromocytoma. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 May 1;8(3):442-7. Available from: https://izlik.org/JA72EX82XC