Abstract:Objective To evaluate the relationship between aldosterone levels and the parathyroid hormone (PTH) .vitamin D.calcium axis in patients with primary aldosteronism (PA) , and compare it with non-secretory adrenal tumor (NS) patients with sufficient vitamin D levels. Methods A retrospective analysis was conducted on the clinical data of 79 adrenal tumor patients in the Department of Endocrinology, General Hospital of the Northern Theater from January 2022 to February 2024. The patients were divided into two groups: the PA group (n=30) and the NS group (n=49) . General data and laboratory test results were collected and compared between the two groups. The relationship between aldosterone and PTH levels in mineral metabolism was evaluated. Results Compared with the NS group, the PA group had higher levels of blood pressure, blood sodium, 2.hour aldosterone/renin activity ratio (ARR) , aldosterone, and PTH (P＜0.05) , while blood potassium and renin levels were lower (P＜0.05) . In both the overall cohort and the PA sub. group, aldosterone levels were positively correlated with PTH levels (overall queue r=0.474,P<0.001; PA queue r=0.750,P=0.032) . In multivariate analysis, both aldosterone concentration and urinary calcium excretion were significantly correlated with PTH levels［β=0.040 (0.012-0.067) , t=2.873,P=0.006; β=-4.160 (-6.616.-1.695) , t=3.378, P=0.001］, where as no significant correlation was found between 25 (OH) D or other bone metabolism parameters and PTH. Conclusion PTH levels are associated with aldosterone, which may be independent of 25 (OH) D levels and Whether aldosterone directly interacts with parathyroid hormone remains to be determined.