Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 0 0 2026 08 08 1 7 Liqun Wang Department of Endocrinology, The Second Hospital of Yinzhou, Ningbo, China Qing Li Department of Endocrinology, The Second Hospital of Yinzhou, Ningbo, China Fei Xie Department of Endocrinology, The Second Hospital of Yinzhou, Ningbo, China Xiaojing Wang Department of Endocrinology, The Second Hospital of Yinzhou, Ningbo, China Lingyan Ruan Department of Endocrinology, The Second Hospital of Yinzhou, Ningbo, China Qian Chen Department of Endocrinology, The Second Hospital of Yinzhou, Ningbo, China Endi Song Department of Endocrinology, The Second Hospital of Yinzhou, Ningbo, China Jiangyong Lou Department of Urology, The Second Hospital of Yinzhou, Ningbo, China 2025 11 18 2026 04 21 This study aimed to characterize serum immune-inflammatory biomarkers in primary aldosteronism (PA) and to evaluate their correlations and independent associations with target organ damage (TOD) using a propensity score–matched cohort design. This retrospective propensity score–matched (PSM) cohort study included 80 patients initially diagnosed with PA (PA group) and 80 matched patients with essential hypertension (EH group) between February 2021 and February 2025. Serum levels of C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and monocyte chemoattractant protein 1 (MCP-1) were measured. TOD assessment included left ventricular mass index (LVMI), carotid intima-media thickness (IMT), and renal parameters (urinary albumin to creatinine ratio [UACR] and estimated glomerular filtration rate [eGFR]). Group comparisons, correlation analyses, and multivariate logistic regression were performed. After matching, baseline characteristics were balanced. The PA group had significantly higher levels of all four biomarkers and a higher prevalence of cardiac, vascular, and renal damage. Sensitivity analyses confirmed consistent associations across all organ systems. Elevated IL-6 and CRP strongly correlated with TOD indicators and were independently associated with composite TOD in multivariate analysis (IL-6: OR=1.86; CRP: OR=1.52). PA is associated with a distinct immune-inflammatory phenotype. IL-6 and CRP are independently associated with multi-system TOD and may serve as practical biomarkers for early risk stratification and timely intervention. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4663 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4663/2384