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Tokgöz Çakır B, Aktemur G, Karabay G, Şeyhanlı Z, Çetin S, Filiz AA, Vanlı Tonyalı N, Çağlar AT. Evaluation of Platelet Indices and Inflammation Markers in Preeclampsia. J Clin Med 2025; 14:1406. [PMID: 40094777 PMCID: PMC11900627 DOI: 10.3390/jcm14051406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2025] [Revised: 02/04/2025] [Accepted: 02/10/2025] [Indexed: 03/19/2025] Open
Abstract
Background: Preeclampsia is a serious pregnancy complication known to be related to the pathophysiology of platelet dysfunction and inflammation. The aim of this study was to investigate the role of platelet indices and inflammatory markers in preeclampsia and their importance in predicting adverse neonatal outcomes. Methods: A total of 118 preeclampsia cases (84 with mild preeclampsia and 34 with severe preeclampsia) and 118 healthy pregnant women were included in the study. Blood samples obtained at the time of preeclampsia diagnosis were analyzed for platelet indices (platelet count (PC), platelet distribution width (PDW), mean platelet volume (MPV), and platelet/large cell ratio (P-LCR)) and inflammation indices (neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-lymphocyte ratio (MPVLR)). Results: The PC and PLR were lower in the severe preeclampsia group compared to the other groups. The PDW was higher in both mild and severe preeclampsia groups compared to the control group. A PDW value above 13.15 was identified as a significant predictor of composite adverse neonatal outcomes (area under the curve (AUC): 0.633; sensitivity: 60.9%; specificity: 58%). Conclusions: PC and PLR decrease in severe preeclampsia. This study highlights the potential of PDW as a marker for predicting adverse neonatal outcomes in preeclampsia.
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Affiliation(s)
- Betül Tokgöz Çakır
- Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, Türkiye; (G.A.); (G.K.); (Z.Ş.); (A.A.F.); (N.V.T.); (A.T.Ç.)
| | - Gizem Aktemur
- Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, Türkiye; (G.A.); (G.K.); (Z.Ş.); (A.A.F.); (N.V.T.); (A.T.Ç.)
| | - Gülşan Karabay
- Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, Türkiye; (G.A.); (G.K.); (Z.Ş.); (A.A.F.); (N.V.T.); (A.T.Ç.)
| | - Zeynep Şeyhanlı
- Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, Türkiye; (G.A.); (G.K.); (Z.Ş.); (A.A.F.); (N.V.T.); (A.T.Ç.)
| | - Sevinç Çetin
- Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara 06170, Türkiye;
| | - Ahmet Arif Filiz
- Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, Türkiye; (G.A.); (G.K.); (Z.Ş.); (A.A.F.); (N.V.T.); (A.T.Ç.)
| | - Nazan Vanlı Tonyalı
- Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, Türkiye; (G.A.); (G.K.); (Z.Ş.); (A.A.F.); (N.V.T.); (A.T.Ç.)
| | - Ali Turhan Çağlar
- Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, Türkiye; (G.A.); (G.K.); (Z.Ş.); (A.A.F.); (N.V.T.); (A.T.Ç.)
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Li Y, Xiang W, Xue H, Meng T, Zhang T, Zhang J, Wang J, Zhao J, Wang B. The impact of platelet indices on ischemic stroke: a Mendelian randomization study and mediation analysis. Front Neurol 2023; 14:1302008. [PMID: 38145119 PMCID: PMC10741650 DOI: 10.3389/fneur.2023.1302008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Platelet indices (PIs) are hematological parameters that indicate the number, morphology, and activation of platelets. Although some clinical trials suggest an association between PIs and the risk of stroke, the lack of robust evidence is attributed to confounding effects and reverse causation. Objective This study aimed to evaluate the association between PIs and stroke risk through Mendelian randomization (MR) while exploring the mediating effect of blood pressure in this association. Methods We identified genetic variants associated with PIs, including platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), and platelet crit (PCT), in the UK Biobank (n = 350,474). Relevant genome-wide association studies were utilized to gather summary statistics pertaining to the traits of interest. We primarily used the inverse-variance weighted analysis to obtain estimates for individual causal power. Result We observed a positive correlation between genetically predicted increases in PCT levels with the stroke onset [PCT: OR (95%CI) = 1.113(1.047, 1.183), p < 0.001]. However, no significant causal relationship was found between PLT, PDW, and MPV and the risk of stroke [PLT: OR (95%CI) = 1.037(0.979, 1.098), p = 0.221; PDW: OR (95%CI) = 0.973(0.923, 1.024), p = 0.294; MPV: OR (95%CI) = 0.990(0.945, 1.038), p = 0.675]. Multivariable MR analyses and mediation analysis found that the proportion mediated by systolic blood pressure (SBP) is 23.71% [95%CI (10.85-33.31%)] and the proportion mediated by diastolic blood pressure (DBP) is 28.09% [95%CI (12.92-39.63%)]. Conclusion This large MR study presents evidence for the potential causal relationship between the PCT level and the risk of ischemic stroke, which might be mediated by blood pressure.
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Affiliation(s)
- Yang Li
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Wenping Xiang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Hui Xue
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Tianyu Meng
- Graduate School, Chongqing Medical University, Chongqing, China
| | - Tianyou Zhang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Jinfeng Zhang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Jingbo Wang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Jili Zhao
- Graduate School, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Baojun Wang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
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Woldeamanuel GG, Tlaye KG, Wu L, Poon LC, Wang CC. Platelet count in preeclampsia: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2023; 5:100979. [PMID: 37098392 DOI: 10.1016/j.ajogmf.2023.100979] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVE Many studies have reported the association between platelets and preeclampsia. However, sample sizes were small, and their findings were inconsistent. We conducted a systematic review and meta-analysis to evaluate the association in pooled samples and in detail. DATA SOURCES A systematic literature search was performed using Medline, Embase, ScienceDirect, Web of Science, Cochrane Library, NICHD-DASH, LILACS, and Scopus from inception to April 22, 2022. STUDY ELIGIBILITY CRITERIA Observational studies comparing platelet count between women with preeclampsia and normotensive pregnant women were included. METHODS The mean differences with 95% confidence interval in platelet count were calculated. Heterogeneity was assessed using I2 statistics. Sensitivity and subgroup analyses were conducted. Statistical analysis was performed using RevMan 5.3 and ProMeta 3 software. RESULTS A total of 56 studies comprising 4892 preeclamptic and 9947 normotensive pregnant women were included. Meta-analysis showed that platelet count was significantly lower in women with preeclampsia than in normotensive controls (overall: mean difference, -32.83; 95% confidence interval, -40.13 to -25.52; P<.00001; I2=92%; mild preeclampsia: mean difference, -18.65; 95% confidence interval, -27.17 to -10.14; P<.00001; I2=84%; severe preeclampsia: mean difference, -42.61; 95% confidence interval, -57.53 to -27.68; P<.00001; I2=94%). Significantly lower platelet count was also observed in the second trimester (mean difference, -28.84; 95% confidence interval, -44.59 to -13.08; P=.0003; I2=93%), third trimester (mean difference, -40.67; 95% confidence interval, -52.14 to -29.20; P<.00001; I2=92%), and before the diagnosis of preeclampsia (mean difference, -18.81; 95% confidence interval, -29.98 to -7.64; P=.009; I2=87%), but not in the first trimester (mean difference, -15.14; 95% confidence interval, -37.71 to 7.43; P=.19; I2=71%). Overall, the pooled sensitivity and specificity of platelet count were 0.71 and 0.77, respectively. The area under the curve was 0.80. CONCLUSION This meta-analysis confirmed that platelet count was significantly lower in preeclamptic women, irrespective of severity and presence or absence of associated complications, even before the onset of preeclampsia and in the second trimester of pregnancy. Our findings suggest that platelet count may be a potential marker to identify and predict preeclampsia.
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Affiliation(s)
- Gashaw Garedew Woldeamanuel
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Kenean Getaneh Tlaye
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Ling Wu
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Liona C Poon
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR.
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Wu J, Zhang J, Yang J, Zheng TQ, Chen YM. Association between platelet indices and risk of preeclampsia in pregnant women. J OBSTET GYNAECOL 2022; 42:2764-2770. [PMID: 35959779 DOI: 10.1080/01443615.2022.2109136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We aimed to examine the association between the platelet indices and the risk of preeclampsia (PE) at different gestational weeks (GW) to explore the feasibility of early prediction of PE with these indices. About 7314 normotensive pregnant women and 396 PE patients were included and platelet indices, including platelet count (PC), plateletcrit (PCT), platelet distribution width (PDW), mean platelet volume (MPV) at different gestational weeks (1-12, 13-28, 29-32, 33-36 and 37-41 GW) were compared in two statistical methods. Patients with PE tended to have higher means of PC, PCT, PDW and MPV than normal pregnant women at early stage of pregnancy. The odds of PE were significantly increased with the increase of PC, PCT, PDW and MPV both at 13-28 GW and 29-32 GW, which indicated that increased values of PC, PCT, PDW and MPV at 13-32 GW were associated with greater subsequent risk of preeclampsia. Increased PC, PCT, PDW and MPV may have potential to predict preeclampsia before the disease onset.Impact StatementWhat is already known on this subject? Previous studies indicated that preeclampsia patients may have decreased platelet count (PC), plateletcrit (PCT) and increased platelet distribution width (PDW) and mean platelet volume (MPV). Increased PDW and MPV or decreased PC/MPV may have predictive values for PE.What do the results of this study add? The discrepancy with previous studies lay in the increased values of PC and PCT in PE patients at early stage of pregnancy. The study indicated that increased PC, PCT, PDW and MPV may have potential to predict preeclampsia far ahead of the disease onset. The results may reflect the abnormal turnover of platelets in PE patients.What are the implications of these findings for clinical practice and/or further research? These findings may help to guide early interventions before progress to overt preeclampsia by predicting onset of preeclampsia via easily available platelet indices in early weeks of gestation, which is especially valuable in areas lacking medical resources. The inconsistency with previous studies can facilitate researchers to further explore the coagulation mechanism beneath preeclampsia and pay more attention to the dynamic changes of platelet indices and other coagulation indices during pregnancy.
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Affiliation(s)
- Jinjuan Wu
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jing Zhang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jinying Yang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Thomas Qintian Zheng
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China.,Department of Obstetrics and Gynecology, Valleywise Health/District Medical Group, 2601 E. Roosevelt Road, Phoenix, AZ, USA.,Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Yu-Ming Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China
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Walle M, Gelaw Y, Getu F, Asrie F, Getaneh Z. Preeclampsia has an association with both platelet count and mean platelet volume: A systematic review and meta-analysis. PLoS One 2022; 17:e0274398. [PMID: 36103491 PMCID: PMC9473393 DOI: 10.1371/journal.pone.0274398] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 08/26/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Preeclampsia (PE) is a pregnancy-specific disorder characterized by endothelial dysfunction, and activation of the coagulation system. Alteration of PLT parameters is the common hematological abnormality observed in women with PE. The main aim of this study was to systematically review previous studies from around the world to generate evidence about the relationship between platelet count (PC) and PE, as well as mean platelet volume (MPV) and PE, by calculating the pooled weighted mean difference (WMD) of PC and MPV between PE and normotensive (NT) groups.
Methods
Relevant articles which were published in the English language from January 10, 2011, to January 10, 2021, were systematically searched through PubMed, Web of Science, and African journals online. In addition, reference probing of published articles searching was employed through Google Scholar and Google for searching grey literature. The methodological qualities of articles were assessed using Joana Brigg’s institute critical appraisal checklist. A random-effects model was used to estimate pooled WMD of PLT parameters between the two groups with the respective 95% confidence intervals (CI) using Stata version 11.0. The I2 statistics and Egger’s regression test were used to assess heterogeneity and publication bias among included studies, respectively.
Results
A total of 25 articles were included in this systematic review and meta-analysis. Of which, 23 studies were used in each PC and MPV analysis. The overall pooled WMD of PC and MPV between PE and NT groups were -41.45 × 109/L [95% CI; -51.8, -31.0] and 0.98 fl [95% CI; 0.8, 1.1], respectively. The pooled WMD revealed that PC decreased significantly in the PE group compared to the NT group while MPV increased significantly in the PE group.
Conclusions
This systematic review and meta-analysis indicated that there is a significant decrease in PC and a significant increase in MPV during PE development among pregnant women. As a result, a change in these parameters among pregnant women may indicate the development of PE.
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Affiliation(s)
- Muluken Walle
- Medicallaboratory Science Department, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Yemataw Gelaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fasil Getu
- Medicallaboratory Science Department, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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First Trimester Mean Platelet Volume, Neutrophil to Lymphocyte Ratio, and Platelet to Lymphocyte Ratio Values Are Useful Markers for Predicting Preeclampsia. Ochsner J 2022; 21:364-370. [PMID: 34984051 PMCID: PMC8675624 DOI: 10.31486/toj.21.0026] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Preeclampsia complicates 2% to 8% of all pregnancies. Systemic inflammatory response (SIR) markers are widely used in the diagnosis of many inflammatory diseases and in the prediction of complicated pregnancies. This study examined the diagnostic value of SIR markers during the first trimester of pregnancy to predict preeclampsia development. Methods: This retrospective case-control study was conducted from January 2020 to May 2020. We included 94 patients diagnosed with mild preeclampsia, 107 patients diagnosed with severe preeclampsia, and 100 normotensive pregnant patients as controls. We obtained the first trimester (6 to 14 weeks) complete blood cell counts for all patients. We used a receiver operating characteristic curve to evaluate the cutoff, sensitivity, and specificity values. Results: First trimester mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) values were significantly higher in patients who developed preeclampsia in later pregnancy weeks. The optimal cutoff value for MPV was 10.65 fL, with a sensitivity of 63.7% and a specificity of 65.0%. The best predictor for preeclampsia was NLR at an optimal cutoff value of 4.12, with a sensitivity of 82.1% and specificity of 62.0%. At a cutoff value of 131.8, PLR predicted preeclampsia with a sensitivity rate of 65.0% and a specificity rate of 60.2%. Conclusion: The results of this study suggest that first trimester MPV, NLR, and PLR values are clinically useful markers in the prediction of preeclampsia. The increased first trimester values of MPV, NLR, and PLR also indicate that inflammation may play a crucial role in preeclampsia pathogenesis.
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Medjedovic E, Kurjak A. The Importance of Doppler Analysis of Uterine Circulation in Pregnancy for a Better Understanding of Preeclampsia. Med Arch 2021; 75:424-430. [PMID: 35169369 PMCID: PMC8802687 DOI: 10.5455/medarh.2021.75.424-430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The etiology of preeclampsia has still not been completely explained. Early identification of women with the risk of developing preeclampsia is a key goal of antenatal care. OBJECTIVE To investigate risk factors for preeclampsia from the history, laboratory and ultrasound findings (Doppler). METHODS Pregnant women with normal Doppler sonography in the second trimester of pregnancy were classified as a control group, while pregnant women with impaired Doppler in the second trimester were considered as the investigated group with presumably increased risk for preeclampsia. A total number of 80 patients was included in the study (40 patients in each group). RESULTS The difference of urea, uric acid and lactate dehydrogenase (LDH) in the serum of the control and investigated group was statistically significant, while the differences were not statistically significant for creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The presence of a notch sign during assessment of blood flow in uterine arteries in subjects in the investigated group with the diagnosis of preeclampsia had the specificity of 47.62%, and sensitivity of 88.89%. The positive predictive value of a notch sign during assessment of blood flow in uterine arteries as a marker for diagnosis of preeclampsia in the second trimester of pregnancy was 90.91%, and its negative. Systolic and diastolic blood pressure are dependent variables which are predicting preeclampsia, whilst a notch sign in uterine arteries was designated as an independent variable predicting preeclampsia. CONCLUSION From the laboratory tests the following parameters were considered as the risk factors for preeclampsia: increasing levels of urea, uric acid, and LDH. Notch sign was considered to be a very strong predictor of preeclampsia, especially if present bilaterally. Doppler sonography in the second trimester of pregnancy is a good predictor for early diagnosis of preeclampsia.
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Affiliation(s)
- Edin Medjedovic
- Clinic of Gynecology and Obstetrics, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Department of Gynecology, Obstetrics and Reproductive medicine, School of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Asim Kurjak
- Department of Gynecology, Obstetrics and Reproductive medicine, School of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
- Department of Obstetrics and Gynecology, Medical School University of Zagreb, Zagreb, Croatia
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Sachan R, Patel ML, Vandana, Sachan P, Shyam R. Role of platelet count and mean platelet volume and red cell distribution width in the prediction of preeclampsia in early pregnancy. J Family Med Prim Care 2021; 10:838-843. [PMID: 34041086 PMCID: PMC8138391 DOI: 10.4103/jfmpc.jfmpc_1528_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/16/2020] [Accepted: 09/27/2020] [Indexed: 01/27/2023] Open
Abstract
Introduction: Mean platelet volume (MPV), platelet count (PC), and red cell distribution width (RDW) are various blood indices that play important role in preeclampsia. This study aimed to evaluate the role of MPV, RDW, and PC for the prediction of preeclampsia in the early second trimester of pregnancy and to observe its correlation with disease severity. Material and Methods: A prospective case-control study was conducted for 1 year in the Department of Obstetrics and Gynecology. A total of 543 healthy pregnant women were recruited, after obtaining informed consent and ethical clearance and followed till 6 weeks postpartum, 43 were lost to follow-up. Out of 500 women, nonsevere preeclampsia (NSPE) occurred in 16 women and severe preeclampsia (SPE) in 34 women. Around 51 healthy normotensive pregnant women were recruited after systematic randomization from the same cohort, who had not developed the disease, served as controls. NSPE and SPE were defined as per ACOG 2013b guideline. MPV, RDW, and PC were measured two times by the Siemens Advia analyzer; the first samples were withdrawn at the time of enrolment and the next sample was taken after the development of the disease, and both samples were analyzed. Results: MPV was increased with the severity of preeclampsia, diagnostic accuracy was 69.4%, at a cutoff value of ≥9.05 fl and MPV discriminated controls and NSPE with 50.0% sensitivity and 82.4% specificity. To discriminate between controls and SPE, diagnostic accuracy was 74.6% at a cutoff value of ≥9.05 fl, with a sensitivity of 50%. For control versus SPE, MPCs at the cutoff value of ≥2.085 lac/mm3 had sensitivity 52.9% and specificity 66.7%, and diagnostic accuracy 61.2%. For RDW NSPE, at a cutoff value of ≥11.5%, it discriminated against controls and NSPE with 85.3% sensitivity and 49.0% specificity. Conclusion: NSPE, MPV, RDW, and PCs had good discriminatory value with the severity of the disease.
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Affiliation(s)
- Rekha Sachan
- Department of Obstetrics and Gynecology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Munna Lal Patel
- Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Vandana
- Department of Obstetrics and Gynecology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Pushplata Sachan
- Department of Physiology, Career Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Radhey Shyam
- Department of Geriatric Mental Health, King George Medical University, Lucknow, Uttar Pradesh, India
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Kang SY, Wang Y, Zhou LP, Zhang H. New indicators in evaluation of hemolysis, elevated liver enzymes, and low platelet syndrome: A case-control study. World J Clin Cases 2021; 9:1259-1270. [PMID: 33644193 PMCID: PMC7896688 DOI: 10.12998/wjcc.v9.i6.1259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/16/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) are considered new markers of the systemic inflammatory response (SIR), and have been widely implemented for the diagnosis of patients with inflammatory diseases. These new indicators have also been widely investigated in preeclampsia (PE) but less analyzed in hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome.
AIM To compare SIR markers among HELLP patients, PE only patients, and healthy gravidae.
METHODS This retrospective case-control study enrolled 630 cases, including 210 patients with HELLP syndrome (HELLP group), 210 patients with only PE (PE group) and 210 healthy gravidae (control group). The three groups were matched by age, parity, status of assisted reproduction, and multiple pregnancies. Birthweight, gestational age at complete blood count collection, gestational age at delivery, mode of delivery, etc. were recorded. The main indices as NLR, PLR, MPV, PDW, and RDW among the groups were compared, as well as some secondary outcomes including neutrophil, platelets, and hemoglobin.
RESULTS The NLR (6.4 vs 4.3 vs 3.5), MPV (11.9 vs 11.2 vs 10.7), PDW (16.4 vs 13.3 vs 14.2), leukocyte (12.4 × 109/L vs 9.7 × 109/L vs 8.7 × 109/L) and neutrophil count (9.9 × 109/L vs 7.3 × 109/L vs 6.1 × 109/L) were highest in the HELLP group, lower in the PE group, and lowest in the control group. Both the overall comparisons between the three groups (all bP < 0.01) and pairwise comparisons between every two groups elicited statistically significant differences (all dP < 0.01, except control vs PE: cP < 0.05 in PDW). The average lymphocyte counts were 1.4 (1.1, 2.0) × 109/L in the HELLP group, 1.6 (1.3, 2.0) × 109/L in the PE group and 1.7 (1.4, 2.0) × 109/L in the control group. The overall comparison of lymphocyte count within the three groups had statistically significant differences (P = 0.000). The pairwise comparisons between every two groups demonstrated that the HELLP group had a lower lymphocyte count than both the PE (P = 0.019) and control groups (P = 0.000), but the difference between the PE and control groups was not statistically significant (P = 0.432). The overall comparisons on platelet counts and the PLR among these three groups also showed statistically significant differences (both P = 0.000), from low to high being those in the HELLP group (43.4 × 109/L, 64.0), control group (180.5 × 109/L, 103.6) and PE group (181.5 × 109/L, 112.8). Pairwise comparisons of neither index displayed statistically significant differences between the PE and control groups (both P > 0.05), while the differences in the two indices between the HELLP group and the two other groups were still statistically significant (all P = 0.000). RDW values were highest in the HELLP group (14.5% [13.6, 15.3]), lower in the control group (14.1% [13.5, 14.8]) and lowest in the PE group (13.9% [13.4, 14.9]). The difference between the PE and control group did not show statistical significance (P = 1.000), while RDW values in the HELLP group were higher than those in the other two groups (cP < 0.05 vs control, dP < 0.01 vs PE).
CONCLUSION SIR markers such as NLR, RDW, MPV, and PDW were increased and PLR was decreased in HELLP. These SIR markers may become new indicators in the evaluation of HELLP syndrome.
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Affiliation(s)
- Su-Ya Kang
- Department of Obstetrics, Suzhou Affiliated Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, Jiangsu Province, China
| | - Yun Wang
- Department of Obstetrics, Suzhou Affiliated Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, Jiangsu Province, China
| | - Li-Ping Zhou
- Department of Obstetrics, Suzhou Affiliated Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, Jiangsu Province, China
| | - Hong Zhang
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
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Yang XJ, Zhang LY, Ma QH, Sun HP, Xu Y, Chen X, Pan CW. Platelet parameters in Chinese older adults with metabolic syndrome. Endocr Connect 2020; 9:696-704. [PMID: 32567552 PMCID: PMC7424361 DOI: 10.1530/ec-20-0209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/18/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE We aimed to examine the associations of platelet parameters with the presence of metabolic syndrome in community-dwelling older Chinese adults. METHODS Study sample was from the Weitang Geriatric Diseases Study, which included 4338 individuals aged 60 years or above. The mean age of the participants was 68 years. Metabolic syndrome was defined based on the Adult Treatment Panel III criteria. Platelet parameters were assessed using an automated hematology analyzer. Multiple logistic regression models were fitted to examine relationships between the platelet parameters and the presence of metabolic syndrome after adjusting for potential confounders. RESULTS The adjusted odds ratio (95% CI) of metabolic syndrome for the highest quartile of platelet parameters (platelet count, mean platelet volume, plateletcrit, platelet distribution width, platelet larger cell ratio) when compared to the lowest quartile were 1.32 (1.06, 1.64), 1.00 (0.81, 1.24), 1.37 (1.10, 1.71), 1.45 (1.14, 1.83), 1.11 (0.89, 1.39), respectively. Hypertension and diabetes modified the relationship between platelet distribution width and metabolic syndrome with the associations being significant in hypertensive and non-diabetic groups. The levels of platelet distribution width increased with the risk of metabolic syndrome in men but not in women. CONCLUSION The levels of platelet count, plateletcrit and platelet distribution width increased in older adults with metabolic syndrome, suggesting that these parameters may be useful biomarkers for further risk appraisal of metabolic syndrome in aged population.
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Affiliation(s)
- Xue-Jiao Yang
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Le-Yang Zhang
- Medical College of Soochow University, Suzhou, China
| | - Qing-Hua Ma
- The 3rd People’s Hospital of Xiangcheng District, Suzhou, China
| | - Hong-Peng Sun
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yong Xu
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xing Chen
- Department of Children Health Care, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Correspondence should be addressed to X Chen or C-W Pan: or
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Correspondence should be addressed to X Chen or C-W Pan: or
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Çintesun E, Incesu Çintesun FN, Ezveci H, Akyürek F, Çelik Ç. Systemic inflammatory response markers in preeclampsia. J Lab Physicians 2020; 10:316-319. [PMID: 30078969 PMCID: PMC6052816 DOI: 10.4103/jlp.jlp_144_17] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), platelet distribution width (PDW), red cell distribution width (RDW), mean platelet volume (MPV), and plateletcrit (PCT) are known as systemic inflammatory response markers. In this study, we aimed to evaluate changes in NLR, PLR, PDW, RDW, MPV, and PCT in preeclampsia (PE) and their use in predicting its severity. MATERIALS AND METHODS This is a retrospective case-control study. The study comprised 64 control group (healthy pregnant females), 51 females with mild PE, and 13 with severe PE. These three groups were compared with demographic data and inflammation markers. RESULTS There were no statistically significant differences between healthy pregnant females and preeclaptic females in terms of median age, hemoglobin, lymphocyte, neutrophil, platelet, NLR, PLR, PDV, RDW, MPV, PCT (P > 0.05). The control group has a higher number of gravity and parity than the PE group (P < 0.001). MPV value is a lower PE group than the control group (P < 0.001). Both gravity and parity were significantly higher in the patients with mild PE than in the control group (P < 0.001). MPV value was statistically higher in the control group compared both mild and severe PE (P < 0.001), however, no statistical difference between mild and severe PE (P = 0.305). CONCLUSIONS MPV may be clinically useful markers in the prediction of PE. Further, prospective multicenter studies are needed to reveal the association between these markers and PE.
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Affiliation(s)
- Ersin Çintesun
- Department of Obstetrics and Gynecology, Selcuk University, Konya, Turkey
| | | | - Huriye Ezveci
- Department of Obstetrics and Gynecology, Selcuk University, Konya, Turkey
| | - Fikret Akyürek
- Department of Biochemistry, Selçuk University, Konya, Turkey
| | - Çetin Çelik
- Department of Obstetrics and Gynecology, Selcuk University, Konya, Turkey
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12
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Örgül G, Aydın Haklı D, Özten G, Fadiloğlu E, Tanacan A, Beksaç MS. First trimester complete blood cell indices in early and late onset preeclampsia. Turk J Obstet Gynecol 2019; 16:112-117. [PMID: 31360585 PMCID: PMC6637787 DOI: 10.4274/tjod.galenos.2019.93708] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/20/2019] [Indexed: 12/01/2022] Open
Abstract
Objective This study aimed to compare the first trimester complete blood count (CBC) indices of pregnancies complicated by early-onset preeclampsia (EOPE) or late-onset preeclampsia (LOPE). Material and Methods A retrospective case-control study was conducted with 186 patients. Patients were classified into three subgroups: EOPE, LOPE, and control groups. First trimester CBC results were obtained for each patient. Hemoglobin, hematocrit, red blood cell distribution width, mean corpuscular volume, white blood cell (WBC) count, neutrophil, eosinophil, basophil, lymphocyte, monocyte, mean platelet volume, platelet distribution width, plateletcrit, and platelet count were compared. The neutrophil lymphocyte ratio was calculated by dividing the absolute lymphocyte count by the absolute neutrophil count. The platelet lymphocyte ratio was calculated by dividing the absolute lymphocyte count by the absolute platelet count. Results The total number of cases was 21, 42, and 123, in the EOPE, LOPE, and control groups, respectively. There were statistically significant differences in the total WBC and neutrophil counts between the three groups (both p<0.05). WBC and neutrophil counts were found to be highest in the EOPE group, and the LOPE group had higher levels compared with controls. The optimal cut-off values to predict EOPE for WBC and neutrophil counts were 9.55×103/ μL (sensitivity 71.4% and specificity 70.7%) and 6.45×103/μL (sensitivity 66.7% and specificity 74.8%), respectively. Conclusion Increased first trimester WBC and neutrophil counts may be predictive for EOPE.
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Affiliation(s)
- Gökçen Örgül
- Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Duygu Aydın Haklı
- Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Gonca Özten
- Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Erdem Fadiloğlu
- Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Atakan Tanacan
- Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Mehmet Sinan Beksaç
- Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
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13
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Doğan M, Karahan I. Evaluation of complete blood count parameters, cell ratios, and cell volume indices in mushroom poisonings. Hum Exp Toxicol 2019; 38:1127-1131. [PMID: 31215240 DOI: 10.1177/0960327119855131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Mushroom poisoning is still a significant health-care problem, with the potential to affect blood parameters. The present study analyses the effect of mushroom poisoning on complete blood cell parameters, cell ratios, and cell volume indices and the effect of the mentioned parameters on prognosis/hospital length of stay. METHODS The study involved the retrospective assessment of 48 patients who became symptomatic after ingesting mushrooms. Patients who were 18 years and above and who spent at least one day in hospital were included in the study. The control group comprised individuals with similar characteristics to the patient group. The complete blood cell parameters, platelet indices (mean platelet volume, plateletcrit (PCT)), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio levels were compared between the two groups, and these ratios were analyzed for any correlation with length of hospital stay. RESULTS NLR was significantly higher and PCT was significantly lower in the mushroom-poisoned group, while all other parameters were similar between the groups. NLR had a positive correlation and PCT had a negative correlation with length of hospital stay. CONCLUSION NLR and PCT levels can provide information about prognosis and can aid in the prediction of hospital stay in mushroom-poisoned patients. Further investigations are needed to investigate effects of intoxication on hematological system elements.
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Affiliation(s)
- M Doğan
- 1 Department of Internal Medicine, Erol Olçok Training and Research Hospital, Hitit University, Corum, Turkey
| | - I Karahan
- 2 Department of Internal Medicine, School of Medicine, Kırıkkale University, Yahşihan, Kırıkkale, Turkey
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14
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Kisa E, Yucel C, Keskin MZ, Karabicak M, Yalcin MY, Cakmak O, Ilbey YO. The Role of Hematological Parameters in Predicting Fuhrman Grade and Tumor Stage in Renal Cell Carcinoma Patients Undergoing Nephrectomy. ACTA ACUST UNITED AC 2019; 55:medicina55060287. [PMID: 31216752 PMCID: PMC6630220 DOI: 10.3390/medicina55060287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/09/2019] [Accepted: 06/17/2019] [Indexed: 01/04/2023]
Abstract
Background and objective: We investigated the ability of preoperative serum values of red blood cell distribution width (RDW), neutrophil lymphocyte ratio (NLR) and plateletcrit (PCT) to predict Fuhrman grades (FG) and tumor stages of renal cell carcinoma in patients who underwent radical nephrectomy. Materials and methods: Records of 283 patients that underwent radical or partial nephrectomy of renal masses at our clinic between January 2010 and April 2018, whose pathology results indicated renal cell carcinoma (RCC), and who had their FG and T1–4 N0M0 identified were retrospectively evaluated. The patients were divided into two groups based on their FG as low (I–II) and high (III–IV) and their T stages were similarly grouped as limited to kidney (pT1–pT2) and not limited to kidney (pT3–pT4). Results: Mean RDW, NLR, PCT cut-off values of the patients for FG and T stage were 15.65%, 3.54, 0.28% and 14.35%, 2.69, 0.28%, respectively. The RDW and NLR were determined to be statistically significant predictors of a pathologically high FG, whereas the PCT value was not a statistically significant predictor of high FG (p = 0.003, p = 0.006, p = 0.075, respectively). The relationship of RDW, NLR and PCT values with a limited to the kidney pathological T stage revealed statistically significant correlations for all three values. Conclusions: We determined that only RDW and NLR were markers predicting FG, while PCT had no prognostic value. On the other hand, all three of these values were associated with a limited to the kidney pathological T stage in patients who underwent nephrectomy due to renal masses and whose pathologies suggested RCC.
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Affiliation(s)
- Erdem Kisa
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Cem Yucel
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Mehmet Zeynel Keskin
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Mustafa Karabicak
- Department of Urology, Batman Training and Research Hospital, 72070 Batman, Turkey.
| | - Mehmet Yigit Yalcin
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Ozgur Cakmak
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Yusuf Ozlem Ilbey
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
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15
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Baghersalimi A, Koohmanaee S, Darbandi B, Farzamfard V, Hassanzadeh Rad A, Zare R, Tabrizi M, Dalili S. Platelet Indices Alterations in Children With Type 1 Diabetes Mellitus. J Pediatr Hematol Oncol 2019; 41:e227-e232. [PMID: 30883461 DOI: 10.1097/mph.0000000000001454] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Platelet (PLT) hyperactivity is a key factor which contributes to cardiovascular complications in patients with type 2 diabetes mellitus even in preclinical stages of disease. To the best of our knowledge, there is limited researches in this regard among patients with type 1 diabetes. The aim of this study was to evaluate hematologic indices indicating PLT activity in children with type 1 diabetes. This was a case-control study which was conducted on 166 inpatients in 17 Shahrivar children hospital, Rasht, Iran during April 2016 to April 2017. Cases and controls were 83 children with type 1 diabetes mellitus and 83 children hospitalized for thorough assessment of short stature, respectively. Groups were matched for age and sex. Demographic characteristics and hematologic variables were assessed. The Shapiro-Wilk test was used to determine the normality of the distribution. Results for continuous and categorical variables were demonstrated as mean±SD and number and percent, respectively. Continuous variables without normal distribution were demonstrated as median (interquartile range). The χ/Fisher's exact test was used to compare categorical variables. The normal and non-normal distributed quantitative variables were respectively assessed by independent T-test or Mann-Whitney U test. P-value <0.05 noted statistical significance. The median (interquartile range) age of all children was 10 (6 to 13) years old. Thirty-five (42.2) of patients with diabetes and 35 (42.2) of control group were male individuals. There were positive correlation between age (r=0.370; P=0.001), hemoglobin (r=0.278; P=0.009), blood sugar (r=0.243; P=0.027), PLT distribution width (r=0.229; P=0.038), plateletcrit (PCT) (r=0.290; P=0.008), PLT to lymphocyte ratio (r=0.230; P=0.037) and glycosylated hemoglobin in children with diabetes. The cut-off point of PCT was 0.19 (sensitivity=87.8%, specificity=66.7%). Only increased PCT (>0.19) was related with poor metabolic control and can put the patients to the risk of future cardiovascular events. The authors recommend considering multiple PLT parameters, and not just one of them, and even designing a scoring system in terms of PLT parameters for type 1 diabetes mellitus management programs.
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Affiliation(s)
- Adel Baghersalimi
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Shaahin Koohmanaee
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Bahram Darbandi
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Venus Farzamfard
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Afagh Hassanzadeh Rad
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Roghaye Zare
- Department of Epidemiology and Biostatistics, Tehran University of Medical Science, Tehran, Iran
| | - Manijeh Tabrizi
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Setila Dalili
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Thalor N, Singh K, Pujani M, Chauhan V, Agarwal C, Ahuja R. A correlation between platelet indices and preeclampsia. Hematol Transfus Cell Ther 2018; 41:129-133. [PMID: 31084762 PMCID: PMC6517612 DOI: 10.1016/j.htct.2018.08.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/03/2018] [Accepted: 08/13/2018] [Indexed: 11/16/2022] Open
Abstract
Background Preeclampsia is one of the major health problems causing maternal morbidity and mortality, complicating 3–8% of pregnancies. It has been suggested that the alterations in the coagulation and fibrinolysis play a role in the pathogenesis of preeclampsia. The markers of platelet activation include platelet count, platelet distribution width, mean platelet volume and plateletcrit. Study design It was a case-controlled study which included a total of 60 patients (30 cases and 30 controls). Blood samples were collected and the platelet indices – platelet count, plateletcrit, mean platelet volume and platelet distribution width – were evaluated using the Sysmex XN1000 and compared between the two groups. Results The MPV and PDW also showed a significant difference (p > 0.05) between the two groups, with a significant positive correlation with increasing blood pressure (MPV – r = +0.6126, p < 0.05 and PDW – r = +0.6441, p < 0.05). The PC and PCT had lower values in the preeclampsia patients, however the difference between the two groups was not statistically significant. Conclusion The MPV and PDW showed a significant difference between the two groups and increasing values with increasing BP. However, the PC and PCT in our study did not show a significant correlation with preeclampsia. Thus, the platelet indices, mainly the MPV and PDW, which are economical and easily available, can be reliable in the prediction and early diagnosis of preeclampsia, as well as a marker for the severity of preeclampsia.
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Affiliation(s)
- Nitesh Thalor
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
| | - Kanika Singh
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India.
| | - Mukta Pujani
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
| | - Varsha Chauhan
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
| | - Charu Agarwal
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
| | - Rashmi Ahuja
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
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Gogoi P, Sinha P, Gupta B, Firmal P, Rajaram S. Neutrophil-to-lymphocyte ratio and platelet indices in pre-eclampsia. Int J Gynaecol Obstet 2018; 144:16-20. [PMID: 30362112 DOI: 10.1002/ijgo.12701] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/08/2018] [Accepted: 10/24/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To compare the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and platelet indices between women with pre-eclampsia and normotensive pregnant women. METHODS A cross-sectional study conducted from January to July 2017 at a tertiary care hospital in Delhi, India. The study compared pregnant women aged 18-40 years with pre-eclampsia diagnosed at term with healthy pregnant women matched for gestational age. Venous blood samples were drawn and complete blood count was analyzed. The parameters recorded were hemoglobin, red cell distribution width (RDW), platelet count, mean platelet volume (MPV), plateletcrit, and platelet distribution width. RESULTS There were 67 women included in each group. NLR was higher in women with pre-eclampsia compared with the control group (6.8 ± 7.6 vs 3.0 ± 0.98; P=0.001). Both PLR (14.18 ± 14.4 vs 9.54 ± 3.6; P=0.012) and MPV (9.45 ± 1.19 vs 9.02 ± 1.1; P=0.029) were higher in the study group compared with the control group. Platelet count was lower in pre-eclamptic women compared with the control group (188 ± 89.7 vs 200.1 ± 62.36; P=0.014). RDW was also higher in the study group (P=0.025). CONCLUSIONS The present study found that the inflammatory markers NLR, PLR, RDW, and MPV were higher in women with pre-eclampsia. Measuring NLR and PLR may be useful in predicting pre-eclampsia among women at high risk during prenatal follow-up.
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Affiliation(s)
- Priyanka Gogoi
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Pallavi Sinha
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Bindiya Gupta
- Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Priyanka Firmal
- Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Shalini Rajaram
- Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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18
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Bellos I, Fitrou G, Pergialiotis V, Papantoniou N, Daskalakis G. Mean platelet volume values in preeclampsia: A systematic review and meta-analysis. Pregnancy Hypertens 2018; 13:174-180. [DOI: 10.1016/j.preghy.2018.06.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/23/2018] [Indexed: 12/29/2022]
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Singh A, Varma R. Role of Platelet Distribution Width (PDW) and Plateletcrit in the Assessment of Nonthrombocytopenic Preeclampsia and Eclampsia. J Obstet Gynaecol India 2017; 68:289-293. [PMID: 30065544 DOI: 10.1007/s13224-017-1036-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 07/10/2017] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate the role of platelet indices in preeclampsia and eclampsia. Methods An observational analytical study was conducted in Department of Obstetrics and Gynaecology, Ambedkar Hospital, Pandit Jawaharlal Nehru Memorial Medical College, Raipur. It was performed on 150 women between March 2015 and February 2016; among them, 42 were taken as controls, 36 were preeclampsia and 72 were eclampsia. Their platelet count and platelet indices were done, analyzed and compared. Result In our study, we found that mean platelet count and mean plateletcrit showed a significant decrease while mean MPV and mean PDW showed a significant increase with increasing severity of disease. Also, we observed that 66.7% preeclampsia and 51.4% eclampsia were nonthrombocytopenic. Among these women, a decrease in the values of plateletcrit and an increase in PDW were seen in a significantly higher number of eclampsia patients. So these two platelet indices can become the new marker for an adverse outcome in preeclampsia and eclampsia even in women presenting with normal platelet counts. Conclusion Platelet indices showed a significant variation along with the severity of the disease. Platelet indices, especially PDW and plateletcrit, can be used along with platelet count to evaluate the severity of preeclampsia and eclampsia instead of relying on platelet count alone.
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Affiliation(s)
- Abha Singh
- Department of Obstetrics and Gynecology, Pt.J.N.M.Medical Collage, E-8, Shankar Nagar, Raipur, Chhattisgarh India
| | - Ruchi Varma
- Department of Pathology, Pt.J.N.M.Medical Collage, D- 49, Sector- 2, Devendra Nagar, Raipur, Chhattisgarh India
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Białas AJ, Pedone C, Piotrowski WJ, Antonelli Incalzi R. Platelet distribution width as a prognostic factor in patients with COPD - pilot study. Int J Chron Obstruct Pulmon Dis 2017; 12:2261-2267. [PMID: 28814854 PMCID: PMC5546588 DOI: 10.2147/copd.s131868] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Platelets may actively participate in inflammation in COPD. Platelet distribution width (PDW), a measure of platelets’ volume heterogeneity, may increase in platelets’ activation. We hypothesized that PDW may be a marker of hypercoagulation, which plays a significant role in conditions associated with worse survival of patients with COPD, eg, acute myocardial infarction and other forms of ischemic heart disease. Methods Retrospective analysis of 79 patients. Variables were compared after grouping patients according to the upper normal limit of PDW, using Welch’s t-tests or Mann–Whitney U, and chi-square tests. Survival in the two groups was compared using the Kaplan–Meier method and Cox proportional hazards regression. Results Ten patients presented values of PDW above 16 fL, which was the upper limit of normality for our laboratory. Compared to patients with normal PDW, they had lower forced expiratory flow between 25% and 75% of vital capacity (FEF 25–75) – 35% of reference value vs 57% (P=0.003) and peak expiratory flow – 39% vs 54% (P<0.001). The median survival of patients with elevated PDW was 743 days compared to those with normal PDW (1,305 days) (P=0.025). The adjusted HR was 4.59 (95% CI: 1.1, 19.19; P=0.04). Conclusion Our analysis indicates that elevated PDW is associated with reduced survival of patients with COPD. If our data are to be confirmed, PDW may be used as an inexpensive and repeatable prognostic tool in COPD.
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Affiliation(s)
- Adam J Białas
- Department of Pneumology and Allergy, Medical University of Lodz, Łódź, Poland.,Healthy Aging Research Centre (HARC), Medical University of Lodz, Łódź, Poland
| | - Claudio Pedone
- Department of Geriatrics, Campus Bio-Medico University of Rome, Rome, Italy
| | - Wojciech J Piotrowski
- Department of Pneumology and Allergy, Medical University of Lodz, Łódź, Poland.,Healthy Aging Research Centre (HARC), Medical University of Lodz, Łódź, Poland
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Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens 2016; 7:29-32. [PMID: 28279444 DOI: 10.1016/j.preghy.2016.12.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/18/2016] [Accepted: 12/20/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION AND AIM Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), red cell distribution width (RDW) and plateletcrit (PCT) have all been recognized as systemic inflammatory response (SIR) markers. Our aim was to evaluate changes in NLR, PLR, RDW, MPV and PCT in preeclampsia and their use in predicting the severity of PE. STUDY DESIGN This retrospective cohort study included 219 patients. Of them, 27 had mild PE, 82 had severe PE, and 110 were healthy, normotensive pregnant patients. RESULTS There were no significant differences in NLR between the groups (p=0.423). Both PLR and PCT were lower in the patients with severe PE than in the control group, and these differences showed a statistical significance (p=0.007 and p<0.001). On the other hand, both RDW and MPV were statistically higher in the patients with severe PE compared to the control group (p=0.011 and p<0.001). ROC analyzes were used to examine the ability of markers to predict those with severe PE from those with mild PE. Areas under the curve for NLR, PLR and RDW were not statistically significant (p=0.636, 0.104 and 0.36, respectively). For MPV and PCT, the values of area under the curve were 0.641 and 0.712, respectively, and the p values for these parameters statistically differed (p=0.028, p=0.001). CONCLUSION MPV or PCT may be clinical useful markers in the prediction of severe PE. Further, prospective multicenter studies are warranted to better reveal the association between SIR markers and PE.
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Affiliation(s)
- Burak Yücel
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
| | - Batuhan Ustun
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
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AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vasc Health Risk Manag 2016; 12:477-480. [PMID: 27920548 PMCID: PMC5123587 DOI: 10.2147/vhrm.s120944] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although the exact pathophysiology of preeclampsia is not completely understood, the utility of different platelets indices can be utilized to predict preeclampsia. OBJECTIVE To compare platelet indices, namely platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), and PC to MPV ratio in women with preeclampsia compared with healthy controls. SETTING Qassim Hospital, Kingdom of Saudi Arabia. DESIGN A case-control study. Sixty preeclamptic women were the cases and an equal number of healthy pregnant women were the controls. RESULTS There was no significant difference in age, parity, and body mass index between the study groups. Sixteen and 44 of the cases were severe and mild preeclampsia, respectively. There was no significant difference in PDW and MPV between the preeclamptic and control women. Both PC and PC to MPV ratios were significantly lower in the women with preeclampsia compared with the controls. There was no significant difference in the PC, PDW, MPV, and PC to MPV ratio when women with mild and severe preeclampsia were compared. Using receiver operating characteristic (ROC) curves, the PC cutoff was 248.0×103/µL for diagnosis of pre-eclampsia (P=0.019; the area under the ROC curve was 62.4%). Binary regression suggests that women with PC <248.010×103/µL were at higher risk of preeclampsia (odds ratio =2.2, 95% confidence interval =1.08-4.6, P=0.03). The PC/MPV cutoff was 31.2 for diagnosis of preeclampsia (P=0.035, the area under the ROC curve was 62.2%). CONCLUSION PC <248.010×103/µL and PC to MPV ratio 31.2 are valid predictors of preeclampsia.
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Affiliation(s)
- Muneera A AlSheeha
- Department of Obstetrics and Gynaecology, College of Medicine, Qassim University, Buriadah
| | - Rafi S Alaboudi
- Department of Obstetrics and Gynaecology, College of Medicine, Qassim University, Buriadah
| | - Mohammad A Alghasham
- Department of Obstetrics and Gynaecology, College of Medicine, Qassim University, Buriadah
| | - Javed Iqbal
- Department of Obstetrics and Gynecology, Maternity and Children’s Hospital, Qassim, Kingdom of Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynaecology, College of Medicine, Qassim University, Buriadah
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Abstract
PURPOSE The aim of this study was to compare all platelet markers, especially plateletcrit (PCT, total platelet mass), in patients with and without ocular pseudoexfoliation (PEX) syndrome. METHODS One hundred six patients with ocular PEX syndrome (study group) and 106 individuals without ocular PEX syndrome (control group) were enrolled in this retrospective case-control study. The biochemical/hematological laboratory results of both the study and control groups were analyzed by a clinician blinded to the group assignments. The main outcome measures were the PCT, platelet count (PLT), mean platelet volume (MPV), and platelet distribution width (PDW). RESULTS The mean PCT in the study and control groups were 0.206%±0.520% and 0.171%±0.410%, respectively (P<0.001), and the mean PDW in the study and control groups were 16.12%±1.21% and 14.68%±1.40%, respectively (P<0.001). There were no differences in the MPV or mean PLT (P=0.138 and P=0.055, respectively). The PCT cutoff value was 0.180 (area under the receiver operating characteristics curve, 0.706; P<0.001; 65% sensitivity; 74% specificity). CONCLUSIONS The PCT and PDW were significantly higher in patients with than without ocular PEX syndrome. These increased parameters may cause microvascular blood flow resistance and the heightened inflammatory response caused by excessive platelet activity, as with other cardiovascular diseases, and may also decrease aqueous humor outflow in ocular PEX syndrome.
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