Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study
Yıl: 2022 Cilt: 19 Sayı: 1 Sayfa Aralığı: 7 - 20 Metin Dili: İngilizce DOI: 10.4274/tjod.galenos.2022.36744 İndeks Tarihi: 23-06-2022
Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study
Öz: Objective: In this study, we examined the serum hematologic and lipid parameters of pregnant women with preeclampsia and an age- and gestational-age
matched normotensive control group. We also compared the ratios of hemato-lipid parameters defined as systemic inflammatory markers and determined
the predictive value of these values in preeclampsia.
Materials and Methods: All patients diagnosed with late-onset preeclampsia or severe preeclampsia between 34 and 40 weeks of gestation at Inonu
University Faculty of Medicine between March 2019 and October 2020 were included.
Results: A total of 253 pregnant women were included in the study period. When the study groups were compared in terms of hematological and blood
lipid profile; while serum lymphocyte, triglyceride, and total cholesterol levels were significantly higher in the preeclampsia group than in the control
group (p<0.001, p<0.001, p=0.013, respectively); high-density lipoprotein (HDL)-cholesterol levels were found to be significantly lower (p=0.017). The
cut-off value for the monocyte/HDL ratio in predicting severe preeclampsia was 16.65 with 59.0% sensitivity and 85.4% specificity [the area under the
receiver operating characteristic 0.756, 95% confidence interval (CI) 0.681-0.821, p<0.001]. Multivariate analysis showed that the monocyte/HDL ratio
was independently associated with both preeclampsia and severe preeclampsia [odds ratio (OR): 1.094; 95% CI 1.009-1.185 and OR: 1.731; 95% CI
1.218-2.459, respectively].
Conclusion: This study demonstrated that serum triglyceride and total cholesterol levels were significantly higher and serum HDL-cholesterol levels were
significantly lower in pregnant women with late-onset preeclampsia compared to normotensive pregnant women. Additionally, this study revealed that the
measurement of monocyte/HDL ratio in the pregnant population could be a useful clinical tool for predicting preeclampsia.
Anahtar Kelime: Preeklamptik gebelerde dislipideminin değerlendirilmesi ve hemato-lipid profilin prediktif değerinin belirlenmesi: Prospektif, kesitsel, olgu-kontrol çalışması
Öz: Amaç: Bu çalışmada preeklamptik gebeler ile preeklampsi ile komplike olmayan gebelerin serumlarında hematolojik ve lipid parametreleri değerlendirildi.
Ayrıca sistemik enflamatuvar marker olarak da tanımlanan hemato-lipid parametrelerin oranları karşılaştırılıp bu oranların preeklampsideki prediktif değeri
belirlendi.
Gereç ve Yöntemler: Çalışmaya İnönü Üniversitesi Tıp Fakültesi Hastanesi’nde 01.03.2019-01.10.2020 tarihleri arasında gebeliğin 34-40. haftasında geç
başlangıçlı preeklampsi ve şiddetli preeklampsi tanısı alan ve çalışma kriterlerine uygun tüm hastalar alınmış olup katılımcıların serum örneklerinde rutin
laboratuvar testlerinin yanında lipid profili analizi yapılıp, gebelerin perinatal ve neonatal sonuçları kaydedildi.
Bulgular: Çalışma periyodu içinde toplam 253 gebe çalışmaya dahil edildi. Çalışma grupları hematolojik ve kan lipid profili açısından karşılaştırıldığında;
preeklampsi grubunda kontrol grubuna göre serum lenfosit, trigliserid ve total kolesterol seviyeleri anlamlı olarak yüksek iken (sırasıyla p<0,0001, p<0,001,
p=0,013); yüksek yoğunluklu lipoprotein (HDL)-kolesterol düzeyleri anlamlı olarak düşük saptandı (p=0,017). Hematolojik ve lipid parametrelerinin
oranları değerlendirildiğinde kontrol grubu ile karşılaştırıldığında monosit/HDL oranı ve monosit/lenfosit oranlarının hem preklampsi hem de şiddetli
preeklampsi grubunda anlamlı olarak yüksek olduğu saptandı (sırasıyla p=0,007, p<0,0001 ve p=0,021, p<0,0001). Şiddetli preeklampsi prediksiyonunda
monosit/HDL oranı için cut-off değeri %59,0 sensitivite, %85,4 spesifite ile 16,65 [alıcı çalışma karakteristiğinin altındaki alan 0,756, %95 güven aralığı
(GA) 0,681-0,821, p<0,0001] saptandı. Multivariate analiz monosit/HDL oranının bağımsız olarak hem preeklampsi hem de şiddetli preeklampsi ilişkili
olduğunu gösterdi [sırasıyla risk oranı (OR): 1,094; %95 GA 1,009-1,185 ve OR: 1,731; %95 GA 1,218-2,459].
Sonuç: Bu çalışma geç başlangıçlı preeklampsi saptanan gebelerde normotansif gebelere göre serum trigliserid ve total kolesterol düzeylerinin anlamlı
oranda yüksek, serum HDL-kolesterol düzeylerinin ise anlamlı oranda düşük olduğunu göstermekle birlikte gebe popülasyonunda monosit/HDL oranı
ölçümünün preeklampsi gelişiminin prediksiyonu açısından yararlı olabileceğini ortaya koymuştur
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. No authors listed. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol 2013;122:1122-31.
- 2. Ghosh SK, Raheja S, Tuli A, Raghunandan C, Agarwal S. Serum PLGF as a potential biomarker for predicting the onset of preeclampsia. Arch Gynecol Obstet 2012;285:417-22.
- 3. Buhimschi IA, Nayeri UA, Zhao G, Shook LL, Pensalfini A, Funai EF, et al. Protein misfolding, congophilia, oligomerization, and defective amyloid processing in preeclampsia. Sci Transl Med 2014;6:245-92.
- 4. Hu WT, Li MQ, Liu W, Jin LP, Li DJ, Zhu XY. IL-33 enhances proliferation and invasiveness of decidual stromal cells by up-regulation of CCL2/CCR2 via NF-Kb and ERK1/2 signaling. Mol Hum Reprod 2014;20:358-72.
- 5. Palei AC, Spradley FT, Warrington JP, George EM, Granger JP. Pathophysiology of hypertension in preeclampsia: a lesson in integrative physiology. Acta Physiol (Oxf) 2013;208:224-33.
- 6. Ossoli A, Remaley AT, Vaisman B, Calabresi L, Gomaraschi M. Plasma- derived and synthetic high-density lipoprotein inhibit tissue factor in endothelial cells and monocytes. Biochem J 2016;473:211-9.
- 7. Usta A, Avci E, Bulbul CB, Kadi H, Adali E. The monocyte counts to HDL cholesterol ratio in obese and lean patients with polycystic ovary syndrome. Reprod Biol Endocrinol 2018;16:34.
- 8. Ganjali S, Gotto AM Jr, Ruscica M, Atkin SL, Butler AE, Banach M, et al. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol 2018;233:9237-46.
- 9. Uslu AU, Sekin Y, Tarhan G, Canakcı N, Gunduz M, Karagulle M. Evaluation of Monocyte to High-Density Lipoprotein Cholesterol Ratio in the Presence and Severity of Metabolic Syndrome. Clin Appl Thromb Hemost 2018;24:828-33.
- 10. Canzoneri BJ, Lewis DF, Groome L, Wang Y. Increased neutrophil numbers account for leukocytosis in women with preeclampsia. Am J Perinatol 2009;26:729-32
- 11. Mtali YS, Lyimo MA, Luzzatto L, Massawe SN. Hypertensive disorders of pregnancy are associated with an inflammatory state: evidence from hematological findings and cytokine levels. BMC Pregnancy Childbirth 2019;19:237.
- 12. Ramma W, Buhimschi IA, Zhao G, Dulay AT, Nayeri UA, Buhimschi CS, et al. The elevation in circulating anti-angiogenic factors is independent of markers of neutrophil activation in preeclampsia. Angiogenesis 2012;15:333-40.
- 13. Serin S, Avcı F, Ercan O, Köstü B, Bakacak M, Kıran H. Is neutrophil/ lymphocyte ratio a useful marker to predict the severity of pre- eclampsia? Pregnancy Hypertens 2016;6:22-5.
- 14. Tesfa E, Nibret E, Munshea A. Maternal lipid profile and risk of pre- eclampsia in African pregnant women: A systematic review and meta- analysis. PLoS One 2020;15:e0243538
- 15. Han C, Huang P, Lyu M, Dong J. Oxidative Stress and Preeclampsia- Associated Prothrombotic State. Antioxidants (Basel) 2020;9:1139.
- 16. Ghio A, Bertolotto A, Resi V, Volpe L, Di Cianni G. Triglyceride metabolism in pregnancy. Adv Clin Chem 2011;55:133-53.
- 17. Spracklen CN, Smith CJ, Saftlas AF, Robinson JG, Ryckman KK. Maternal hyperlipidemia and the risk of preeclampsia: a meta-analysis. Am J Epidemiol 2014;180:346-58.
- 18. Çintesun E, Incesu Çintesun FN, Ezveci H, Akyürek F, Çelik Ç. Systemic inflammatory response markers in preeclampsia. J Lab Physicians 2018;10:316-9.
- 19. Gogoi P, Sinha P, Gupta B, Firmal P, Rajaram S. Neutrophil-to- lymphocyte ratio and platelet indices in preeclampsia. Int J Gynaecol Obstet 2019;144:16-20.
- 20. Hwang SY, Shin TG, Jo IJ, Jeon K, Suh GY, Lee TR. Neutrophil-to- lymphocyte ratio as a prognostic marker in critically-ill septic patients. Am J Emerg Med 2017;35:234-9.
- 21. Seng JJB, Kwan YH, Low LL, Thumboo J, Fong WSW. Role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) in assessing disease control in Asian patients with axial spondyloarthritis. Biomarkers 2018;23:335-8.
- 22. Ji F, Liang Y, Fu SJ, Guo ZY, Shu M, Shen SL, et al. A novel and accurate predictor of survival for patients with hepatocellular carcinoma after surgical resection: the neutrophil to lymphocyte ratio (NLR) combined with the aspartate aminotransferase/platelet count ratio index (APRI). BMC Cancer 2016;16:137.
- 23. Kang Q, Li W, Yu N, Fan L, Zhang Y, Sha M, et al. Predictive role of neutrophil-to-lymphocyte ratio in preeclampsia: A meta-analysis including 3982 patients. Pregnancy Hypertens 2020;20:111-8.
- 24. Wang J, Zhu QW, Cheng XY, Sha CX, Cui YB. Clinical significance of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in women with hyperglycemia. Postgrad Med 2020;132:702-8.
- 25. Guilliams M, Mildner A, Yona S. Developmental and Functional Heterogeneity of Monocytes. Immunity 2018;49:595-613.
- 26. Tall AR, Yvan-Charvet L. Cholesterol, inflammation and innate immunity. Nat Rev Immunol 2015;15:104-16.
- 27. Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014;46:1619- 25.
- 28. Dincgez Cakmak B, Dundar B, Ketenci Gencer F, Aydin BB, Yildiz DE. TWEAK and monocyte to HDL ratio as a predictor of metabolic syndrome in patients with polycystic ovary syndrome. Gynecol Endocrinol 2019;35:66-71
| APA | MELEKOGLU R, YAŞAR Ş, ZEYVELI CELIK N, Özdemir H (2022). Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. , 7 - 20. 10.4274/tjod.galenos.2022.36744 |
| Chicago | MELEKOGLU RAUF,YAŞAR Şeyma,ZEYVELI CELIK NESIBE,Özdemir Halis Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. (2022): 7 - 20. 10.4274/tjod.galenos.2022.36744 |
| MLA | MELEKOGLU RAUF,YAŞAR Şeyma,ZEYVELI CELIK NESIBE,Özdemir Halis Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. , 2022, ss.7 - 20. 10.4274/tjod.galenos.2022.36744 |
| AMA | MELEKOGLU R,YAŞAR Ş,ZEYVELI CELIK N,Özdemir H Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. . 2022; 7 - 20. 10.4274/tjod.galenos.2022.36744 |
| Vancouver | MELEKOGLU R,YAŞAR Ş,ZEYVELI CELIK N,Özdemir H Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. . 2022; 7 - 20. 10.4274/tjod.galenos.2022.36744 |
| IEEE | MELEKOGLU R,YAŞAR Ş,ZEYVELI CELIK N,Özdemir H "Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study." , ss.7 - 20, 2022. 10.4274/tjod.galenos.2022.36744 |
| ISNAD | MELEKOGLU, RAUF vd. "Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study". (2022), 7-20. https://doi.org/10.4274/tjod.galenos.2022.36744 |
| APA | MELEKOGLU R, YAŞAR Ş, ZEYVELI CELIK N, Özdemir H (2022). Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. Turkish Journal of Obstetrics and Gynecology, 19(1), 7 - 20. 10.4274/tjod.galenos.2022.36744 |
| Chicago | MELEKOGLU RAUF,YAŞAR Şeyma,ZEYVELI CELIK NESIBE,Özdemir Halis Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. Turkish Journal of Obstetrics and Gynecology 19, no.1 (2022): 7 - 20. 10.4274/tjod.galenos.2022.36744 |
| MLA | MELEKOGLU RAUF,YAŞAR Şeyma,ZEYVELI CELIK NESIBE,Özdemir Halis Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. Turkish Journal of Obstetrics and Gynecology, vol.19, no.1, 2022, ss.7 - 20. 10.4274/tjod.galenos.2022.36744 |
| AMA | MELEKOGLU R,YAŞAR Ş,ZEYVELI CELIK N,Özdemir H Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. Turkish Journal of Obstetrics and Gynecology. 2022; 19(1): 7 - 20. 10.4274/tjod.galenos.2022.36744 |
| Vancouver | MELEKOGLU R,YAŞAR Ş,ZEYVELI CELIK N,Özdemir H Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study. Turkish Journal of Obstetrics and Gynecology. 2022; 19(1): 7 - 20. 10.4274/tjod.galenos.2022.36744 |
| IEEE | MELEKOGLU R,YAŞAR Ş,ZEYVELI CELIK N,Özdemir H "Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study." Turkish Journal of Obstetrics and Gynecology, 19, ss.7 - 20, 2022. 10.4274/tjod.galenos.2022.36744 |
| ISNAD | MELEKOGLU, RAUF vd. "Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross- sectional, case-control study". Turkish Journal of Obstetrics and Gynecology 19/1 (2022), 7-20. https://doi.org/10.4274/tjod.galenos.2022.36744 |
