Comparison of neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV) and platelet lymphocyte ratio (PLR) in preeclampsia and normotensive pregnancies

https://doi.org/10.19106/JMedSci005404202204

Dinar Yudistira Firdaus(1*), Assangga Guyansyah(2), Umiyanti Thenu(3), Selvia D. Denggo(4)

(1) General Practitioner, Weda Public Hospital, Maluku,
(2) Departemen Obstetric and Gynecology, Faculty of Medicine, Trisakti University, Jakarta
(3) Departemen Obstetric and Gynecology, Weda Public Hospital, Maluku,
(4) Departemen Clinical Pathology, Weda Public Hospital, Maluku, Indonesia
(*) Corresponding Author

Abstract


The study aimed to compare the NLR (neutrophil lymphocyte ratio), MPV (meanplatelet volume), and PLR (platelet lymphocyte ratio) values in preeclampsiaand normotensive pregnancies. This was a retrospective case-control studyusing medical records of pregnancies between January 1, – December 31, 2019.A total 31 pregnancies with preeclampsia who met the inclusion and exclusioncriteria were involved in the study. As control, 31 normotensive pregnanciesrecruited by simple random sampling were used. The data were presented asmean ± standard deviation (SD) and analyzed by using SPSS program. Receiveroperating characteristic (ROC) curve were used to determine the optimal cutoff point for predicting preeclampsia. The NLR and MPV values of patients withpreeclampsia were significantly higher compare to normotensive pregnancy(p<0.001). Whereas, the PLR value of both groups was not significantlydifferent (p>0.245). The result of AUC analysis showed that the NLR and MPVhave AUC values of 0.758 (95%CI:0.637-0.878; p=0.000) and 0.903 (95%CI:0.816-0.989; p=0.000), respectively. Further analysis showed that the optimal cut-offpoint for NLR was 4.0 (sensitivity of 64.5% and a specificity of 71.0%) and forMPV was 7.55 (sensitivity of 87.1% and specificity of 80.0%). In conclusion, theNLR and MPV values are significantly higher in preeclampsia. However, theMPV value has a better predictive value than NLR for preeclampsia.

Keywords


preeclampsia; normotensive pregnancy; NLR; MPV; PLR

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References

Worl Health Organization. Maternal mortality [internet]. WHO 2019 [cited: 24 July 2021] Available at https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.
2.Say L, Chou D, Gemmil A, Tuncalp O, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systemic analysis. Lancet Glob Health 2014; 2(6):e323-33.
https://doi.org/10.1016/S2214-109X(14)70227-X
3.Sekretariat Jendral Kementerian Kesehatan RI. Profil kesehatan Indonesia tahun 2019. Jakarta: Kementerian Kesehatan RI, 2019.
4.Dinas Kesehatan Kabupaten Halmahera Tengah. Profil kesehatan Kabupaten Halmahera Tengah 2014. Halmahera: Dinkes Halmahera Tengah, 2015.
5.Wibowo N, Irwinda R, Frisdiantiny E, Karkata MK, Mose JC, Chalid MT, et al. Pedoman Nasional Pelayanan Kedokteran: diagnosis dan tatalaksana preeklampsia. Pogi-hkfm 2016; 1-46.
6.Akbar MIA. Preeklampsia, tanda bahaya penyakit kardiovaskular di masa mendatang. Surabaya: Departemen Obstetrik Ginekologi, Universitas Airlangga, 2018.
7.Espinoza J, Vidaeff A, Pettker CM, Simhan H. Gestational hypertension and preeclampsia. ACOG Practice Bulletin No. 222. Obstet Gynecol 2020; 135(6): e237-60.
https://doi.org/10.1097/AOG.0000000000003891
8.Abalos E, Cuesta C, Carroli G, Qureshi Z, Widmer M, Vogel JP, et al. Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the Worl Health Organization multicountry survey on maternal and newborn health. BJOG 2014; 121(Suppl 1):14-24.
https://doi.org/10.1111/1471-0528.12629
9.Cintesun E, Cintesun FNI, Ezveci H, Akyurek F, Celik C. Systemic inflammatory response marker in preeclampsia. J Lab Physicians 2018; 10(3):316-9.
https://doi.org/10.4103/JLP.JLP_144_17
10.Mannaerts D, Heyvaert S, Cordt C, Macken C, Loos C, Jacquemyn Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? J Matern Fetal Neonatal Med 2019; 32(9):1412-9.
https://doi.org/10.1080/14767058.2017.1410701
11.Syahputra MI. Perbandingan nilai neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), dan mean platelet volume (MVP) pada kehamilan dengan preeklamsia dam kehamilan normal [Thesis]. Sumatera Utara: Universitas Sumatera Utara, 2019.
http://repositori.usu.ac.id/handle/123456789/12326
12.Giyantno CC, Pramono BA. Perbandingan profil hematologi pada preeklamsia/eklampsia dengan kehamilan normotensi di RSUP Dr. Kariadi Semarang. MMM 2015; 4(4):1726-35.
13.Cunningham FG. William obstetric. Ed. 25. New York: McGraw Hill Edu, 2018.
14.Angelina M, Surya IGP, Suwardewa TGA. High sensitivity C-reactive protein dan leukosit serum yang tinggi merupakan faktor risiko terjadinya preeklampsia. Medicina 2019; 50(1):123-8.
15.Morton A. Hematological normal in pregnancy. In: Lowe S, editor. Maternal medical health and disorder in pregnancy. New South Wales: Glowm, 2021; 1-13.
https://doi.org/10.15562/medicina.v50i1.201
16.Yucel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens 2017; 7:29-32.
https://doi.org/10.1016/j.preghy.2016.12.002
17.Zheng WF, Zhan J, Chen A, Ma H, Yang H, Maharjan R. Diagnostic value of neutrophil-lymphocyte ratio in preeclampsia. A prisma- compliant systematic review and meta-analysis. Medicine 2019; 98(51):e18496.
https://doi.org/10.1097/MD.0000000000018496
18.Singgih R, Firmansyah Y, Dewi AK. Kemampuan klinis neutrophil lymphocyte ratio (NLR) pada kehamilan sebagai predictor preeklamsia. Prosiding Seminar Nasional Biologi di Era Pandemi COVID-19. 2020; 325-33.
https://doi.org/10.24252/psb.v6i1.15886
19.Kang Q, Li W, Yu N, fan L, Zhang Y, Sha M, et al. Chen S. Predictive role of neutrophil-to-lymphocyte ratio in preeclamsia: a meta-analysis including 3982 patiens. Pregnancy Hypertensi 2020; 20:111-8.
https://doi.org/10.1016/j.preghy.2020.03.009
20.Singhal K, Pal AK, Tiwari S, Singh R, Kushwaha R. Neutophil lymphocyte ratio (NLR) as a bio inflammatory marker in pre-eclampsia. Int J Contemporary Med Res 2019: 6(4):d1-d3.
http://dx.doi.org/10.21276/ijcmr.2019.6.4.17
21.Setianingrum ELS, Widyastuti NS. Perbedaan antara rasio neutrophil/limfosit dan rasio platelet/limfosit pada kehamilan normal, preeklampsia ringan dan berat. Cendana Med J 2019; 17(2):334-40.
https://doi.org/10.35508/cmj.v7i2.1807
22.Prasetyo A, Bororing SR, Sukadarma Y. Neutrophil to lymphocyte ratio in preeclampsia. Indones J Obstet Gynecol 2021; 9(2):115-8.
https://doi.org/10.32771/inajog.v9i2.1502
23.Thalor N, Singh K, Pujani M, Chauhan V, Agarwal C, Ahuja R. A correlation between platelet indices and preeclampsia. Hematol Transfuse Cell Ther 2019; 41(2):129-33.
https://doi.org/10.1016/j.htct.2018.08.008
24.Surgit O, Pusuroglu H, Erturk M, Akgul O, Buturak A, Akkaya E, et al. Assessment of platelet volume in patients with resistant hypertension, controlled hypertension dan normotensives. Eurasian J Med 2015; 47(2):79-84.
https://doi.org/10.5152/eurasianjmed.2015.43
25.Kim MA, Han GH, Kwon JY, Kim YH. Clinical significance of platelet-to-lymphocyte ratio in women with preeclampsia. Am J Repro Immunol 2018; 80(1):e12974.
https://doi.org/10.1111/aji.12973
26.Toptas M, Asik H, Kalyoncouglu M, Can E, Can MM. Are neutrophil/lymphocyte ratio dan platelet/lymphocyte ratio predictors for severity of preeclamsia? J Clin Gynec Obstet 2016; 5(1):27-31.
http://dx.doi.org/10.14740/jcgo389w



DOI: https://doi.org/10.19106/JMedSci005404202204

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