Alterations of Several Serum Parameters Are Associated with Preeclampsia and May Be Potential Markers for the Assessment of PE Severity

Duan, Zhongliang; Li, Cui; Leung, Wing Ting; Wu, Jiang‐Nan; Wang, Mingyan; Ying, Chunmei; Wang, Ling

doi:10.1155/2020/7815214

Cited by 28 publications

(25 citation statements)

References 39 publications

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“…reported no significant difference in PCs and MPV with the presence of preeclampsia or with the severity of preeclampsia. [ 23 ] In our study, in preeclampsia patients, RDW had a significant difference from controls, and our findings matched with one meta-analysis which concluded that the RDW level is higher in SPE as compared to NSPE. [ 24 ] In our study, RDW predicts NSPE and SPE with 85.3% and 93.8% sensitivity, specificity 49%, and 44.1%, respectively.…”

Section: Discussionsupporting

confidence: 89%

Role of platelet count and mean platelet volume and red cell distribution width in the prediction of preeclampsia in early pregnancy

Sachan

Patel

Vandana

et al. 2021

Journal of Family Medicine and Primary Care

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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 MPV, RDW, and PC were measured two times by the Siemens Advia analyzer; the first samples were withdrawn at the time of enrolment and the next sample was taken after the development of the disease, and both samples were analyzed.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/mm 3 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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Section: Discussionsupporting

confidence: 89%

Role of platelet count and mean platelet volume and red cell distribution width in the prediction of preeclampsia in early pregnancy

Sachan

Patel

Vandana

et al. 2021

Journal of Family Medicine and Primary Care

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“…The sensitivity of LDH in predicting preeclampsia was reported in four articles that were particularly heterogeneous due to the quite heterogeneous optimal cut-off values that were evaluated; thus, precluding analysis of results. Specifically, Duan et al reported an area under the curve (AUC) that reached 0.899 and a sensitivity of 92.5% using a cut-off value of 183.5 U/L [20]. Similarly, Khalil observed that LDH could help differentiate severe preeclampsia from healthy controls as well as patients with proteinuria, gestational hypertension and mild preeclampsia using a cut-off value of 208 U/L (sensitivity 100%, AUC 71.2%) [21].…”

Section: Qualitative Analysismentioning

confidence: 99%

Serum LDH values in hypertensive disorders of pregnancy and their association with maternal and neonatal morbidity: a meta-analysis

Pergialiotis

Panagiotopoulos

Bellos

et al. 2021

Preprint

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Objectives: Serum lactate dehydrogenase has been extensively studied in hypertensive disorders of pregnancy. However, to date, its clinical usefulness in the field remains unknown. The present meta-analysis has been designed to evaluate differences in serum LDH values among patients with hypertensive disorders of pregnancy and to help determine its diagnostic accuracy as well its predictive accuracy in determining adverse pregnancy outcomes. Methods: We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar databases from their inception till March 18, 2021. Meta-analysis was performed using the meta and metafor functions in Rstudio. Pooled mean differences (MD) were calculated with the Hartung-Knapp-Sidik-Jonkman. Meta-regression analyses, publication bias assessment and Trim and Fill function were also performed. The adequacy of the sample size was evaluated with Trial Sequential Analysis. Results: Fifty-two articles were included that comprised 5,340 women with hypertensive disorders of pregnancy and 2,890 healthy controls. The meta-analysis revealed significant differences among patients with preeclampsia (either mild or severe) compared to controls, as well as among patients with mild and severe preeclampsia. Significant asymmetry was noted after examining funnel plots, however, and the trim and fill analysis revealed that differences were significant only among cases with severe preeclampsia and healthy controls. Morbidity outcomes increased with LDH levels > 600 IU/L and particularly when these exceeded 800 IU/L. However, confidence and prediction intervals indicated an underpowered sample size for the accurate determination of the odds of developing maternal morbidity. Conclusions: Despite the extensive research in the field of hypertensive disorders of pregnancy, there is still lack of evidence concerning the diagnostic performance of serum LDH in clinical practice; hence, research should expand in this direction to evaluate its clinical utility.

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“…PE progresses rapidly. There are currently no specific laboratory indicators to diagnose and grade the severity of PE patients, which may have an impact on the subsequent treatment of patients (8,9). The anti-angiogenic factor sFlt-1 is secreted by the placenta and is involved in vascular regulation.…”

Section: Discussionmentioning

confidence: 99%

Expression and significance of serum soluble fms-like tyrosine kinase 1 (sFlt-1), CXC chemokine ligand 16 (CXCL16), and lipocalin 2 (LCN-2) in pregnant women with preeclampsia

Li¹,

Ling²,

Mei³

et al. 2021

Ann Palliat Med

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Background: To explore the value of serum soluble fms-like tyrosine kinase 1 (sFlt-1), CXC chemokine ligand 16 (CXCL16), and lipocalin 2 (LCN-2) in the diagnosis and grading of preeclampsia (PE).Methods: A total of 186 patients with PE diagnosed and treated in our hospital were included. According to the disease severity, the patients were divided into the mild PE group (99 cases) and the severe PE group (87 cases). A total of 72 healthy pregnant women who underwent antenatal care were selected as the healthy control group. The levels of serum sFlt-1, CXCL16, and LCN-2 before medication were compared among the patients, and the diagnosis and grading value of the above 3 indicators were analyzed. Results: For PE patients vs. healthy controls, the levels of sFlt-1 (132.71±14.49 vs. 68.43±9.28 μg/L), CXCL16 (2.15±0.35 vs. 0.61±0.12 μg/L), and LCN-2 (70.81±8.25 vs. 19.22±3.14 μg/L) were all significantly higher in PE patients than in the healthy controls (P<0.05). For severe PE vs. mild PE, the levels of sFlt-1 (142.16±20.23 vs. 124.41±10.36 μg/L), CXCL16 (2.87±0.59 vs. 1.51±0.28 μg/L), and LCN-2 (90.76±10.16vs. 53.27±6.19 μg/L) in the severe PE group were higher than those in the mild PE group (P<0.05). Receiver operating characteristic curve (ROC) analysis showed that when the cut-off values of sFlt-1, CXCL16, and LCN-2 were 99.65, 1.36, and 0.84 μg/L, respectively, the diagnostic efficacy of PE was the highest. With these cut-off values, the diagnostic sensitivities of sFlt-1, CXCL16, and LCN-2 were 86.67%, 73.33%, and 93.33%, respectively. The specificities of sFlt-1, CXCL16, and LCN-2 were 80.00%, 86.67%, and 60.00%, respectively. The areas under the curves (AUC) of sFlt-1, CXCL16, and LCN-2 were 0.764, 0.769, and 0.831, respectively. When the cut-off values for sFlt-1, CXCL16, and LCN-2 were 135.16, 2.24, and 70.38 μg/L, respectively, the efficacy was the highest in distinguishing mild and severe PE. With these cut-off values, the AUC values of sFlt-1, CXCL16, and LCN-2 were 0.837, 0.808, and 0.869, respectively.Conclusions: sFlt-1, CXCL16, and LCN-2 have certain significance in the diagnosis and grading of PE.Among them, LCN-2 has the highest correlation with the diagnosis and grading of PE.

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Alterations of Several Serum Parameters Are Associated with Preeclampsia and May Be Potential Markers for the Assessment of PE Severity

Cited by 28 publications

References 39 publications

Role of platelet count and mean platelet volume and red cell distribution width in the prediction of preeclampsia in early pregnancy

Role of platelet count and mean platelet volume and red cell distribution width in the prediction of preeclampsia in early pregnancy

Serum LDH values in hypertensive disorders of pregnancy and their association with maternal and neonatal morbidity: a meta-analysis

Expression and significance of serum soluble fms-like tyrosine kinase 1 (sFlt-1), CXC chemokine ligand 16 (CXCL16), and lipocalin 2 (LCN-2) in pregnant women with preeclampsia

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