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The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum

Year 2020, Volume: 7 Issue: 3, 124 - 127, 29.12.2020
https://doi.org/10.47572/muskutd.677093

Abstract

This study was aimed to investigate the diagnostic value of the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), platelet distribution width (PDW), mean platelet volume (MPV), plateletcrit (PCT) and red cell distribution width (RDW) in patients with hyperemesis gravidarum (HG). We conducted this retrospective study in a tertiary center between August and December 2019.A total of 72 pregnant patients with HG and 78 pregnant women without nausea and vomiting were included in the study. Hemoglobin (Hb), white blood cell count (WBC), neutrophil count, lymphocyte count, platelet count, RDW, PDW, MPV, PCT, and CRP values were all derived from patients' medical files. The student's t-test was used to compare the normally distributed data. Mann-Whitney U test was used to compare the non-normally distributed data. The median NLR value of the HG group was 3.4 (1.1-7.2), and the control group was 1.98 (1.0-4.6). This difference was statistically significant (p<0.05). The median PLR value of the HG group (152.6 [69.8-338.1]) was significantly higher (p<0.05) than the PLR value of the control group (88.1 [48.3-201.2]). The results of this study suggest that NLR and PLR can be used as effective markers in the diagnosis of HG. The increased values of NLR and PLR also indicate that inflammation may act a crucial role in the pathogenesis of HG.

References

  • 1. Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018;131(1):15-30.
  • 2. Bustos M, Venkataramanan R, Caritis S. Nausea and vomiting of pregnancy - What's new? Auton Neurosci. 2017;202:62-72.
  • 3. Zur E. Nausea and vomiting in pregnancy: a review of the pathology and compounding opportunities. Int J Pharm Compd. 2013;17(2):113-23.
  • 4. Groleau D, Benady-Chorney J, Panaitoiu A, Jimenez V. Hyperemesis Gravidarum in the context of migration: when the absence of cultural meaning gives rise to ''blaming the victim''. BMC Pregnancy Childbirth. 2019;19(1):197.
  • 5. London V, Grube S, Sherer DM, Abulafia O. Hyperemesis Gravidarum: A Review of Recent Literature. Pharmacology. 2017;100(3-4):161-71.
  • 6. Oğlak SC, Aydın MF. Are neutrophil to lymphocyte ratio and platelet to lymphocyte ratio clinically useful for the prediction of early pregnancy loss? Ginekol Pol. 2020;91(9):524-7.
  • 7. Nadeau-Vallée M, Obari D, Palacios J, et al. Sterile inflammation and pregnancy complications: a review. Reproduction. 2016;152(6):277-92.
  • 8. Christiansen OB, Nielsen HS, Kolte AM. Inflammation and miscarriage. Semin Fetal Neonatal Med. 2006;11(5):302-8.
  • 9. Kalagiri RR, Carder T, Choudhury S, et al. Inflammation in Complicated Pregnancy and Its Outcome. Am J Perinatol. 2016;33(14):1337-56. 10. Kuscu NK, Yildirim Y, Koyuncu F, Var A, Uyanik BS. Interleukin-6 levels in hyperemesis gravidarum. Arch Gynecol Obstet. 2003;269(1):13-5.
  • 11. Niemeijer MN, Grooten IJ, Vos N, Bais JM, van der Post JA, Mol BW. Diagnostic markers for hyperemesis gravidarum: a systematic review and metaanalysis. Am J Obstet Gynecol. 2014;211(2):150.e1-15.
  • 12. Engin-Ustun Y, Tonguç E, Var T, et al. Vaspin and C-reactive protein levels in hyperemesis gravidarum. Eur Rev Med Pharmacol Sci. 2013;17(1):138-40.
  • 13. Caglayan EK, Engin-Ustun Y, Gocmen AY, et al. Is there any relationship between serum sirtuin-1 level and neutrophil-lymphocyte ratio in hyperemesis gravidarum? J Perinat Med. 2016;44(3):315-20.
  • 14. Tang J, Gao X, Zhi M, et al. Platelecrit: a sensitive biomarker for evaluating disease activity in Crohn's disease with low hs-CRP. J Dig Dis. 2015;16(3):118-24.
  • 15. Yao C, Liu X, Tang Z. Prognostic role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for hospital mortality in patients with AECOPD. Int J Chron Obstruct Pulmon Dis. 2017;12:2285-90.
  • 16. Dear CR, Shemar M, Ostrowski GAU, Painter RC. Management of severe pregnancy sickness and hyperemesis gravidarum. BMJ. 2018;363:k5000.
  • 17. Practice Bulletin Summary No. 153: Nausea and Vomiting of Pregnancy. Obstet Gynecol. 2015;126(3):687-8.
  • 18. Kaplan PB, Gücer F, Sayin NC, Yüksel M, Yüce A, Yardim T. Maternal serum cytokine levels in women with hyperemesis gravidarum in the first trimester of pregnancy. Fertil Steril. 2003;79(3):498-502.
  • 19. Kiyokawa Y, Yoneyama Y. Relationship between adenosine and T-helper 1/T-helper 2 balance in hyperemesis gravidarum. Clin Chim Acta. 2006;370(1-2):137-42.
  • 20. Verit FF, Erel O, Celik H. Paraoxonase-1 activity in patients with hyperemesis gravidarum. Redox Rep. 2008;13(3):134-8.
  • 21. Kim MA, Han GH, Kwon JY, Kim YH. Clinical significance of platelet-to-lymphocyte ratio in women with preeclampsia. Am J Reprod Immunol. 2018;80(1):e12973.
  • 22. Wada H, Dohi T, Miyauchi K, et al. Mean platelet volume and long-term cardiovascular outcomes in patients with stable coronary artery disease. Atherosclerosis. 2018;277:108-12.
  • 23. Wincup C, Parnell C, Cleanthous S, et al. Red cell distribution width correlates with fatigue levels in a diverse group of patients with systemic lupus erythematosus irrespective of anaemia status. Clin Exp Rheumatol. 2019;37(5):852-54.
  • 24. Beyazit F, Öztürk FH, Pek E, Ünsal MA. Evaluation of the hematologic system as a marker of subclinical inflammation in hyperemesis gravidarum: a case control study. Ginekol Pol. 2017;88(6):315-9.
  • 25. Cintesun E, Akar S, Gul A, et al. Subclinical inflammation markers in hyperemesis gravidarum and ketonuria: A case-control study. J Lab Physicians. 2019;11(2):149-53.
  • 26. Jenne CN, Kubes P. Platelets in inflammation and infection. Platelets. 2015;26(4):286-92.
  • 27. Karateke A, Kurt RK, Baloğlu A. Relation of platelet distribution width (PDW) and platelet crit to preeclampsia. Ginekol Pol. 2015;86(5):372-5.
  • 28. Tayfur C, Burcu DC, Gulten O, et al. Association between platelet to lymphocyte ratio, plateletcrit and the presence and severity of hyperemesis gravidarum. J Obstet Gynaecol Res. 2017;43(3):498-504.
  • 29. Kurt RK, Güler A, Silfeler DB, Ozçil MD, Karateke A, Hakverdi AU. Relation of inflammatory markers with both presence and severity of hyperemesis gravidarum. Ginekol Pol. 2014;85(8):589-93.

Sistemik İnflamatuar Belirteçlerin Hyperemezis Gravidarum Tanısındaki Rolü

Year 2020, Volume: 7 Issue: 3, 124 - 127, 29.12.2020
https://doi.org/10.47572/muskutd.677093

Abstract

Bu çalışmada hiperemezis gravidarumu olan hastalarda nötrofil-lenfosit oranı (NLO), trombosit-lenfosit oranı (TLO), trombosit dağılım genişliği (TDG), ortalama trombosit hacmi (OTH), plateletcrit (PKT) ve eritrosit dağılım genişliğinin (EDG) tanısal değeri araştırılmıştır. Bu retrospektif çalışmayı üçüncü basamak bir merkezde Ağustos ve Aralık 2019 tarihleri arasında gerçekleştirdik. Çalışmaya hiperemezis gravidarumu olan 72 hasta ve bulantı ve kusması olmayan 78 gebe dahil edildi. Hemoglobin (Hb), EDG, TDG, OTH, PKT ve C-reaktif protein (CRP) değerleri hastaların tıbbi dosyalarından elde edildi. Normal dağılım gösteren verileri karşılaştırmak için Student's t testi, normal dağılıma uymayan verileri karşılaştırmak için Mann-Whitney U testi kullanıldı. HG grubunun ortanca NLO değeri 3.4 (1.1-7.2), kontrol grubunun 1.98 (1.0-4.6) idi. Bu farklılık istatistiksel olarak anlamlıydı (p<0.05). HG grubunun ortanca PLO değeri (152.6 [69.8-338.1]), kontrol grubunun PLO değerinden (88.1 [48.3-201.2]) anlamlı olarak daha yüksekti (p<0.05). Bu çalışmanın sonuçları NLO ve PLO’nun HG tanısında etkili belirteçler olarak kullanılabileceğini düşündürmektedir. Artan NLO ve PLO değerleri, inflamasyonun HG patogenezinde önemli bir rol oynuyor olabileceğini de göstermektedir.

References

  • 1. Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018;131(1):15-30.
  • 2. Bustos M, Venkataramanan R, Caritis S. Nausea and vomiting of pregnancy - What's new? Auton Neurosci. 2017;202:62-72.
  • 3. Zur E. Nausea and vomiting in pregnancy: a review of the pathology and compounding opportunities. Int J Pharm Compd. 2013;17(2):113-23.
  • 4. Groleau D, Benady-Chorney J, Panaitoiu A, Jimenez V. Hyperemesis Gravidarum in the context of migration: when the absence of cultural meaning gives rise to ''blaming the victim''. BMC Pregnancy Childbirth. 2019;19(1):197.
  • 5. London V, Grube S, Sherer DM, Abulafia O. Hyperemesis Gravidarum: A Review of Recent Literature. Pharmacology. 2017;100(3-4):161-71.
  • 6. Oğlak SC, Aydın MF. Are neutrophil to lymphocyte ratio and platelet to lymphocyte ratio clinically useful for the prediction of early pregnancy loss? Ginekol Pol. 2020;91(9):524-7.
  • 7. Nadeau-Vallée M, Obari D, Palacios J, et al. Sterile inflammation and pregnancy complications: a review. Reproduction. 2016;152(6):277-92.
  • 8. Christiansen OB, Nielsen HS, Kolte AM. Inflammation and miscarriage. Semin Fetal Neonatal Med. 2006;11(5):302-8.
  • 9. Kalagiri RR, Carder T, Choudhury S, et al. Inflammation in Complicated Pregnancy and Its Outcome. Am J Perinatol. 2016;33(14):1337-56. 10. Kuscu NK, Yildirim Y, Koyuncu F, Var A, Uyanik BS. Interleukin-6 levels in hyperemesis gravidarum. Arch Gynecol Obstet. 2003;269(1):13-5.
  • 11. Niemeijer MN, Grooten IJ, Vos N, Bais JM, van der Post JA, Mol BW. Diagnostic markers for hyperemesis gravidarum: a systematic review and metaanalysis. Am J Obstet Gynecol. 2014;211(2):150.e1-15.
  • 12. Engin-Ustun Y, Tonguç E, Var T, et al. Vaspin and C-reactive protein levels in hyperemesis gravidarum. Eur Rev Med Pharmacol Sci. 2013;17(1):138-40.
  • 13. Caglayan EK, Engin-Ustun Y, Gocmen AY, et al. Is there any relationship between serum sirtuin-1 level and neutrophil-lymphocyte ratio in hyperemesis gravidarum? J Perinat Med. 2016;44(3):315-20.
  • 14. Tang J, Gao X, Zhi M, et al. Platelecrit: a sensitive biomarker for evaluating disease activity in Crohn's disease with low hs-CRP. J Dig Dis. 2015;16(3):118-24.
  • 15. Yao C, Liu X, Tang Z. Prognostic role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for hospital mortality in patients with AECOPD. Int J Chron Obstruct Pulmon Dis. 2017;12:2285-90.
  • 16. Dear CR, Shemar M, Ostrowski GAU, Painter RC. Management of severe pregnancy sickness and hyperemesis gravidarum. BMJ. 2018;363:k5000.
  • 17. Practice Bulletin Summary No. 153: Nausea and Vomiting of Pregnancy. Obstet Gynecol. 2015;126(3):687-8.
  • 18. Kaplan PB, Gücer F, Sayin NC, Yüksel M, Yüce A, Yardim T. Maternal serum cytokine levels in women with hyperemesis gravidarum in the first trimester of pregnancy. Fertil Steril. 2003;79(3):498-502.
  • 19. Kiyokawa Y, Yoneyama Y. Relationship between adenosine and T-helper 1/T-helper 2 balance in hyperemesis gravidarum. Clin Chim Acta. 2006;370(1-2):137-42.
  • 20. Verit FF, Erel O, Celik H. Paraoxonase-1 activity in patients with hyperemesis gravidarum. Redox Rep. 2008;13(3):134-8.
  • 21. Kim MA, Han GH, Kwon JY, Kim YH. Clinical significance of platelet-to-lymphocyte ratio in women with preeclampsia. Am J Reprod Immunol. 2018;80(1):e12973.
  • 22. Wada H, Dohi T, Miyauchi K, et al. Mean platelet volume and long-term cardiovascular outcomes in patients with stable coronary artery disease. Atherosclerosis. 2018;277:108-12.
  • 23. Wincup C, Parnell C, Cleanthous S, et al. Red cell distribution width correlates with fatigue levels in a diverse group of patients with systemic lupus erythematosus irrespective of anaemia status. Clin Exp Rheumatol. 2019;37(5):852-54.
  • 24. Beyazit F, Öztürk FH, Pek E, Ünsal MA. Evaluation of the hematologic system as a marker of subclinical inflammation in hyperemesis gravidarum: a case control study. Ginekol Pol. 2017;88(6):315-9.
  • 25. Cintesun E, Akar S, Gul A, et al. Subclinical inflammation markers in hyperemesis gravidarum and ketonuria: A case-control study. J Lab Physicians. 2019;11(2):149-53.
  • 26. Jenne CN, Kubes P. Platelets in inflammation and infection. Platelets. 2015;26(4):286-92.
  • 27. Karateke A, Kurt RK, Baloğlu A. Relation of platelet distribution width (PDW) and platelet crit to preeclampsia. Ginekol Pol. 2015;86(5):372-5.
  • 28. Tayfur C, Burcu DC, Gulten O, et al. Association between platelet to lymphocyte ratio, plateletcrit and the presence and severity of hyperemesis gravidarum. J Obstet Gynaecol Res. 2017;43(3):498-504.
  • 29. Kurt RK, Güler A, Silfeler DB, Ozçil MD, Karateke A, Hakverdi AU. Relation of inflammatory markers with both presence and severity of hyperemesis gravidarum. Ginekol Pol. 2014;85(8):589-93.
There are 28 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Original Article
Authors

Süleyman Cemil Oğlak 0000-0001-7634-3008

Mehmet Obut 0000-0002-6925-4784

Publication Date December 29, 2020
Submission Date January 19, 2020
Published in Issue Year 2020 Volume: 7 Issue: 3

Cite

APA Oğlak, S. C., & Obut, M. (2020). The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 7(3), 124-127. https://doi.org/10.47572/muskutd.677093
AMA Oğlak SC, Obut M. The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum. MMJ. December 2020;7(3):124-127. doi:10.47572/muskutd.677093
Chicago Oğlak, Süleyman Cemil, and Mehmet Obut. “The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 7, no. 3 (December 2020): 124-27. https://doi.org/10.47572/muskutd.677093.
EndNote Oğlak SC, Obut M (December 1, 2020) The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 7 3 124–127.
IEEE S. C. Oğlak and M. Obut, “The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum”, MMJ, vol. 7, no. 3, pp. 124–127, 2020, doi: 10.47572/muskutd.677093.
ISNAD Oğlak, Süleyman Cemil - Obut, Mehmet. “The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 7/3 (December 2020), 124-127. https://doi.org/10.47572/muskutd.677093.
JAMA Oğlak SC, Obut M. The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum. MMJ. 2020;7:124–127.
MLA Oğlak, Süleyman Cemil and Mehmet Obut. “The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, vol. 7, no. 3, 2020, pp. 124-7, doi:10.47572/muskutd.677093.
Vancouver Oğlak SC, Obut M. The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum. MMJ. 2020;7(3):124-7.