Şiddetli preeklampside bileşik biyobelirteçler olarak transaminaz kompleks-platelet oranı (TACPR) ve platelet-albümin oranının (PAR) değerlendirilmesi

Öz

Amaç: Şiddetli preeklampsi (PE) tanılı gebelerde, obstetrik ve perinatal sonuçları öngörmede transaminaz kompleks-platelet oranı (TACPR) ve platelet-albümin oranının (PAR) klinik önemini değerlendirmektir. Gereç ve Yöntemler: Ankara Bilkent Şehir Hastanesinde, şiddetli PE tanısı alan 60 gebe ve gebelik yaşı eşleştirilmiş 120 sağlıklı kadını içeren kontrol grubuyla retrospektif bir çalışma yapılmıştır. Bileşik biyobelirteçlerden TACPR, (AST×ALT) /PLT sayısı olarak, PAR ise PLT/Albümin olarak hesaplandı. Gruplar arasında klinik, laboratuvar ve perinatal sonuçlar karşılaştırıldı. TACPR'nin preterm doğum için öngörü performansını değerlendirmek için ROC eğrisi analizi kullanıldı. Proteinüri şiddetine göre (spot idrar <+2 vs. ≥+2) alt grup analizleri yapıldı. Bulgular: Demografik verilerde gruplar arasında anlamlı farklar gözlenmedi (p > 0,05). TACPR, şiddetli PE vakalarında anlamlı olarak yükselirken (p < 0,05), PAR arasında anlamlı fark gözlenmedi (p > 0,05). Şiddetli PE, preterm doğum, düşük doğum ağırlığı (DDA) ve YBÜ'ye yatış oranlarında anlamlı olarak daha yüksek oranlarla ilişkiliydi (p < 0,001). ROC analizi, preterm doğumun tahmininde 0,86'lık bir TACPR kesme noktası belirlemiştir (AUC = 0,701, duyarlılık %63,6, özgüllük %63,2). Şiddetli PE hastaları arasında, ≥+2 proteinüri olanlar, preterm doğum ve DDA oranlarının artmasıyla birlikte daha yüksek kan basıncı, kreatinin ve albümin düzeyleri sergilemiştir. Ancak, TACPR ve PAR, proteinüri düzeyleri arasında önemli bir fark göstermemiştir. Sonuç: TACPR, şiddetli PE'de olumsuz perinatal sonuçlarla ilişkili yeni ve erişilebilir bir bileşik biyobelirteçtir. Klinik değerlendirmeye dahil edilmesi, risk sınıflandırmasını iyileştirebilir. PAR, obstetrik ve perinatal sonuçların tahmininde sınırlı yarara sahiptir. Yine de bu konuda büyük popülasyona sahip çok merkezli prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• şiddetli preeklampsi
• TACPR
• PAR
• perinatal sonuçlar
• bileşik biyobelirteçler

Assessing the transaminase complex-platelet ratio (TACPR) and the platelet-albumin ratio (PAR) as composite biomarkers in severe preeclampsia

Öz

Aim: To evaluate the clinical significance of the transaminase complex-platelet ratio (TACPR) and the platelet-albumin ratio (PAR) in predicting obstetric and perinatal outcomes among women with severe preeclampsia (PE). Material and Methods: A retrospective study was conducted at Ankara Bilkent City Hospital, including 60 pregnant women diagnosed with severe PE and 120 gestational age-matched healthy controls. TACPR was calculated as (AST×ALT)/PLT count, and PAR as PLT/Albumin. Clinical, laboratory, and perinatal outcomes were compared between groups. ROC curve analysis was used to assess the predictive performance of TACPR for preterm birth. Subgroup analysis was performed based on proteinuria severity (spot urine <+2 vs. ≥+2). Results: No significant differences were observed between groups in demographic data (p > 0.05). TACPR was significantly elevated in severe PE cases (p < 0.05), while PAR did not differ significantly (p > 0.05). Severe PE was associated with significantly higher rates of preterm birth, low birth weight (LBW), and NICU admission (p < 0.001). ROC analysis identified a TACPR cut-off of 0.86 for predicting preterm birth (AUC = 0.701, sensitivity 63.6%, specificity 63.2%). Among severe PE patients, those with ≥+2 proteinuria exhibited higher blood pressures, creatinine, and albumin levels, along with increased rates of preterm birth and LBW. However, TACPR and PAR did not significantly differ across proteinuria levels. Conclusion: TACPR is a novel and accessible composite biomarker that correlates with adverse perinatal outcomes in severe PE. Its integration into clinical assessment could enhance risk stratification. PAR showed limited utility near delivery. Further multicenter prospective studies are warranted.

Anahtar Kelimeler

• severe preeclampsia
• TACPR
• PAR
• perinatal outcomes
• composite biomarkers

Kaynakça

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