Araştırma Makalesi
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Kan eozinofil-bazofil oranı, eozinofil-lenfosit oranı ve bazofil-lenfosit oranı değerleri gebelikteki intrahepatik kolestazın şiddetini tahmin edebilir mi?

Yıl 2020, Cilt: 45 Sayı: 4, 1742 - 1749, 27.12.2020
https://doi.org/10.17826/cumj.834063

Öz

Amaç: Alerjik hastalıklar için kullanılan inflamatuvar belirteçler ile intrahepatik gebelik kolestazı (ICP) arasındaki ilişkiyi araştırmayı amaçladık.
Gereç ve Yöntem: Bu retrospektif vaka-kontrol çalışmasına 87si hafif kolestazlı (grup 1) ve 27si şiddetli kolestazlı (grup 2) olmak üzere toplam 114 intrahepatik gebelik kolestazlı hasta ve kontrol grubunda 292 sağlıklı gebe (grup 3) çalışmaya dahil edildi. Bu çalışmada kullanılan bazofil, eozinofil, eozinofil-bazofil oranı (EBO), eozinofil-lenfosit oranı (ELO) ve bazofil-lenfosit oranı (BLO), nötrofi-lenfosit oranı (NLO) ve platelet-lenfosit oranı (PLO) değerleri herhangi bir tıbbi veya cerrahi işlem başlatılmadan önce alınan kanlardan değerlendirilmiştir.
Bulgular: ELO, NLO ve PLO değerleri açısından gruplar arasında anlamlı bir fark olduğu saptandı. ELO, NLO, PLO değerleri hafif kolestaz grubunda kontrol grubuna göre anlamlı olarak daha yüksekti. Gebelik kolestazını tahmin etmek için, alıcı işletim karakteristik eğrisi (ROC) analizi kullanıldı. ELO'nın kesme değeri 0,2243 olduğu zaman %76,3 duyarlılık ve %56,1 özgüllük, NLO kesme değeri 11.27 olduğu zaman duyarlılığı 70% ve özgüllük 54,2%, PLO kesme değeri 194,46 olduğu zaman duyarlılığı 60% ve özgüllük 58%olarak saptandı.
Sonuç: Serum inflamasyon belirteçleri ve alerji belirteçleri intrahepatik gebelik kolestazda tanı koydurucu olabilir ancak hastalığın şiddetini saptamada belirleyici değildir.

Destekleyen Kurum

bulunmamaktadır

Proje Numarası

Reference number: 10840098-772.02-E.60609, 10/11/2020

Kaynakça

  • 1, Lammert F, Marschall HU, Glantz A, Matern S. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol 2000;33:1012-21.
  • 2. Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Pruritus may precede abnormal liver function tests in pregnant women with obstetric cholestasis: a longitudinal analysis. BJOG 2001;108:1190-2.
  • 3. Brouwers L, Koster MP, Page-Christiaens GC, Kemperman H, Boon J, Evers IM, et al. Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels. Am J Obstet Gynecol 2015;212:100.e1-e7.
  • 4. Pathak B, Sheibani L, Lee RH. Cholestasis of pregnancy. Obstet Gynecol Clin North Am 2010;37:269-82.
  • 5. Allen K, Jaeschke H, Copple BL. Bile acids induce inflammatory genes in hepatocytes: a novel mechanism of inflammation during obstructive cholestasis. Am J Pathol 2011;178:175-86.
  • 6. Gujral JS, Farhood A, Bajt ML, Jaeschke H. Neutrophils aggravate acute liver injury during obstructive cholestasis in bile duct-ligated mice. Hepatology 2003;38:355–63.
  • 7. Aynıoglu O et al Can Plateletcrit be a Marker for Recurrent Pregnancy Loss? Clin Appl Thromb Hemost 2016;22(5):447–452.
  • 8. Serin S et al Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia? Pregnancy Hypertens 2016;6(1):22–25.
  • 9.Akgun N, Namli Kalem M, Yuce E, Kalem Z, Aktas H Correlations of maternal neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight The Journal of Maternal-Fetal & Neonatal Medicine,2017; 30:17, 2086-2091.
  • 10. Colak E et al Role of mean platelet volume in pregnancy to predict gestational diabetes mellitus in the first trimester. J Matern Fetal Neonatal Med 2020;33(21):3689-3694.
  • 11. Abide Ç et al Can we predict severity of intrahepatic cholestasis of pregnancy using inflammatory markers? Turk J Obstet Gynecol 2017;14:160-5.
  • 12. Kirbas A, Biberoglu E, Daglar K, İskender C, Erkaya S, Dede H, et al. Neutrophil-to-lymphocyte ratio as a diagnostic marker of intrahepatic cholestasis of pregnancy. Eur J Obstet Gynecol Reprod Biol 2014;180:12-5.
  • 13. Mays JK. The active management of intrahepatic cholestasis of pregnancy. Curr Opin Obstet Gynecol 2010;22:100–3.
  • 14. Oztas E, Erkenekli K, Ozler S, Ersoy AO, Kurt M, Oztas E, et al. Can routine laboratory parameters predict üadverse pregnancy outcomes in intrahepatic cholestasis of pregnancy? J Perinat Med 2015;43:667-74.
  • 15. Ren X, Meng Z, Liu M, Zhu M, MD, He Q, Zhang Q.No associations exist between mean platelet volume or platelet distribution width and thyroid function in ChineseMedicine 2016; 95:40-4573)
  • 16. Oztas E, Erkenekli K, Ozler S, Ersoy AO, Kurt M, Oztas E, et al. Can routine laboratory parameters predict üadverse pregnancy outcomes in intrahepatic cholestasis of pregnancy? J Perinat Med 2015;43:667-74.
  • 17. Nording HM, Seizer P, Langer HF. Platelets in inflammation and atherogenesis. Front Immunol2015; 6: 98.
  • 18.Caglayan EK et al Is there any relationshipbetween serum sirtuin-1 level and neutrophil-lymphocyte ratio in hyperemesis gravidarum? J Perinat Med2016; 44(3): 315–320.
  • 19. Zhang WW, Liu KJ, Hu GL, Liang WJ. Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients. Tumour Biol 2015;36:8831-7.
  • 20. Sargın MA et al. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: are they useful for predicting gestational diabetes mellitus during pregnancy? Ther Clin Risk Manag 2016;12: 657–665.
  • 21. Ekin A et al Risk factors and perinatal outcomes associated with latency in preterm premature rupture of membranes between 24 and 34 weeks of gestation. Arch Gynecol Obstet 2014;290(3): 449–455.
  • 22. Ata N, Kulhan M, Kulhan NG, Turkler C Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threatened abortion and early pregnancy loss? Ginekologia Polska 2020;91(4): 210–215.
  • 23.Sahoo D, Gosaib H, Harsodaa JM, Palana BM A Comparative Hematological Profile Study Among Young Individuals. Canadian Journal of Basic and Applied Sciences 2015;3: 178-181.
  • 24. Tembe N et al Reference Values for Clinical Laboratory Parameters in Young Adults in Maputo, Mozambique. PLoS ONE. 2014; 9: 973-991.
  • 25.Chandra S, Tripathi AK, Mishra S, Amzarul M, Vaish AK. Physiological Changes in Hematological Parameters During Pregnancy. Indian J Hematol Blood Transfus 2014;28: 144-146.
  • 26. Elmas B, Kıncı MF, Gök İE, Alkan A, Toğrul C, Sarıkaya S Is higher IgE levels in preeclamptic pregnancies suggest autoimmune pathophysiology? Cukurova Med J 2019;44(1):547-554.
  • 27. Keski-Nisula L, Heinonen S, Remes S, Pekkanen J Pre-eclampsia, placental abruption and increased risk of atopic sensitization in male adolescent offspring. Am J Reprod Immunol 2009;62:293-300.

Can blood eosinophil to basophil ratio, eosinophil to lymphocyte ratio and basophil to lymphocyte ratio predict the severity of intrahepatic cholestasis in pregnancy?

Yıl 2020, Cilt: 45 Sayı: 4, 1742 - 1749, 27.12.2020
https://doi.org/10.17826/cumj.834063

Öz

Purpose: The purpose of the study was to investigate the relation between inflammatory markers used for allergic diseases and intrahepatic pregnancy cholestasis (ICP).
Materials and Methods: In this retrospective case-control study, a total of 114 intrahepatic pregnancy cholestasis patients; 87 with mild cholestasis (group 1) and 27 with severe cholestasis (group 2) and 292 healthy pregnant women in the control group (group 3) were included in the study. The basophil, eosinophil, eosinophil-basophil ratio (EBR), eosinophil-lymphocyte ratio (ELR) and basophil-lymphocyte ratio (BLR), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) values used in this study.
Results: Significant differences were detected between groups in terms of ELR, NLR and PLR values. ELR, NLR, PLR values were significantly higher in the mild cholestasis group than in the control group. To predict the pregnancy cholestasis, receiver operating characteristic curve (ROC) analysis was made, which yielded 76.3% sensitivity and 56.1% specificity when ELR’s interrupt value was 0.2243, NLR interrupt value 11.27% when sensitivity was 70% and specificity 54,000 2%, and PLR cut-off value was 194.46 when sensitivity was 60% and specificity was 58%.
Conclusion: Serum inflammation markers and allergy markers may be diagnostic in intrahepatic pregnancy cholestasis; however, they are not decisive in determining the severity of the disease.

Proje Numarası

Reference number: 10840098-772.02-E.60609, 10/11/2020

Kaynakça

  • 1, Lammert F, Marschall HU, Glantz A, Matern S. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol 2000;33:1012-21.
  • 2. Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Pruritus may precede abnormal liver function tests in pregnant women with obstetric cholestasis: a longitudinal analysis. BJOG 2001;108:1190-2.
  • 3. Brouwers L, Koster MP, Page-Christiaens GC, Kemperman H, Boon J, Evers IM, et al. Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels. Am J Obstet Gynecol 2015;212:100.e1-e7.
  • 4. Pathak B, Sheibani L, Lee RH. Cholestasis of pregnancy. Obstet Gynecol Clin North Am 2010;37:269-82.
  • 5. Allen K, Jaeschke H, Copple BL. Bile acids induce inflammatory genes in hepatocytes: a novel mechanism of inflammation during obstructive cholestasis. Am J Pathol 2011;178:175-86.
  • 6. Gujral JS, Farhood A, Bajt ML, Jaeschke H. Neutrophils aggravate acute liver injury during obstructive cholestasis in bile duct-ligated mice. Hepatology 2003;38:355–63.
  • 7. Aynıoglu O et al Can Plateletcrit be a Marker for Recurrent Pregnancy Loss? Clin Appl Thromb Hemost 2016;22(5):447–452.
  • 8. Serin S et al Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia? Pregnancy Hypertens 2016;6(1):22–25.
  • 9.Akgun N, Namli Kalem M, Yuce E, Kalem Z, Aktas H Correlations of maternal neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight The Journal of Maternal-Fetal & Neonatal Medicine,2017; 30:17, 2086-2091.
  • 10. Colak E et al Role of mean platelet volume in pregnancy to predict gestational diabetes mellitus in the first trimester. J Matern Fetal Neonatal Med 2020;33(21):3689-3694.
  • 11. Abide Ç et al Can we predict severity of intrahepatic cholestasis of pregnancy using inflammatory markers? Turk J Obstet Gynecol 2017;14:160-5.
  • 12. Kirbas A, Biberoglu E, Daglar K, İskender C, Erkaya S, Dede H, et al. Neutrophil-to-lymphocyte ratio as a diagnostic marker of intrahepatic cholestasis of pregnancy. Eur J Obstet Gynecol Reprod Biol 2014;180:12-5.
  • 13. Mays JK. The active management of intrahepatic cholestasis of pregnancy. Curr Opin Obstet Gynecol 2010;22:100–3.
  • 14. Oztas E, Erkenekli K, Ozler S, Ersoy AO, Kurt M, Oztas E, et al. Can routine laboratory parameters predict üadverse pregnancy outcomes in intrahepatic cholestasis of pregnancy? J Perinat Med 2015;43:667-74.
  • 15. Ren X, Meng Z, Liu M, Zhu M, MD, He Q, Zhang Q.No associations exist between mean platelet volume or platelet distribution width and thyroid function in ChineseMedicine 2016; 95:40-4573)
  • 16. Oztas E, Erkenekli K, Ozler S, Ersoy AO, Kurt M, Oztas E, et al. Can routine laboratory parameters predict üadverse pregnancy outcomes in intrahepatic cholestasis of pregnancy? J Perinat Med 2015;43:667-74.
  • 17. Nording HM, Seizer P, Langer HF. Platelets in inflammation and atherogenesis. Front Immunol2015; 6: 98.
  • 18.Caglayan EK et al Is there any relationshipbetween serum sirtuin-1 level and neutrophil-lymphocyte ratio in hyperemesis gravidarum? J Perinat Med2016; 44(3): 315–320.
  • 19. Zhang WW, Liu KJ, Hu GL, Liang WJ. Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients. Tumour Biol 2015;36:8831-7.
  • 20. Sargın MA et al. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: are they useful for predicting gestational diabetes mellitus during pregnancy? Ther Clin Risk Manag 2016;12: 657–665.
  • 21. Ekin A et al Risk factors and perinatal outcomes associated with latency in preterm premature rupture of membranes between 24 and 34 weeks of gestation. Arch Gynecol Obstet 2014;290(3): 449–455.
  • 22. Ata N, Kulhan M, Kulhan NG, Turkler C Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threatened abortion and early pregnancy loss? Ginekologia Polska 2020;91(4): 210–215.
  • 23.Sahoo D, Gosaib H, Harsodaa JM, Palana BM A Comparative Hematological Profile Study Among Young Individuals. Canadian Journal of Basic and Applied Sciences 2015;3: 178-181.
  • 24. Tembe N et al Reference Values for Clinical Laboratory Parameters in Young Adults in Maputo, Mozambique. PLoS ONE. 2014; 9: 973-991.
  • 25.Chandra S, Tripathi AK, Mishra S, Amzarul M, Vaish AK. Physiological Changes in Hematological Parameters During Pregnancy. Indian J Hematol Blood Transfus 2014;28: 144-146.
  • 26. Elmas B, Kıncı MF, Gök İE, Alkan A, Toğrul C, Sarıkaya S Is higher IgE levels in preeclamptic pregnancies suggest autoimmune pathophysiology? Cukurova Med J 2019;44(1):547-554.
  • 27. Keski-Nisula L, Heinonen S, Remes S, Pekkanen J Pre-eclampsia, placental abruption and increased risk of atopic sensitization in male adolescent offspring. Am J Reprod Immunol 2009;62:293-300.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kadın Hastalıkları ve Doğum
Bölüm Araştırma
Yazarlar

Derya Kanza Gül 0000-0001-8879-9299

Ayça Şolt 0000-0001-6733-5348

Proje Numarası Reference number: 10840098-772.02-E.60609, 10/11/2020
Yayımlanma Tarihi 27 Aralık 2020
Kabul Tarihi 14 Aralık 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 45 Sayı: 4

Kaynak Göster

MLA Kanza Gül, Derya ve Ayça Şolt. “Can Blood Eosinophil to Basophil Ratio, Eosinophil to Lymphocyte Ratio and Basophil to Lymphocyte Ratio Predict the Severity of Intrahepatic Cholestasis in Pregnancy?”. Cukurova Medical Journal, c. 45, sy. 4, 2020, ss. 1742-9, doi:10.17826/cumj.834063.