Neutrophil and Platelet to Lymphocyte Ratio in Prevailing the Oxidative Stress and its Relation with the Endothelial Dysfunction in Preeclampsia

ABSTRACT

Background: Preeclampsia (PE) is a pregnancy specific,hypertensive disorder. It affects 2-8% pregnancies.Oxidative stress and systemic inflammation areproposed to contribute significantly to the preeclampsiapathophysiology. The present study, aim is to determineand compare the markers of oxidative stress, endothelialdysfunction, systemic inflammatory markersNeutrophil/Lymphocyte Ratio (NLR) and Platelet/Lymphocyte Ratio (PLR) in preeclampsia andgestational age matched healthy controls. Material andMethods: This study was conducted in the Departmentof Biochemistry and Department of Obstetrics andGynecology, Sri Devaraj Urs Medical College, Kolar,Karnataka. The study included 98 preeclamptic womenand 98 normotensive pregnant women. Five ml venousblood was collected from all the study subjects. Bloodsample in EDTA vials was used for the complete bloodcount. NLR and PLR were calculated. Plasma was usedfor Ferric Reducing Ability of Plasma (FRAP) assay.Serum was used for the estimation of Malondialdehyde(MDA), nitric oxide, blood sugar, renal parameters andliver enzymes i.e., Aspartate Transaminase (AST),Alanine Transaminase (ALT), Lactate Dehydrogenase(LDH) and magnesium. Corresponding urine sampleswere collected for urinary protein analysis by dipstickmethod. Fetal outcome was recorded. Results:Gestational age was significantly low in preeclampticwomen as compared to those of controls. Bloodpressure (Systolic and diastolic), mean arterial pressure,body mass index, pulse rate, serum creatinine, uric acid,AST, ALT, LDH, MDA and NLR were increasedsignificantly in preeclamptic women as compared tothose of controls. In subgroup analysis, NLR wasincreased significantly in severe preeclamptics ascompared to mild preeclamptics. Serum Nitric Oxide(NO) and FRAP levels were decreased significantly inpreeclamptic women as compared to those of controls.Significantly decreased birth weight was observed inbabies born to preeclamptic mothers compared withcontrols. Conclusion: The present study resultsconclude that increased oxidative stress in termsincreased MDA, decreased NO and reduced antioxidantstatus (FRAP) in preeclamptic women, results inadverse perinatal outcome. In addition, maternal NLRcould be considered as a marker for severity ofpreeclampsia