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All Journal Jurnal Ilmu Kedokteran (Journal of Medical Science) Narra J
Adenin, Ichwanul
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Predictive biomarkers of preeclampsia severity in a low resource setting: Role of red blood cell indices, NLR, and albumin-to-creatinine ratio Tobing, Immanuel DL.; Lumbanraja, Sarma N.; Lintang, Letta S.; Edwar, Rafli R.; Adenin, Ichwanul; Lubis, Muara P.; Sukatendel, Khairani; Suarthana, Eva
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.729

Abstract

Preeclampsia (PE), a serious medical condition with substantial maternal and perinatal implications, poses a significant challenge, particularly in high-incidence countries like Indonesia. Red blood cell (RBC) indices, neutrophil-to-lymphocyte ratio (NLR), and microalbuminuria (albumin-to-creatinine ratio (ACR)) may signal systemic inflammation and endothelial dysfunction, recently recognized as potential indicators for diagnosing and predicting disease severity. The aim of this study was to analyze RBC indices, NLR, and ACR changes in women with PE and their potential for predicting disease severity. A cross-sectional study was conducted at multi-center hospitals across Medan, Indonesia, from June 2022 to June 2023. The patients were grouped into PE cases with and without severe features. Demographic characteristics and complications were recorded while blood and urine were tested. The Chi-squared test, Fisher's exact test and Mann-Whitney test were used to determine biomarkers associated with severe PE. A total of 208 PE patients were included in the study (104 patients for each PE with and without severe features). Our data indicated that PE patients with severe features had higher red cell distribution width (18.5% vs 13.7%; p<0.001), NLR (5.66% vs 4.1%; p<0.001), and ACR (755.97 mg/dL vs 468.63 mg/dL; p<0.001) compared to those without severe features. In contrast, the platelet count was lower in severe features than those without (21.9 × 106/µL vs 27.0 × 106/µL; p=0.002). This study highlighted that PE patients with severe features predominantly had higher levels of RDW, NLR, and ACR and lower platelet counts compared to those without severe features. Therefore, basic tests such as complete blood count and urinalysis, which are inexpensive and feasible in primary care settings with limited resources, offer hope as valuable diagnostic biomarkers for pregnant women diagnosed with PE in a low resource setting.
Pengaruh Pemberian Esomeprazole Terhadap Ekspresi Imunohistokimia Soluble Fms-Like Tyrosine Kinase (Sflt-1) Dan Soluble Endoglin (Seng) Pada Tikus Dengan Model Preeklamsia Andri, Sofyan; Aldiansyah, Dudy; Dina, Sarah; Marpaung, Johny; Adenin, Ichwanul; Faradina, Dwi
Jurnal Ilmu Kedokteran Vol 19, No 1 (2025): Jurnal Ilmu Kedokteran
Publisher : Fakultas Kedokteran Universitas Riau

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26891/JIK.v19i1.2025.66-76

Abstract

Preeclampsia is a systemic disorder affecting approximately 3–8% of pregnant women, occurring during or after pregnancy. The exact cause and underlying mechanisms of this condition remain unclear. It is believed that the anti-angiogenic molecules soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng), which are excessively produced by the placenta in preeclampsia, play a significant role in endothelial dysfunction. Recent studies suggest that esomeprazole, a proton pump inhibitor, is generally well tolerated in preeclamptic patients. This study aimed to evaluate the effect of esomeprazole administration on the reduction of sFlt-1 and sEng expression in a preeclampsia-induced rat model using an analytical approach with a quasi-experimental design. The research was conducted at two laboratories within the Faculty of Medicine and the Faculty of Mathematics and Natural Sciences at Universitas Sumatera Utara: the Anatomical Pathology Laboratory and the Biology Laboratory. The study subjects consisted of 30 healthy and active female laboratory rats (Rattus norvegicus), aged 10 weeks, modeled to resemble preeclamptic conditions. The study was carried out in May 2021. After the intervention, significant differences were observed between the intervention and control groups in systolic blood pressure, diastolic blood pressure, and mean arterial pressure (MAP) (p = 0.001; p = 0.014; p = 0.001). Additionally, the proportion of proteinuria was lower in the intervention group than in the control group. The mean expression levels of sFlt-1 and sEng also showed statistically significant differences between the intervention and control groups (p = 0.002; p = 0.001). The findings indicate statistically significant changes in MAP, systolic and diastolic blood pressure, and proteinuria across all groups following the intervention. A comparison of sFlt-1 and sEng expression levels among the negative control, positive control, and intervention groups revealed statistically significant differences. Esomeprazole administration at a dosage of 4.68 mg/kgBW/day significantly reduced sFlt-1 expression, demonstrating the therapeutic potential of esomeprazole in suppressing anti-angiogenic factors in preeclampsia.
Co-Authors Aldiansyah, Dudy Dina, Sarah Dwi Faradina Edwar, Rafli R. Eva Suarthana Lintang, Letta S. Lubis, Muara P. Lumbanraja, Sarma N. Marpaung, Johny Sofyan Andri Sukatendel, Khairani Tobing, Immanuel DL.