Skip to main content Skip to main navigation menu Skip to site footer

Lebar distribusi sel darah merah (RDW) yang tinggi dan kadar high density lipoprotein cholesterol (HDL-C) yang rendah sebagai faktor risiko terjadinya preeklampsia di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar, Bali, Indonesia

  • Putu Pradnya Paramitha Dewi ,
  • Anak Agung Ngurah Jaya Kusuma ,
  • Ryan Saktika Mulyana ,
  • I Wayan Megadhana ,
  • Putu Doster Mahayasa ,
  • I Nyoman Bayu Mahendra ,
  • I Nyoman Gede Budiana ,

Abstract

Background: Preeclampsia is a multisystem disease defined as new onset hypertension accompanied by proteinuria at gestational age above 20 weeks which is associated with high rates of premature birth, placental abruption, infant and maternal mortality rates. RDW is known to be associated with inflammation and oxidative stress, while HDL can lose its function of vasoprotective effects and anti-atherogenic effects if it is in low values. There is a relationship between RDW and HDL with inflammation and endothelial dysfunction, therefore, a study was conducted on RDW and HDL levels as risk factors for preeclampsia.

Methods: We designed an matched case-control study to include 52 cases of pregnant women in Prof I.G.N.G Ngoerah Hospital, with 23 cases are pregnant women with preeclampsia and 23 cases are pregnant women without preeclampsia who treated at Prof I.G.N.G Ngoerah General Hospital Denpasar. From the data obtained for the RDW and HDL results, a normality test was performed, bivariate and multivariate analysis and a correlation test between the two variables. The Chi-Square test is used to determine the odds ratio of RDW and HDL to the occurrence of preeclampsia.

Results: This study included a total of 52 pregnant women, of which 26 each had preeclampsia and 26 non-preeclampsia. The median age of mothers in the preeclampsia group was significantly higher (34.5 years, p=0.002), with most of the patients in this study having term pregnancy (65.4%) and multipara (67.3%), only 7, 7% of patients categorized as obese. Patients with high RDW have a 5.12 times higher risk for preeclampsia than those with low RDW and patients with low HDL levels have a 5.06 times higher risk for preeclampsia than those with high HDL levels. High RDW and low HDL increase the risk of preeclampsia by 8 and 4 times. With the correlation test, the value of r = -0.236, where the value of RDW to HDL has a negative value with a low degree of correlation.

Conclusions: High RDW and low HDL are risk factors for preeclampsia, with a negative relationship and a low degree of correlation between the two variables.

 

Latar belakang: Preeklampsia merupakan penyakit multisistem yang didefinisikan sebagai hipertensi awitan baru disertai proteinuria pada usia kehamilan di atas 20 minggu yang dikaitkan dengan tingginya angka kelahiran prematur, solusio plasenta, angka kematian bayi dan ibu. RDW diketahui berhubungan dengan inflamasi dan stress oksidatif, sedangkan HDL dapat kehilangan fungsi efek vasoprotektif serta efek anti-aterogenik bila dalam nilai rendah. Adanya hubungan antara RDW dan HDL dengan inflamasi dan disfungsi endotel, oleh karena itu, dilakukannya studi mengenai RDW dan kadar HDL sebagai faktor risiko terjadinya preeklampsia

Metode: Penelitian ini menggunakan rancangan kasus kontrol berpasangan, yang melibatkan total 52 wanita, dengan masing-masing 26 ibu hamil dengan preeklampsia dan 26 ibu hamil tidak preeklampsia yang dirawat di RSUP Prof I.G.N.G Ngoerah, Denpasar. Dari data nilai hasil RDW dan HDL yang didapat, dilakukan uji normalitas, analisis bivariat dan multivariat serta uji korelasi antara kedua variabel. Uji Chi-Square digunakan untuk mengetahui rasio Odds dari RDW dan HDL terhadap terjadinya preeklampsia.

Hasil: Penelitian ini menginklusi total 52 wanita hamil, dimana masing-masing 26 wanita mengalami preeklampsia dan 26 non-preeklampsia. Median umur ibu pada kelompok preeklampsia secara signifikan lebih tinggi (34,5 tahun, p=0,002), dengan sebagian besar pasien pada penelitian ini memiliki usia kehamilan aterm (65,4%) dan multipara (67,3%), hanya 7,7% pasien yang dikategorikan memiliki IMT obesitas. Pasien dengan RDW tinggi memiliki risiko mengalami preeklampsia sebesar 5,12 kali lebih tinggi dibandingkan dengan yang memiliki RDW rendah dan pasien dengan kadar HDL rendah memiliki risiko mengalami preeklampsia sebesar 5,06 kali lebih tinggi dibandingkan dengan kadar HDL tinggi. RDW yang tinggi dan HDL yang rendah meningkatkan risiko kejadian preeklampsia sebesar 8 dan 4 kali. Dengan uji korelasi nilai r = - 0.236, dimana nilai RDW terhadap HDL memiliki nilai negatif dengan korelasi derajat hubungan yang lemah.

Simpulan: RDW yang tinggi dan HDL yang rendah merupakan faktor risiko terjadinya preklampsia, dengan hubungan negatif dan derajat korelasi rendah antara kedua variabel.

References

  1. World Health Organization (WHO). (2019). Maternal mortality. [online] Tersedia di: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality [Diakses 20 September 2020].
  2. Kemenkes RI, 2020. Profil Kesehatan Indonesia tahun 2019.
  3. Dinas Kesehatan Provinsi Bali, 2018. Profil Kesehatan Provinsi Bali 2017.
  4. World Health Organization (WHO). (2013). Who Recommendations for Prevention and Treatment of Preeclampsia and Eclampsia Implications and Actions. [online] Tersedia di: https://apps.who.int/iris/bitstream/handle/10665/119627/WHO_RHR_14.17_eng.pdf;jsessionid=CDB3B0702FCD434603CC5CA8F99013F7?sequence=1 [Diakses 20 September 2020].
  5. Kaur DB, Nidhi D, Fayyaz DS. Study of serum lipid profile in pregnancy and its correlation with preeclampsia. Obstet & Gynecol Int J. 2019;10(3):169–74. Available from: http://dx.doi.org/10.15406/ogij.2019.10.00439
  6. Yılmaz ZV, Yılmaz E, Küçüközkan T. Red blood cell distribution width: A simple parameter in preeclampsia. Pregnancy Hypertens An Int J Women’s Cardiovasc Heal. 2016;6(4):285–7. Available from: http://dx.doi.org/10.1016/j.preghy.2016.05.001
  7. Anuradha R, Durga T. Estimation of Lipid Profile among Preeclampsia Woman by Comparing with Normal Pregnancy. International Journal of Contemporary Medical Research. 2016;3(7);1958-1963.
  8. Einbinder Y, Biron-Shental T, Agassi-Zaitler M, Tzadikevitch-Geffen K, Vaya J, Khatib S, et al. High-density lipoproteins (HDL) composition and function in preeclampsia. Arch Gynecol Obstet. 2018;298(2):405–13. Available from: http://dx.doi.org/10.1007/s00404-018-4824-3.
  9. Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennström M, et al. Predictive Value of the sFlt-1. Obstet & Gynecol Surv. 2016;71(5):273–4. Available from: http://dx.doi.org/10.1097/01.ogx.0000482523.79556.f6
  10. Stepan H, Herraiz I, Schlembach D, Verlohren S, Brennecke S, Chantraine F, et al. Implementation of the sFlt-1/PlGF ratio for prediction and diagnosis of pre-eclampsia in singleton pregnancy: implications for clinical practice. Ultrasound Obstet Gynecol. 2015;45(3):241–6. Available from: https://pubmed.ncbi.nlm.nih.gov/25736847.
  11. Adam I, Mutabingwa TK, Malik EM. Red cell distribution width and preeclampsia: a systematic review and meta-analysis. Clin Hypertens. 2019;25:15. Available from: https://pubmed.ncbi.nlm.nih.gov/31338207
  12. Kurt RK, Aras Z, Silfeler DB, Kunt C, Islimye M, Kosar O. Relationship of Red Cell Distribution Width With the Presence and Severity of Preeclampsia. Clin Appl Thromb. 2013;21(2):128–31. Available from: http://dx.doi.org/10.1177/1076029613490827
  13. Ying H-Q, Deng Q-W, He B-S, Pan Y-Q, Wang F, Sun H-L, et al. The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients. Med Oncol. 2014;31(12). Available from: http://dx.doi.org/10.1007/s12032-014-0305-0.
  14. Patel K V, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med. 2009;169(5):515–23. Available from: https://pubmed.ncbi.nlm.nih.gov/19273783
  15. Lippi G, Sanchis-Gomar F, Danese E, Montagnana M. Association of red blood cell distribution width with plasma lipids in a general population of unselected outpatients. Kardiol Pol. 2013;71(9):931–6. Available from: http://dx.doi.org/10.5603/kp.2013.0228
  16. Weiss G, Goodnough LT. Anemia of Chronic Disease. N Engl J Med. 2005;352(10):1011–23. Available from: http://dx.doi.org/10.1056/nejmra041809
  17. Pierce CN, Larson DF. Inflammatory cytokine inhibition of erythropoiesis in patients implanted with a mechanical circulatory assist device. Perfusion. 2005;20(2):83–90. Available from: http://dx.doi.org/10.1191/0267659105pf793oa.
  18. Vanderjagt DJ, Patel RJ, El-Nafaty AU, Melah GS, Crossey MJ, Glew RH. High-density lipoprotein and homocysteine levels correlate inversely in preeclamptic women in northern Nigeria. Acta Obstet Gynecol Scand. 2004;83(6):536–42. Available from: http://dx.doi.org/10.1111/j.1600-0412.2004.00513.x
  19. Mishra DPK. Evaluation of Serum Uric Acid and Lipid Profile in Pre-eclamptic Women: A Hospital Based Study. J Med Sci Clin Res. 2016; Available from: http://dx.doi.org/10.18535/jmscr/v4i7.22
  20. Tesfa E, Nibret E, Munshea A. Maternal lipid profile and risk of pre-eclampsia in African pregnant women: A systematic review and meta-analysis. PLoS One. 2020;15(12):e0243538–e0243538. Available from: https://pubmed.ncbi.nlm.nih.gov/33362205
  21. Staff AC, Ranheim T, Khoury J, Henriksen T. Increased contents of phospholipids, cholesterol, and lipid peroxides in decidua basalis in women with preeclampsia. Am J Obstet Gynecol. 1999;180(3):587–92. Available from: http://dx.doi.org/10.1016/s0002-9378(99)70259-0
  22. Ray JG, Diamond P, Singh G, Bell CM. Brief overview of maternal triglycerides as a risk factor for pre-eclampsia. BJOG An Int J Obstet Gynaecol. 2006;113(4):379–86. Available from: http://dx.doi.org/10.1111/j.1471-0528.2006.00889.x
  23. Cassandra NS, Caitlin JS, Audrey FS, Jennifer G. Robinson, Kelli K. Ryckman. 2014. Maternal Hyperlipidemia and the Risk of Preeclampsia: a Meta-Analysis. American Journal of Epidemiology. 2014;180(4):346–358. Available from: https://doi.org/10.1093/aje/kwu145
  24. Sen-yu W, Chao X. Assessment of the relationship between red blood cell distribution width and preganecy hypertension disease. J Obstet Gynaecol Res. 2016;42(10):1258–62. Available from: http://dx.doi.org/10.1111/jog.13067
  25. Avci E, Kiris T, Demirtas AO, Kadi H. Relationship between high-density lipoprotein cholesterol and the red cell distribution width in patients with coronary artery disease. Lipids Health Dis. 2018;17(1):53. Available from: https://pubmed.ncbi.nlm.nih.gov/29548288
  26. Ferrucci L, Guralnik JM, Woodman RC, Bandinelli S, Lauretani F, Corsi AM, et al. Proinflammatory state and circulating erythropoietin in persons with and without anemia. Am J Med. 2005;118(11):1288.e11-1288.e19. Available from: http://dx.doi.org/10.1016/j.amjmed.2005.06.039

How to Cite

Dewi, P. P. P., Jaya Kusuma, A. A. N., Mulyana, R. S. ., Megadhana, I. W. ., Mahayasa, P. D. ., Mahendra, I. N. B. ., & Budiana, I. N. G. . (2023). Lebar distribusi sel darah merah (RDW) yang tinggi dan kadar high density lipoprotein cholesterol (HDL-C) yang rendah sebagai faktor risiko terjadinya preeklampsia di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar, Bali, Indonesia. Intisari Sains Medis, 14(3), 1109–1115. https://doi.org/10.15562/ism.v14i3.1833

HTML
0

Total
0

Share

Search Panel

Putu Pradnya Paramitha Dewi
Google Scholar
Pubmed
ISM Journal


Anak Agung Ngurah Jaya Kusuma
Google Scholar
Pubmed
ISM Journal


Ryan Saktika Mulyana
Google Scholar
Pubmed
ISM Journal


I Wayan Megadhana
Google Scholar
Pubmed
ISM Journal


Putu Doster Mahayasa
Google Scholar
Pubmed
ISM Journal


I Nyoman Bayu Mahendra
Google Scholar
Pubmed
ISM Journal


I Nyoman Gede Budiana
Google Scholar
Pubmed
ISM Journal