25-Hydroxy Vitamin D Level and Its Correlation with Mean Platelet Volume in Preeclampsia
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Abstract
Background: Preeclampsia is one of the challenging complications of pregnancy, of which little is known about its etiology and pathogenesis. Many studies have shown higher mean platelet volume (MPV) in preeclamptic patients. Vitamin D deficiency is in association with larger-size platelets. Thus, we aimed to determine the correlation of vitamin D with MPV in preeclamptic patients.
Methods: This prospective case–control study was conducted in two tertiary hospitals in Tehran, Iran. Overall, 85 preeclamptic pregnant women and 85 normotensive pregnant women were entered between 2017 and 2018. Serum vitamin D concentration (ng/ml) and MPV (femtoliter) were measured for all patients.
Results: MPV was significantly higher in the cases compared to controls (10.59±1.08 vs 8.10±0.95, P=0.0001). In addition, serum vitamin D level in the preeclamptic group was significantly lower in compare to the control group (17.79±11.03 vs 30.24±12.49; P=0.0001). In multivariate logistic regression analysis, high age of mother (OR: 1.13; 95% CI: 1.01-1.27; P=0.03), low level of serum vitamin D (OR: 0.93; 95% CI: 0.87-0.99; P=0.02) and high MPV (OR: 8.83; 95% CI: 4.17-18.67; P=0.0001) were independent predictors of preeclampsia. Moreover, a correlation analysis revealed that vitamin D levels correlated negatively with MPV (r= -0.41, P<0.0001).
Conclusion: Low levels of vitamin D in preeclamptic pregnancy are associated with higher platelet activity and thrombosis. In fact, the increment of MPV level might be a potential pathway for adverse outcomes of pregnancy including preeclampsia in the context of vitamin D deficiency.
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2. Phipps E, Prasanna D, Brima W, Jim B (2016). Preeclampsia: updates in patho-genesis, definitions, and guidelines. Clin J Am Soc Nephrol, 11(6): 1102-1113.
3. Wei SQ, Audibert F, Hidiroglou N, et al (2012). Longitudinal vitamin D status in pregnancy and the risk of pre-eclampsia. BJOG, 119(7):832-839.
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6. Korzonek-Szlacheta I, Hudzik B, Nowak J, et al (2018). Mean platelet volume is asso-ciated with serum 25-hydroxyvitamin D concentrations in patients with stable coronary artery disease. Heart Vessels, 33(11):1275-1281.
7. Kolusari A, Kurdoglu M, Yildizhan R, et al (2008). Catalase activity, serum trace ele-ment and heavy metal concentrations, and vitamin A, D and E levels in pre-eclampsia. J Int Med Res, 36(6):1335-1341.
8. Bodnar LM, Catov JM, Simhan HN, et al (2007). Maternal vitamin D deficiency in-creases the risk of preeclampsia. J Clin Endocrinol Metab, 92(9):3517-3522.
9. Kuscu NK, Kurhan Z, Yildirim Y, Tavli T, Koyuncu F (2003). Detection of endothe-lial dysfunction in preeclamptic patients by using color Doppler sonography. Arch Gynoclol Obstet, 268(2):113-6.
10. Özdemirci Ş, Başer E, Kasapoğlu T, et al (2016). Predictivity of mean platelet vol-ume in severe preeclamptic women. Hy-pertens Pregnancy, 35(4):474-482.
11. Yuri Gasparyan A, Ayvazyan L, P Mikhai-lidis D, D Kitas G (2011). Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des, 17(1):47-58.
12. Park YC, Kim J, Seo MS, et al (2017). In-verse relationship between vitamin D lev-els and platelet indices in Korean adults. Hematology, 22(10):623-9.
13. Cumhur Cure M, Cure E, Yuce S, Yazici T, Karakoyun I, Efe H (2014). Mean platelet volume and vitamin D level. Ann Lab Med, 34(2):98-103.
14. Gur EB, Karadeniz M, Genc M, et al (2015). Relationship between mean platelet vol-ume and vitamin D deficiency in gesta-tional diabetes mellitus. Arch Endocrinol Metab, 59(5):448-54.
15. Williams B, Mancia G, Spiering W, et al (2018). ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J, 39(33):3021-3104.
16. ACOG Practice Bulletin No. 202: Gestation-al Hypertension and Preeclampsia (2019). Obstet Gynecol, 133(1):1.
17. Thacher TD, Clarke BL (2011). Vitamin D insufficiency. Mayo Clin Proc, 86(1): 50-60.
18. Sohlberg S, Stephansson O, Cnattingius S, Wikström AK (2012). Maternal body mass index, height, and risks of preeclampsia. Am J Hypertens, 25(1):120-5.
19. Lamminpää R, Vehviläinen-Julkunen K, Gissler M, Heinonen S (2012). Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997–2008. BMC Pregnancy Childbirth, 12:47.
20. Valera MC, Parant O, Vayssiere C, Arnal JF, Payrastre B (2010). Physiologic and path-ologic changes of platelets in pregnancy. Platelets, 21(8):587-95.
21. Maconi M, Cardaropoli S, Cenci AM (2012). Platelet parameters in healthy and patho-logical pregnancy. J Clin Lab Anal, 26(1):41-4.
22. Doğan K, Guraslan H, Senturk MB, Helvacioglu C, İdil S, Ekin M (2015). Can platelet count and platelet indices predict the risk and the prognosis of preeclamp-sia? Hypertens Pregnancy. 34(4):434-442.
23. Freitas LG1, Alpoim PN, Komatsuzaki F, et al (2013). Preeclampsia: are platelet count and indices useful for its prognostic? Hematology, 18(6): 360–4.
24. Han L, Liu X, Li H, et al (2014). Blood co-agulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PLoS One, 9(12):e114488.
25. Ceyhan T, Beyan C, Başer İ, et al (2006). The effect of pre-eclampsia on complete blood count, platelet count and mean platelet volume. Ann Hematol, 85(5):320-322.
26. Yavuzcan A, Caglar M, Ustun Y, et al (2014). Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekol Pol, 85(3): 197-203.
27. Yu C, Ertl R, Skyfta E, Akolekar R, Nico-laides K (2013). Maternal serum vitamin D levels at 11–13 weeks of gestation in preeclampsia. J Hum Hypertens, 27(2):115-118.
28. Powe CE, Seely EW, Rana S, et al (2010). First trimester vitamin D, vitamin D binding protein, and subsequent preeclampsia. Hypertension, 56(4):758-763.
29. Halhali A, Villa AR, Madrazo E, et al (2004). Longitudinal changes in maternal serum 1, 25-dihydroxyvitamin D and insulin like growth factor I levels in pregnant women who developed preeclampsia: compari-son with normotensive pregnant women. J Steroid Biochem Mol Biol, 89-90(1-5):553-556.
30. Azar M, Basu A, Jenkins AJ, et al (2011). Se-rum carotenoids and fat-soluble vitamins in women with type 1 diabetes and preeclampsia: a longitudinal study. Diabetes Care, 34(6):1258-1264.
31. Haugen M, Brantsæter AL, Trogstad L, et al (2009). Vitamin D supplementation and reduced risk of preeclampsia in nullipa-rous women. Epidemiology, 20(5):720-726.
32. Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L, Torloni MR (2014). Calcium supple-mentation during pregnancy for prevent-ing hypertensive disorders and related problems. Cochrane Database Syst Rev, 10(10):CD001059. doi: 10.1002/14651858.CD001059.pub4.
33. Akbari S, Khodadadi B, Ahmadi SAY, Ab-baszadeh S, Shahsavar F (2018). Associa-tion of vitamin D level and vitamin D de-ficiency with risk of preeclampsia: A sys-tematic review and updated meta-analysis. Taiwan J Obstet Gynecol, 57(2):241-247.
34. Taziki O, Mohammad Alizadeh T, Alirezaei T (2021). Mean Platelet Volume, Associa-tion with Inflammatory and Nutritional Markers in Maintenance Hemodialysis Patients. Iran J Kidney Dis, 1(2):143-147.
2. Phipps E, Prasanna D, Brima W, Jim B (2016). Preeclampsia: updates in patho-genesis, definitions, and guidelines. Clin J Am Soc Nephrol, 11(6): 1102-1113.
3. Wei SQ, Audibert F, Hidiroglou N, et al (2012). Longitudinal vitamin D status in pregnancy and the risk of pre-eclampsia. BJOG, 119(7):832-839.
4. Bodnar LM, Simhan HN, Catov JM, et al (2014). Maternal vitamin D status and the risk of mild and severe preeclampsia. Ep-idemiology, 25(2):207-14.
5. Evans KN, Bulmer JN, Kilby MD, Hewison M (2004). Vitamin D and placental-decidual function. J Soc Gynecol Investig, 11(5):263-271.
6. Korzonek-Szlacheta I, Hudzik B, Nowak J, et al (2018). Mean platelet volume is asso-ciated with serum 25-hydroxyvitamin D concentrations in patients with stable coronary artery disease. Heart Vessels, 33(11):1275-1281.
7. Kolusari A, Kurdoglu M, Yildizhan R, et al (2008). Catalase activity, serum trace ele-ment and heavy metal concentrations, and vitamin A, D and E levels in pre-eclampsia. J Int Med Res, 36(6):1335-1341.
8. Bodnar LM, Catov JM, Simhan HN, et al (2007). Maternal vitamin D deficiency in-creases the risk of preeclampsia. J Clin Endocrinol Metab, 92(9):3517-3522.
9. Kuscu NK, Kurhan Z, Yildirim Y, Tavli T, Koyuncu F (2003). Detection of endothe-lial dysfunction in preeclamptic patients by using color Doppler sonography. Arch Gynoclol Obstet, 268(2):113-6.
10. Özdemirci Ş, Başer E, Kasapoğlu T, et al (2016). Predictivity of mean platelet vol-ume in severe preeclamptic women. Hy-pertens Pregnancy, 35(4):474-482.
11. Yuri Gasparyan A, Ayvazyan L, P Mikhai-lidis D, D Kitas G (2011). Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des, 17(1):47-58.
12. Park YC, Kim J, Seo MS, et al (2017). In-verse relationship between vitamin D lev-els and platelet indices in Korean adults. Hematology, 22(10):623-9.
13. Cumhur Cure M, Cure E, Yuce S, Yazici T, Karakoyun I, Efe H (2014). Mean platelet volume and vitamin D level. Ann Lab Med, 34(2):98-103.
14. Gur EB, Karadeniz M, Genc M, et al (2015). Relationship between mean platelet vol-ume and vitamin D deficiency in gesta-tional diabetes mellitus. Arch Endocrinol Metab, 59(5):448-54.
15. Williams B, Mancia G, Spiering W, et al (2018). ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J, 39(33):3021-3104.
16. ACOG Practice Bulletin No. 202: Gestation-al Hypertension and Preeclampsia (2019). Obstet Gynecol, 133(1):1.
17. Thacher TD, Clarke BL (2011). Vitamin D insufficiency. Mayo Clin Proc, 86(1): 50-60.
18. Sohlberg S, Stephansson O, Cnattingius S, Wikström AK (2012). Maternal body mass index, height, and risks of preeclampsia. Am J Hypertens, 25(1):120-5.
19. Lamminpää R, Vehviläinen-Julkunen K, Gissler M, Heinonen S (2012). Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997–2008. BMC Pregnancy Childbirth, 12:47.
20. Valera MC, Parant O, Vayssiere C, Arnal JF, Payrastre B (2010). Physiologic and path-ologic changes of platelets in pregnancy. Platelets, 21(8):587-95.
21. Maconi M, Cardaropoli S, Cenci AM (2012). Platelet parameters in healthy and patho-logical pregnancy. J Clin Lab Anal, 26(1):41-4.
22. Doğan K, Guraslan H, Senturk MB, Helvacioglu C, İdil S, Ekin M (2015). Can platelet count and platelet indices predict the risk and the prognosis of preeclamp-sia? Hypertens Pregnancy. 34(4):434-442.
23. Freitas LG1, Alpoim PN, Komatsuzaki F, et al (2013). Preeclampsia: are platelet count and indices useful for its prognostic? Hematology, 18(6): 360–4.
24. Han L, Liu X, Li H, et al (2014). Blood co-agulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PLoS One, 9(12):e114488.
25. Ceyhan T, Beyan C, Başer İ, et al (2006). The effect of pre-eclampsia on complete blood count, platelet count and mean platelet volume. Ann Hematol, 85(5):320-322.
26. Yavuzcan A, Caglar M, Ustun Y, et al (2014). Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekol Pol, 85(3): 197-203.
27. Yu C, Ertl R, Skyfta E, Akolekar R, Nico-laides K (2013). Maternal serum vitamin D levels at 11–13 weeks of gestation in preeclampsia. J Hum Hypertens, 27(2):115-118.
28. Powe CE, Seely EW, Rana S, et al (2010). First trimester vitamin D, vitamin D binding protein, and subsequent preeclampsia. Hypertension, 56(4):758-763.
29. Halhali A, Villa AR, Madrazo E, et al (2004). Longitudinal changes in maternal serum 1, 25-dihydroxyvitamin D and insulin like growth factor I levels in pregnant women who developed preeclampsia: compari-son with normotensive pregnant women. J Steroid Biochem Mol Biol, 89-90(1-5):553-556.
30. Azar M, Basu A, Jenkins AJ, et al (2011). Se-rum carotenoids and fat-soluble vitamins in women with type 1 diabetes and preeclampsia: a longitudinal study. Diabetes Care, 34(6):1258-1264.
31. Haugen M, Brantsæter AL, Trogstad L, et al (2009). Vitamin D supplementation and reduced risk of preeclampsia in nullipa-rous women. Epidemiology, 20(5):720-726.
32. Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L, Torloni MR (2014). Calcium supple-mentation during pregnancy for prevent-ing hypertensive disorders and related problems. Cochrane Database Syst Rev, 10(10):CD001059. doi: 10.1002/14651858.CD001059.pub4.
33. Akbari S, Khodadadi B, Ahmadi SAY, Ab-baszadeh S, Shahsavar F (2018). Associa-tion of vitamin D level and vitamin D de-ficiency with risk of preeclampsia: A sys-tematic review and updated meta-analysis. Taiwan J Obstet Gynecol, 57(2):241-247.
34. Taziki O, Mohammad Alizadeh T, Alirezaei T (2021). Mean Platelet Volume, Associa-tion with Inflammatory and Nutritional Markers in Maintenance Hemodialysis Patients. Iran J Kidney Dis, 1(2):143-147.
| Files | ||
| Issue | Vol 51 No 11 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i11.11177 | |
| Keywords | ||
| Mean platelet volume Vitamin D Preeclampsia | ||
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How to Cite
1.
Alirezaei T, Khandani A, Saleh Gargari S, Akbarzadeh MA, Naeiji Z. 25-Hydroxy Vitamin D Level and Its Correlation with Mean Platelet Volume in Preeclampsia. Iran J Public Health. 2022;51(11):2592-2598.
