Association between Adiponectin Level and Mean Platelet Volume in Neonates with Respiratory Distress Syndrome: A Prospective Cohort Study

Document Type : Original Article

Authors

1 Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

2 Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Abstract

Background: Respiratory distress is a serious condition affecting preterm neonates. The present study was designed to evaluate the association between mean platelet volume (MPV) and adiponectin (APN) levels and the development of respiratory distress syndrome (RDS) in preterm neonates.
Methods: This prospective cohort study was conducted at a tertiary hospital. The target population was preterm neonates (≤ 34 weeks) admitted to the incubator and diagnosed with RDS. A control group was recruited and composed of age-matched neonates seen at the delivery room and required no admission or ventilatory support. Blood samples were withdrawn on days 1 and 7 of life for a complete blood count and another one for APN level measurement .
Results: The study group showed a higher MPV at day 1 and day 7 than the control group (P<0.001) and lower mean APN at day 1 and day 7 than the control group (P<0.001). The MPV had cut-off levels of more than 7.7 (sensitivity of 86.96% and specificity of 100%) and 8.15 (sensitivity of 78.26% and specificity of 91.3%) on days 1 and 7, respectively, to predict RDS. The APN had cut-off levels ≤ 37 (sensitivity of 86.96% and specificity of 60.87%) and ≤ 22.4 (sensitivity of 82.61% and specificity of 69.57%) on days 1 and 7, respectively, to predict RDS.
Conclusion: Based on the findings of the present research, the MPV significantly increased while APN levels were lower in preterm neonates with RDS. Both markers predicted RDS development significantly.
 
 

Keywords


  • Sweet D, Bevilacqua G, Carnielli V, Greisen G, Plavka R, Didrik Saugstad O, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome. J Perinat Med. 2017; 35(3):175–86.
  • Yurdakok M, Yigit S. Hemostatic system in early respiratory distress syndrome: reduced fibrinolytic state? Turk J Pediatr. 2016; 41(4):489–93.
  • Kohelet D, Perlman M, Hanna G, Ballin A. Reduced platelet counts in neonatal respiratory distress syndrome. Biol Neonate. 2015; 57(6):334–42.
  • Homans A. Thrombocytopenia in the neonate. Pediatr Clin North Am. 2016; 43(3):737-56.
  • Teoh H, Quan A, Bang KA, Wang G, Lovren F, Vu V, et al. Adiponectin deficiency promotes endothelial activation and profoundly exacerbates sepsis-related mortality. Am J Physiol Endocrinol Metab. 2018; 295(3):658-64.
  • Xu L, Bao HG, Si YN, Han L, Zhang R, Cai MM, et al. Effects of adiponectin on acute lung injury in cecal ligation and puncture-induced sepsis rats. J Surg Res. 2016; 183(2):752–59.
  • Ballard JL, Khoury JC, Wedig KL, Wang L, Eilers-Walsman BL, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991; 119(3):417-23.
  • Dawson B, Trapp RG. Basic & clinical biostatistics. Singapore; 2001.
  • Fanaroff AA, Martin RJ, Walsh MC. Neonatal-perinatal medicine: diseases of the fetus and infant. St Louis: Elsevier/Mosby; 2011.
  • Canpolat FE, Yurdakök M, Armangil D, Yiğit Ş. Mean platelet volume in neonatal respiratory distress syndrome. Pediatr Int. 2009; 51(2):314–6.
  • Hussein NF, Helaly NS, Ghanya E, Anisb S. Relationship between mean platelet volume and bronchopulmonary dysplasia and intraventricular hemorrhage in very low birth weight neonates. J Am sci. 2012; 8(5):324-39.‏
  • Cekmez F, Tanju IA, Canpolat FE, Aydinoz S, Aydemir G, Karademir F, et al. Mean platelet volume in very preterm infants: a predictor of morbidities? Eur Rev Med Pharmacol Sci. 2013; 17(1):134–7.
  • Sakurai Y, Haga M, Kanno C, Kanno M, Kawabata K, Kanno M, et al. Mean platelet volumes and platelet counts in infants with pulmonary hemorrhage or transient tachypnea of the newborn. J Clin Neonatol. 2018; 7:259-64
  • Yilmaz G, Salihoglu Z. Do Mean platelet volume and red cell distribution width predict mortality in patients with respiratory distress syndrome?. J Microbiol Immunol. 2019; 4(4):97-106.‏
  • Chen X, Li H, Qiu X, Yang C, Walther FJ. Neonatal hematological parameters and the risk of moderate-severe bronchopulmonary dysplasia in extremely premature infants. BMC Pediatr. 2019; 19(1):138.‏
  • Moghaddam KB, Zarkesh M, Kamali A, Dalili S, Heidarzadeh A, Rad AH. The association of mean platelet volume with intra ventricular hemorrhage and broncho pulmonary dysplasia in preterm infants. Iran J Ped Hematol Oncol. 2015; 5(4):227–32.
  • Walkey AJ, Demissie S, Shah D, Romero F, Puklin L, Summer RS. Plasma Adiponectin, clinical factors, and patient outcomes during the acute respiratory distress syndrome. PloS One. 2014; 9(9):e108561.
  • Palakshappa JA, Anderson BJ, Reilly JP, Shashaty MG, Ueno R, Wu Q, et al. Low plasma levels of adiponectin do not explain acute respiratory distress syndrome risk: a prospective cohort study of patients with severe sepsis. Crit Care. 2016; 20(1):71.
  • Konter JM, Parker JL, Baez E, Li SZ, Ranscht B, Denzel M, et al. Adiponectin attenuates lipopolysaccharide-induced acute lung injury through suppression of endothelial cell activation. J Immunol. 2012; 188(2):854–63
  • Walkey AJ, Rice TW, Konter J, Ouchi N, Shibata R, Walsh K, et al. Plasma adiponectin and mortality in critically ill subjects with acute respiratory failure. Crit Care Med. 2010; 38(12):2329–34.
  • Thyagarajan B, Jacobs DR, Smith LJ, Kalhan R, Gross MD, Sood A. Serum adiponectin is positively associated with lung function in young adults, independent of obesity: the CARDIA study. Respir Res. 2010;11(1):1-8.