Berta Dereje Mengesha, Cherie Negesse, Woldu Berhanu, Yalew Aregawi, Chane Elias, Mekuaninnit Amare, Tamir Mebratu, Yiheyis Zufan, Angelo Abiy Ayele, Mulatie Zewudu, Kassie Adamu, Teketelew Bisrat Birke
Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Quality Assurance and Laboratory Management, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Heliyon. 2024 Dec 17;11(1):e41299. doi: 10.1016/j.heliyon.2024.e41299. eCollection 2025 Jan 15.
Blood biomarkers offers an independent insight for the pathophysiology of hyperbilirubinemia. However, they are not practically used for the differential diagnosis of the hyperbilirubinemia severity. Therefore, the current study aimed to assess the differential diagnostic value of peripheral blood biomarkers with disease severity as an alternative.
A cross-sectional study was done on conveniently selected neonates admitted with hyperbilirubinemia during study period. A 4 ml of venous blood was collected for laboratory analysis. The Sysmex KX-21 cellular analysis and Mindray BS-240 automated chemistry analyzer was used for complete blood count and biochemical analysis, respectively. The data were entered into Epi-data (4.6.0) and analyzed by STATA (14) software. The summary statistics were used. The Kruskal Wallis H tests were utilized to compare median differences between groups. To ascertain the diagnostic value, receiver operator characteristic (ROC) curve analysis was performed. Blood biomarkers score area under curve >.7 was selected as the best discriminative marker. The accepted threshold for statistical significance was set at < 0.05.
Current study found that red blood cell (RBC) and absolute lymphocyte count (ALC) can differentiate high-risk from low and intermediate-risk groups. Similarly, they can also stratify low-risk group from the intermediate and high-risk groups. Besides, mean cell volume (MCV), absolute neutrophil count (ANC), neutrophil to lymphocyte (NLR) and platelet to lymphocyte ratio (PLR), can exhibit significant discriminative ability to differentiate high-risk groups from intermediate and low-risk groups as well as low-risk groups from intermediate and high-risk groups. Furthermore, for hemolytic type of hyperbilirubinemia, RBC, Hb (hemoglobin), ALC, NLR, and PLR were found as good diagnostic markers to differentiate high risk group for others. Whereas, for non-hemolytic type of hyperbilirubinemia, MCV, ALC, MPV (mean platelet volume) and NLR were found as good discriminative marker of high-risk group form others.
Peripheral blood biomarkers were found as acceptable to good early differential diagnostic marker with significant association to disease severity. Thus, assessing of baseline blood biomarkers can help to differentiate disease severity in neonates with hyperbilirubinemia.
血液生物标志物为高胆红素血症的病理生理学提供了独立的见解。然而，它们在高胆红素血症严重程度的鉴别诊断中并未得到实际应用。因此，本研究旨在评估外周血生物标志物对疾病严重程度的鉴别诊断价值，作为一种替代方法。
对研究期间方便选取的因高胆红素血症入院的新生儿进行横断面研究。采集4毫升静脉血进行实验室分析。分别使用Sysmex KX-21细胞分析仪和迈瑞BS-240全自动生化分析仪进行全血细胞计数和生化分析。数据录入Epi-data（4.6.0）并使用STATA（14）软件进行分析。采用描述性统计。使用Kruskal Wallis H检验比较组间中位数差异。为确定诊断价值，进行受试者操作特征（ROC）曲线分析。曲线下面积>0.7的血液生物标志物评分被选为最佳鉴别标志物。统计学显著性的公认阈值设定为<0.05。
本研究发现，红细胞（RBC）和绝对淋巴细胞计数（ALC）可区分高危组与低危和中危组。同样，它们也可将低危组与中危和高危组区分开来。此外，平均红细胞体积（MCV）、绝对中性粒细胞计数（ANC）、中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）在区分高危组与中危和低危组以及低危组与中危和高危组方面具有显著的鉴别能力。此外，对于溶血性高胆红素血症，RBC、血红蛋白（Hb）、ALC、NLR和PLR被发现是区分其他高危组的良好诊断标志物。而对于非溶血性高胆红素血症，MCV、ALC、平均血小板体积（MPV）和NLR被发现是区分其他高危组的良好鉴别标志物。
外周血生物标志物被发现是可接受的至良好的早期鉴别诊断标志物，与疾病严重程度显著相关。因此，评估基线血液生物标志物有助于区分高胆红素血症新生儿的疾病严重程度。
