Combined predictive value of inflammatory indexes,fasting plasma glucose and blood lipid in early pregnancy for gestational diabetes mellitus / 新乡医学院学报

ABSTRACT

Objective To explore the relationship between inflammatory indexes,fasting plasma glucose(FPG),blood lipid in early pregnancy(6 to 13W+6D)and gestational diabetes mellitus(GDM).Methods Ninety-eight pregnant women in early pregnancy who underwent prenatal examinations at the First Affiliated Hospital of Xinxiang Medical University from No-vember 2020 to October 2021 were selected as the research subjects.These pregnant women were divided into the GDM group(n=35)and normal glucose tolerance(NGT)group(n=63)according to the oral glucose tolerance test results in the second trimester of pregnancy(24-28W).All subjects kept fasting for at least 8 hours at 6 to 13W+6D of pregnancy,and the blood was collected from the median cubital vein on the morning of the second day,the white blood cell(WBC)count,neutrophil count(NC),lymphocyte count(LC),monocyte count(MC),FPG,and serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)levels were measured.The differences in various indicators of pregnant women between the GDM group and NGT group were compared.The joint predictive factors for GDM was obtained by multivariable logistic regression model,and the independent risk factors of GDM were analyzed,and the efficiency of each risk factor in predicting the occurrence of GDM was evaluated by the receiver operating characteristic(ROC)curve.Results The FPG,WBC,LC,TC,TG and LDL-C levels of pregnant women in the GDM group were significantly higher than those in the NGT group in early pregnancy(P＜0.05);there was no significant difference in the NC,MC and HDL-C levels of pregnant women between the two groups(P＞0.05).Logistic regression model analysis results showed that the increase of FPG,WBC,TC and TG were independent risk factors affecting the occurrence of GDM(P＜0.05).Taking FPG=4.80 mmol·L-1,WBC=9.35 × 109 L-1,TC=4.05 mmol·L-1 and TG=1.61 mmol·L-1 as cut-off values,the area under the curve(AUC)of above indexes in predicting GDM were 0.779,0.721,0.685 and 0.762,respectively;the sensitivity was 0.886,0.514,0.857 and 0.543,respectively;the specificity was 0.587,0.857,0.524 and 0.873,respectively.The AUC of the combined prediction of FPG,WBC,TC and TG for GDM was 0.876,with a sensitivity of 0.857 and a specificity of 0.810.The AUC of the combined prediction of FPG,WBC,TC and TG for GDM was significantly higher than that of FPG,WBC,TC and TG in early pregnancy alone for GDM.Conclusion Elevated levels of FPG,WBC,TC and TG in early pregnancy(6 to 13W+6D)are independent risk factors for GDM,and they can be used as clinical indicators for the early prediction of GDM.The combination of the four indicators has better predictive value for GDM.