Duo Yanbei, Song Shuoning, Qiao Xiaolin, Zhang Yuemei, Xu Jiyu, Zhang Jing, Peng Zhenyao, Chen Yan, Nie Xiaorui, Sun Qiujin, Yang Xianchun, Wang Ailing, Sun Wei, Fu Yong, Dong Yingyue, Lu Zechun, Yuan Tao, Zhao Weigang
Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
Department of Obstetrics, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Feb 7;17:633-646. doi: 10.2147/DMSO.S445927. eCollection 2024.
Gestational diabetes mellitus (GDM) is a condition of glucose intolerance, which may be accompanied with inflammation. The levels of hematological parameters during pregnancy can reflect inflammatory conditions in pregnant women. This study aims to describe the dynamic change of blood cell parameters from the first trimester (6-12 weeks of gestation) to the second trimester (24-28 weeks of gestation) and to investigate the associations of these biomarkers with the risk of GDM.
This study was a prospective double-center study conducted in Beijing, China (clinical trial number: NCT03246295). Hematological parameters were tested four times during the follow-up. Logistic regression analysis and Receiver Operating Characteristic (ROC) curve analysis were used to explore the association and predictive ability of hematological parameters for GDM.
There were 258 of 1027 pregnant women in our study developed GDM. Among the 1027 pregnant women, white blood cells (WBC) gradually increased, and red blood cells (RBC), hemoglobin (HGB), and platelet (PLT) tended to decrease from the first trimester to second trimester. After adjusting for confounding factors, higher levels of RBC, HGB, and PLT in both early and middle pregnancy were positively associated with GDM risk, whereas the level of WBC was associated with GDM risk only in early pregnancy. WBC, RBC, HGB, and PLT in early and middle pregnancy were all correlated with fasting insulin (FINS) in early pregnancy.
Higher levels of hematological parameters in early and middle pregnancy were associated with glucose metabolism in early pregnancy and the subsequent risk of GDM.
妊娠期糖尿病(GDM)是一种糖耐量异常的疾病,可能伴有炎症。孕期血液学参数水平可反映孕妇的炎症状态。本研究旨在描述早孕期(妊娠6 - 12周)至中孕期(妊娠24 - 28周)血细胞参数的动态变化,并探讨这些生物标志物与GDM风险的关联。
本研究是一项在中国北京进行的前瞻性双中心研究(临床试验编号:NCT03246295)。随访期间对血液学参数进行了4次检测。采用逻辑回归分析和受试者工作特征(ROC)曲线分析来探讨血液学参数与GDM的关联及预测能力。
在我们的研究中,1027名孕妇中有258名发生了GDM。在这1027名孕妇中,白细胞(WBC)逐渐升高,而红细胞(RBC)、血红蛋白(HGB)和血小板(PLT)从早孕期到中孕期呈下降趋势。在调整混杂因素后,早孕期和中孕期较高水平的RBC、HGB和PLT与GDM风险呈正相关,而WBC水平仅在早孕期与GDM风险相关。早孕期和中孕期的WBC、RBC、HGB和PLT均与早孕期空腹胰岛素(FINS)相关。
早孕期和中孕期较高水平的血液学参数与早孕期糖代谢及随后的GDM风险相关。