Bozbay Nizamettin, Medinaeva Anara, Akyürek Fikret, Orgul Gokcen
Selcuk University, Faculty of Medicine, Department of Perinatology - Konya, Turkey.
Selcuk University, Faculty of Medicine, Department of Obstetrics and Gynecology - Konya, Turkey.
Rev Assoc Med Bras (1992). 2024 Sep 30;70(10):e20240532. doi: 10.1590/1806-9282.20240532. eCollection 2024.
The aim of this study was to investigate the role of systemic immune-inflammation index, neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, and platelet-lymphocyte ratios calculated in the first trimester as inflammatory markers in predicting gestational diabetes mellitus diagnosis.
This study was conducted retrospectively at a tertiary center between January 2020 and June 2023. A total of 111 pregnant women with gestational diabetes and 378 pregnant women in the control group were included in the study. Systemic immune-inflammation index, neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, and platelet-lymphocyte ratios values were compared between the gestational diabetes mellitus group patients and the healthy group. Receiver operating characteristic analysis curve was used for predicting gestational diabetes mellitus using systemic immune-inflammation index and lymphocyte-monocyte ratio.
In pregnant women in the first trimester, systemic immune-inflammation index and lymphocyte-monocyte ratio values based on routine complete blood count parameters were found to be statistically significantly higher in gestational diabetes mellitus patients compared to healthy patients, while neutrophil-lymphocyte ratio and platelet-lymphocyte ratios values were found to be similar (p=0.033, p=0.005, p=0.211, and p=0.989). For predicting gestational diabetes mellitus, a cut-off value of 655.75 for systemic immune-inflammation index resulted in 80.2% sensitivity and 34.4% specificity, and a cut-off value of 3.62 for lymphocyte-monocyte ratio resulted in 56.8% sensitivity and 63.2% specificity, indicating good discriminatory ability.
We believe that systemic immune-inflammation index and lymphocyte-monocyte ratio values measured in the first-trimester complete blood count parameters are effective in predicting gestational diabetes mellitus but are not effective in determining insulin requirement.
本研究旨在探讨孕早期计算的全身免疫炎症指数、中性粒细胞与淋巴细胞比值、淋巴细胞与单核细胞比值以及血小板与淋巴细胞比值作为炎症标志物在预测妊娠期糖尿病诊断中的作用。
本研究于2020年1月至2023年6月在一家三级中心进行回顾性研究。共纳入111例妊娠期糖尿病孕妇和378例对照组孕妇。比较妊娠期糖尿病组患者和健康组的全身免疫炎症指数、中性粒细胞与淋巴细胞比值、淋巴细胞与单核细胞比值以及血小板与淋巴细胞比值。采用受试者工作特征分析曲线,利用全身免疫炎症指数和淋巴细胞与单核细胞比值预测妊娠期糖尿病。
在孕早期孕妇中,与健康患者相比,妊娠期糖尿病患者基于常规全血细胞计数参数的全身免疫炎症指数和淋巴细胞与单核细胞比值在统计学上显著更高,而中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值相似(p = 0.033、p = 0.005、p = 0.211和p = 0.989)。对于预测妊娠期糖尿病,全身免疫炎症指数的临界值为655.75时,敏感性为80.2%,特异性为34.4%;淋巴细胞与单核细胞比值的临界值为3.62时,敏感性为56.8%,特异性为63.2%,表明具有良好的鉴别能力。
我们认为,孕早期全血细胞计数参数中测量的全身免疫炎症指数和淋巴细胞与单核细胞比值在预测妊娠期糖尿病方面有效,但在确定胰岛素需求量方面无效。