Xiao Yanling, Zhang Haonan, An Songlin, Yu Rui, Yang Jing, Zheng Xingting, Wu Nian, Tao Lin, Liao Dengqing, Deng Mingyu, Hu Zhongmei, Liu Yijun, Chen Qing, Zhou Yuanzhong
School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China.
Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi, Guizhou, China.
Am J Reprod Immunol. 2024 Dec;92(6):e70021. doi: 10.1111/aji.70021.
This study aims to introduce the Bayesian kernel machine regression (BKMR) model to explore the single and joint associations between exposure to blood cell-based inflammatory in early pregnant women and gestational diabetes mellitus (GDM).
The study included 536 singleton pregnant women from the Zunyi Birth Cohort. Logistic regression, restricted cubic spline regression, and BKMR were used to investigate single, nonlinear, and combined associations.
In this study, the adjusted odds ratio (OR) of white blood cell (WBC), neutrophil (NEUT), monocyte (MONO), platelet (PLT), neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index (SII) were 2.20 (95% confidence interval [CI]: 1.43-3.37), 2.27 (95% CI: 1.48-3.48), 1.67 (95% CI: 1.09-2.57), 1.66 (95% CI: 1.07-2.58), 1.65 (95% CI: 1.08-2.54), and 1.89 (95% CI: 1.23-2.91), respectively. Nonlinear associations of WBC (cutoff level: 7.91 × 10/L) and NEUT (cutoff level: 5.52 × 10/L) with GDM were also observed. Furthermore, BKMR analysis showed that the risk of GDM was linked with increased levels of blood cell-based inflammatory indicators.
In early pregnancy, multiple blood cell-based inflammatory indicators are significantly positively correlated with the risk of GDM. Specifically, WBC and NEUT counts exhibit the most prominent association with GDM risk. Therefore, more attention should be paid to the inflammation levels of early pregnant women.
本研究旨在引入贝叶斯核机器回归（BKMR）模型，以探讨孕早期基于血细胞的炎症暴露与妊娠期糖尿病（GDM）之间的单一和联合关联。
该研究纳入了来自遵义出生队列的536名单胎孕妇。采用逻辑回归、受限立方样条回归和BKMR来研究单一、非线性和联合关联。
在本研究中，白细胞（WBC）、中性粒细胞（NEUT）、单核细胞（MONO）、血小板（PLT）、中性粒细胞与淋巴细胞比值（NLR）和全身免疫炎症指数（SII）的调整优势比（OR）分别为2.20（95%置信区间[CI]：1.43 - 3.37）、2.27（95%CI：1.48 - 3.48）、1.67（95%CI：1.09 - 2.57）、1.66（95%CI：1.07 - 2.58）、1.65（95%CI：1.08 - 2.54）和1.89（95%CI：1.23 - 2.91）。还观察到WBC（临界水平：7.91×10⁹/L）和NEUT（临界水平：5.52×10⁹/L）与GDM的非线性关联。此外，BKMR分析表明，GDM的风险与基于血细胞的炎症指标水平升高有关。
在孕早期，多种基于血细胞的炎症指标与GDM风险显著正相关。具体而言，WBC和NEUT计数与GDM风险呈现最显著关联。因此应更加关注孕早期妇女的炎症水平。
