全身免疫炎症指数和全身炎症反应指数与孕产妇妊娠糖尿病的关联：来自一项前瞻性出生队列研究的证据。
Associations of systemic immune-inflammation index and systemic inflammation response index with maternal gestational diabetes mellitus: Evidence from a prospective birth cohort study.
作者信息
Xie Shuanghua, Zhang Enjie, Gao Shen, Su Shaofei, Liu Jianhui, Zhang Yue, Luan Yingyi, Huang Kaikun, Hu Minhui, Wang Xueran, Xing Hao, Liu Ruixia, Yue Wentao, Yin Chenghong
机构信息
Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
出版信息
Chin Med J (Engl). 2025 Mar 20;138(6):729-737. doi: 10.1097/CM9.0000000000003236. Epub 2024 Dec 6.
BACKGROUND
The role of inflammation in the development of gestational diabetes mellitus (GDM) has recently become a focus of research. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), novel indices, reflect the body's chronic immune-inflammatory state. This study aimed to investigate the associations between the SII or SIRI and GDM.
METHODS
A prospective birth cohort study was conducted at Beijing Obstetrics and Gynecology Hospital from February 2018 to December 2020, recruiting participants in their first trimester of pregnancy. Baseline SII and SIRI values were derived from routine clinical blood results, calculated as follows: SII = neutrophil (Neut) count × platelet (PLT) count/lymphocyte (Lymph) count, SIRI = Neut count × monocyte (Mono) count/Lymph count, with participants being grouped by quartiles of their SII or SIRI values. Participants were followed up for GDM with a 75-g, 2-h oral glucose tolerance test (OGTT) at 24-28 weeks of gestation using the glucose thresholds of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Logistic regression was used to analyze the odds ratios (ORs) (95% confidence intervals [CIs]) for the the associations between SII, SIRI, and the risk of GDM.
RESULTS
Among the 28,124 women included in the study, the average age was 31.8 ± 3.8 years, and 15.76% (4432/28,124) developed GDM. Higher SII and SIRI quartiles were correlated with increased GDM rates, with rates ranging from 12.26% (862/7031) in the lowest quartile to 20.10% (1413/7031) in the highest quartile for the SII ( Ptrend <0.001) and 11.92-19.31% for the SIRI ( Ptrend <0.001). The ORs (95% CIs) of the second, third, and fourth SII quartiles were 1.09 (0.98-1.21), 1.21 (1.09-1.34), and 1.39 (1.26-1.54), respectively. The SIRI findings paralleled the SII outcomes. For the second through fourth quartiles, the ORs (95% CIs) were 1.24 (1.12-1.38), 1.41 (1.27-1.57), and 1.64 (1.48-1.82), respectively. These associations were maintained in subgroup and sensitivity analyses.
CONCLUSION
The SII and SIRI are potential independent risk factors contributing to the onset of GDM.
背景
炎症在妊娠期糖尿病（GDM）发生发展中的作用近来成为研究热点。全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）作为新的指标，反映了机体的慢性免疫炎症状态。本研究旨在探讨SII或SIRI与GDM之间的关联。
方法
2018年2月至2020年12月在北京妇产医院进行了一项前瞻性出生队列研究，招募孕早期的参与者。SII和SIRI的基线值来自常规临床血液检查结果，计算方法如下：SII = 中性粒细胞（Neut）计数×血小板（PLT）计数/淋巴细胞（Lymph）计数，SIRI = Neut计数×单核细胞（Mono）计数/Lymph计数，参与者按SII或SIRI值的四分位数分组。在妊娠24 - 28周时，采用国际糖尿病与妊娠研究组（IADPSG）的血糖阈值，通过75g、2小时口服葡萄糖耐量试验（OGTT）对参与者进行GDM随访。采用逻辑回归分析SII、SIRI与GDM风险之间关联的比值比（OR）（95%置信区间[CI]）。
结果
纳入研究的28124名女性中，平均年龄为31.8±3.8岁，15.76%（4432/28124）发生了GDM。较高的SII和SIRI四分位数与GDM发生率增加相关，SII发生率从最低四分位数的12.26%（862/7031）到最高四分位数的20.10%（1413/7031）（Ptrend<0.001），SIRI发生率为11.92 - 19.31%（Ptrend<0.001）。SII第二、第三和第四四分位数的OR（95%CI）分别为1.09（0.98 - 1.21）、1.21（1.09 - 1.34）和1.39（1.26 - 1.54）。SIRI的结果与SII相似。对于第二至第四四分位数，OR（95%CI）分别为1.24（1.12 - 1.38）、1.41（1.27 - 1.57）和1.64（1.48 - 1.82）。这些关联在亚组分析和敏感性分析中保持不变。
结论
SII和SIRI是导致GDM发病的潜在独立危险因素。
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