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妊娠中期血细胞参数与妊娠期糖尿病:一项系统评价与荟萃分析

Blood Cells Parameters in Second Trimester of Pregnancy and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis.

作者信息

Ghasemi Vida, Banaei Mojdeh, Kiani Zahra, Ramezani Tehrani Fahimeh, Saei Ghare Naz Marzieh

机构信息

Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran.

Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

出版信息

Endocrinol Diabetes Metab. 2025 Jan;8(1):e70024. doi: 10.1002/edm2.70024.

Abstract

OBJECTIVE

Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. There is inconsistency between previous studies regarding the blood and inflammatory parameters levels among pregnant women and its association with GDM. This study aimed to investigate the relationship between blood parameters in relation to GDM.

METHODS

Systematic literature searches were carried out through databases like PubMed, Web of Science, Epistemonikos, Scopus, Scientific Information Database and Magiran till May 2024. The effect size of serum blood parameters levels was determined by using standard mean deviations (SMDs) and 95% confidence intervals (CIs).

RESULTS

Thirty articles were included in this study. Meta-analysis showed that compared with the control group, women with GDM had significantly higher levels of haemoglobin (0.343 [95% CI 0.134-0.553] p = 0.01, sensitivity analysis: 0.174 [95% CI 0.0343-0.315] p = 0.01), red blood cell (0.387 [95% CI 0.224-0.550] p < 0.001), mean platelet volume (0.498 [95% CI 0.165-0.831] p = 0.003), white blood cell count (0.351 [95% CI 0.0882-0.615] p = 0.009) and neutrophil-lymphocyte ratio (0.534 [95% CI 0.127-0.941] p = 0.01). However, women with GDM had lower levels of mean corpuscular haemoglobin concentration (-0.249 [95% CI -0.386--0.112] p < 0.001). Pooled results from MPV showed no association between adjusted MPV and GDM (adjusted OR 1.33 [95% CI 0.8-1.86] I = 57.2%).

CONCLUSIONS

Finding supports higher levels of blood parameters (Hb, RBC, WBC, NLR and MPV) among women with GDM in the second trimester of pregnancy. Future studies should investigate the potential role of these haematological markers as predictive tools for adverse pregnancy outcomes and evaluate therapeutic interventions targeting these parameters to enhance maternal and fetal health.

摘要

目的

妊娠期糖尿病(GDM)是孕期最常见的并发症之一。既往关于孕妇血液和炎症参数水平及其与GDM的关联研究结果并不一致。本研究旨在探讨与GDM相关的血液参数之间的关系。

方法

通过PubMed、科学网、Epistemonikos、Scopus、科学信息数据库和Magiran等数据库进行系统的文献检索,检索截至2024年5月的文献。采用标准平均差(SMD)和95%置信区间(CI)确定血清血液参数水平的效应量。

结果

本研究纳入30篇文章。荟萃分析显示,与对照组相比,GDM女性的血红蛋白水平显著更高(0.343 [95%CI 0.134 - 0.553] p = 0.01,敏感性分析:0.174 [95%CI 0.0343 - 0.315] p = 0.01)、红细胞水平(0.387 [95%CI 0.224 - 0.550] p < 0.001)、平均血小板体积(0.498 [95%CI 0.165 - 0.831] p = 0.003)、白细胞计数(0.351 [95%CI 0.0882 - 0.615] p = 0.009)和中性粒细胞与淋巴细胞比值(0.534 [95%CI 0.127 - 0.941] p = 0.01)。然而,GDM女性的平均红细胞血红蛋白浓度较低(-0.249 [95%CI -0.386 - -0.112] p < 0.001)。MPV的汇总结果显示,调整后的MPV与GDM之间无关联(调整后的OR为1.33 [95%CI 0.8 - 1.86],I = 57.2%)。

结论

研究结果支持妊娠中期GDM女性血液参数(血红蛋白、红细胞、白细胞、中性粒细胞与淋巴细胞比值和平均血小板体积)水平较高。未来的研究应调查这些血液学标志物作为不良妊娠结局预测工具的潜在作用,并评估针对这些参数的治疗干预措施,以改善母婴健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d721/11702436/650541f845a4/EDM2-8-e70024-g004.jpg

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