The role of first-trimester systemic immune-inflammation index for the prediction of gestational diabetes mellitus.

Revista da Associacao Medica Brasileira (1992) Pub Date : 2024-09-30 eCollection Date: 2024-01-01 DOI:10.1590/1806-9282.20240532
Nizamettin Bozbay, Anara Medinaeva, Fikret Akyürek, Gokcen Orgul
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Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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首胎全身免疫炎症指数在预测妊娠糖尿病中的作用。
研究目的本研究旨在探讨在妊娠头三个月计算的全身免疫炎症指数、中性粒细胞-淋巴细胞比值、淋巴细胞-单核细胞比值和血小板-淋巴细胞比值作为炎症标志物在预测妊娠糖尿病诊断中的作用:本研究于 2020 年 1 月至 2023 年 6 月期间在一家三级医院进行。研究共纳入 111 名妊娠糖尿病孕妇和 378 名对照组孕妇。比较了妊娠期糖尿病组和健康组的全身免疫炎症指数、中性粒细胞-淋巴细胞比值、淋巴细胞-单核细胞比值和血小板-淋巴细胞比值。利用系统免疫炎症指数和淋巴细胞-单核细胞比值的接收者操作特征分析曲线来预测妊娠糖尿病:在怀孕头三个月的孕妇中,根据常规全血细胞计数参数得出的全身免疫炎症指数和淋巴细胞-单核细胞比值发现,妊娠期糖尿病患者的免疫炎症指数和淋巴细胞-单核细胞比值在统计学上明显高于健康患者,而中性粒细胞-淋巴细胞比值和血小板-淋巴细胞比值与健康患者相似(P=0.033、P=0.005、P=0.211和P=0.989)。在预测妊娠糖尿病方面,全身免疫炎症指数的临界值为 655.75,灵敏度为 80.2%,特异度为 34.4%;淋巴细胞-单核细胞比值的临界值为 3.62,灵敏度为 56.8%,特异度为 63.2%,显示出良好的鉴别能力:我们认为,在第一胎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-单核细胞比值可有效预测妊娠糖尿病,但不能有效确定胰岛素需求量。
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