A new marker predicting gestational diabetes mellitus: First trimester neutrophil/lymphocyte ratio

Abstract

Gestational diabetes mellitus (GDM) is a condition that is very common during pregnancy and has negative consequences for both mother and fetus. Insulin resistance has been shown as an important cause in the pathogenesis of GDM and lowlevel inflammation is suggested to be one of the underlying causes of insulin resistance. We aimed to investigate whether the neutrophil-lymphocyte ratio (NLR), which is an indicator of systemic inflammation, is a predictor for GDM. A total of 228 pregnant women, including 128 GDM (patient group) and 100 healthy pregnant were included in the study. GDM was diagnosed with a 1-step approach between 24 and 28 weeks of pregnancy. We found a significant increase in NLR in the 1st and 3rd trimesters in the GDM group compared to healthy pregnant women, which supports that systemic inflammation starts in the early stages of pregnancy and continues throughout pregnancy. We also reported a positive correlation between NLR and fasting plasma glucose and body mass index in both trimesters. We showed that first trimester NLR independently predicted the development of GDM. Abbreviations: BMI = body mass index, CI = confidence interval, DM = diabetes mellitus, FPG = fasting plasma glucose, GDM = gestational diabetes mellitus, HDL = high-density lipoprotein, hsCRP = high-sensitivity C-reactive protein, LDL = lowdensity-lipoprotein, NLR = neutrophil-lymphocyte ratio, OR = odds ratio, PG = plasma glucose, PLR = platelet/lymphocyte rate, ROC = receiver operating characteristic, SPSS = Statistical Package for Social Sciences, T-C = total cholesterol, TG = triglyceride, Th = T helper.

HtrA1 in Gestational Diabetes Mellitus: A Possible Biomarker?

“…These data were in agreement with previous studies, showing an increased risk of developing GDM in the presence of a high BMI before pregnancy [ 36 , 37 ]. It is possible to hypothesize that the placenta responds to altered glucose metabolism already in the first trimester, secreting high HtrA1 levels, although GDM will only be diagnosed later in pregnancy when the altered maternal blood glucose levels become visible at the OGTT test.…”

Low-Grade Inflammation in Gestational Diabetes Mellitus and Its Correlation with Maternal Insulin Resistance and Fetal Growth Indices

“…Most studies showed an increase in the above components in the GDM group compared with the NGT pregnancy. 21–23 The study by Sahin et al found that NLR was positively correlated with FPG (r = 0.285, p = 0.001) in GDM in the third trimester of pregnancy. 21 In contrast, the study of Hassan et al did not find any difference in the above components between pregnant women with GDM or without GDM.…”

“… 21–23 The study by Sahin et al found that NLR was positively correlated with FPG (r = 0.285, p = 0.001) in GDM in the third trimester of pregnancy. 21 In contrast, the study of Hassan et al did not find any difference in the above components between pregnant women with GDM or without GDM. 24 This difference is probably due to the difference in the timing of the study (the first or third trimester).…”

Predicting Potentially Fatal COVID-19 Disease in Pregnant Patients Using the Neutrophil-to-Lymphocyte Ratio (NLR)

“…To predict the severity of SARS-CoV-2 virus infection, various methods have been used since the occurrence of the disease [7][8][9]. One of these methods was the closer surveillance of neutrophil-to-lymphocyte ratio (NLR) [10,11], which has already been evaluated in pregnant individuals battling with COVID-19 but also in other medical conditions (e.g., pre-eclampsia, gestational diabetes mellitus, and miscarriage) [12][13][14][15]. The neutrophil-tolymphocyte ratio is a simple and widely used biomarker, which is calculated by dividing the absolute neutrophil count (ANC) by the absolute lymphocyte count (ALC).…”