Association of novel inflammatory markers with gestational diabetes mellitus in a representative U.S. sample: evidence from NHANES 2007-2018

Abstract

Background Early detection of gestational diabetes mellitus (GDM) can lower the chance of occurrence. Recent years have seen a surge in research on novel inflammatory indicators, such as systemic immune inflammatory index (SII), lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR). Inflammation is linked to the pathophysiology of GDM and can be targeted for treatment. However, the relationship between GDM and these novel inflammatory markers is unclear. Methods We included participants with a diagnosis of GDM who were between the ages of 20 and 44, as well as complete blood counts from the US National Health and Nutrition Examination conducted between 2007 and 2018. SII, LMR, NLR, and PLR were among the novel inflammatory markers. First, we logarithmically transformed the exposure components to account for skewed distribution. We tested the relationship between GDM and novel inflammatory markers using a multiple logistic regression model and subgroup analyses to analyze the stability. And RCS curves were created to evaluate the non-linear connection. Results Following the inclusion of 3,722 women aged 20–44 years with GDM, multivariate logistic regression analysis revealed a positive correlation between log2-LMR and GDM (OR = 1.55, 95% CI = 1.20–2.01, p = 0.001), while negative correlations were observed between log2-SII, log2-PLR, and log2-NLR with GDM (OR = 0.84, 95% CI = 0.71–0.99, p = 0.04; OR = 0.73, 95% CI = 0.56–0.94, p = 0.01; OR = 0.65, 95% CI = 0.47–0.97, p = 0.03), and the correlation remained significant even after controlling for all confounders. Correlations were consistently shown by subgroup analyses. When the log2-LMR value was less than 1.79, the risk of GDM reduced with rising log2-LMR, and this tendency was reversed when larger than 1.79. Conclusions Elevated levels of new inflammatory markers are correlated with an increased risk of GDM and may offer clinicians with information to screen for GDM and identify GDM therapeutic targets. Further studies are required to investigate the causal relationship between the new inflammatory markers and GDM.