Correlation between Serum D-Dimer and HbA1c Levels and Gestational Diabetes Mellitus, and Their Predictive Value

doi:10.3969/j.issn.1004-5775.2025.03.020

Abstract：Objective: To investigate the changes in serum D-dimer (D-D) and glycated hemoglobin (HbA1c) levels in patients with gestational diabetes mellitus (GDM), and to analyze their predictive value for GDM. Methods: A prospective study was conducted on pregnant women in early pregnancy who underwent prenatal examinations at Tongxu First Hospital from January to December 2022. At 24-28 weeks of gestation, a 75 g oral glucose tolerance test (OGTT) was performed. Among them, 120 cases of GDM patients were selected as the study group, and 120 cases of pregnant women with normal OGTT results, matched by age and gestational week, were selected as the control group. Additionally, 40 non-pregnant healthy women who underwent physical examination at the same time and were age-matched were selected as the healthy control group. The levels of glycolipid metabolism indicators [fasting blood glucose (FBG), insulin resistance index (HOMA-IR), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)] and serum D-D and HbA1c levels were compared among the three groups. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum D-D and HbA1c levels in early pregnancy for GDM. Results: The study group showed higher levels of HOMA-IR, FBG, TG, LDL-C, and TC compared to the control group and the healthy control group, and lower levels of HDL-C, with statistically significant differences (F=291.046, 126.494, 134.130, 28.590, 33.142, 32.161, P<0.05). The serum D-D and HbA1c levels in the study group were higher than those in the control group and the healthy control group, and the control group was higher than the healthy control group, with statistically significant differences (F=100.739, 71.205, P<0.05). The serum D-D and HbA1c levels in the study group were positively correlated with FBG, HOMA-IR, and LDL-C, and negatively correlated with HDL-C, with statistically significant differences (P<0.05). The area under the curve (AUC) of the combined prediction of serum D-D and HbA1c levels in early pregnancy for GDM was greater than that of individual indicators, with statistically significant differences (P<0.05). Conclusion: Serum D-D and HbA1c levels are elevated in GDM patients, which are closely related to glycolipid metabolic disorders. Combined detection of these levels in early pregnancy has a certain predictive value for the occurrence of GDM.