Predictive value of the monocyte to highdensity lipoprotein cholesterol ratio in early pregnancy for gestational diabetes mellitus risk

Zheng Juan; Li Xiaoyan; Chen Na; Xi Xiaomei; Sun Yimei; Li Mingqiao; Yao Xiuling; Hui Zhilong

doi:10.11986/j.issn.1673-873X.2025.04.20

Abstract：Objective To investigate the predictive value of the monocyte(Mono)to highdensity lipoprotein cholesterol ratio(MHR)in early pregnancy for the risk of gestational diabetes mellitus(GDM),thereby providing a reference for clinical inter-vention.Methods A total of 189 pregnant women who registered and delivered at the Second People's Hospital of Hengshui between January 2021 and December 2023 were enrolled.Based on oral glucose tolerance test(OGTT)results at 24-28 weeks'gestation,participants were divided into a GDM group(n=43)and a healthy control group(n=146).Earlypregnancy Mono counts and HDLC levels were measured,and MHR was calculated.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive performance of MHR for GDM risk.Multivariate logistic stepwise regression was used to i-dentify independent risk factors for GDM.Results Compared with healthy controls,women in the GDM group had signifi-cantly higher earlypregnancy Mono counts and MHR and lower HDLC(P<0.05).ROC analysis yielded areas under the curve(AUCs)of 0.719(95%CI:0.674-0.769)for Mono,0.836(95%CI:0.791-0.886)for HDLC,and 0.912(95%CI:0.867-0.962)for MHR,with an optimal MHR cutoff of 0.43.The GDM group also exhibited higher body mass index(BMI),triglycerides,glycated hemoglobin levels,and percentage of a family history of diabetes than controls(P<0.05).Multivariate logistic regression identified BMI≥27.0 kg/m2(OR=2.115;95%CI:1.248-3.583),elevated triglycerides(OR=2.347;95%CI:1.372-4.015),increased glycated hemoglobin(OR=1.697;95%CI:1.179-2.444),a family his-tory of diabetes(OR=2.542;95%CI:1.233-5.240),and MHR≥0.43(OR=4.586;95%CI:2.318-9.071)as independ-ent risk factors for GDM(P<0.05).Conclusion An elevated MHR in early pregnancy is closely associated with the develop-ment of GDM and has strong predictive value for GDM risk.