Predictive Value of the Longitudinal Change Pattern of LAR on the Progression of Gestational Diabetes Mellitus in Pregnant Women with Borderline Blood Glucose
BAI Jieyu
WANG Hui
LU Yuyu
SONG Xiaoyu
Abstract：Objective To explore the predictive value of the longitudinal change pattern of leptin to adiponectin ratio(LAR)on the progression of gestational diabetes mellitus(GDM)in pregnant women with borderline blood glucose.Methods A prospective study was conducted on 99 pregnant women with borderline blood glucose at 24 weeks of gestation admitted to the Third Affiliated Hospital of Xinxiang Medical University from September 2021 to June 2023.Fasting venous serum LAR was measured at 24 weeks,26 weeks and 28 weeks of gestation.Fasting venous serum LAR was measured at 24,26,and 28 weeks of gestation.The changes in LAR among all pregnant women during follow-up were observed.A latent class trajectory model(LCTM)was used to establish a trajectory model for LAR changes.The changes in LAR and baseline data among different trajectory groups were compared.Logistic regression analysis was conducted to investigate the relationship between LAR trajectory and progression to gestational diabetes mellitus(GDM).Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive performance of LAR trajectory for progression to GDM.Results During the follow-up of all pregnant women,the leptin levels were(7.56±2.50)μg·L-1,(8.80±2.74)μg·L-1,and(9.63±2.95)μg·L-1,respectively,and the LAR values were 1.21±0.30,1.56±0.44,and 1.97±0.51,respectively,all showing a significant upward trend.The adiponectin levels were(6.25±0.90)μg·L-1,(5.63±0.87)μg·L-1,and(4.89±0.75)μg·L-1,respectively,showing a significant downward trend,with statistical significance(P＜0.05).LCTM analysis identified three LAR trajectory models:low-to-slow increase(T1 group,30.30％),low-to-moderate-to-rapid increase(T2 group,35.35％),and high-to-rapid increase(T3 group,34.34％).Significant differences were observed in body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and fasting blood glucose(FBG)among the three trajectory groups(P＜0.05).Logistic regression analysis showed that both before and after adjustment,compared with the T1 group,the T2 and T3 groups increased the risk of developing GDM.The T2 and T3 trajectories were independently associated with the development of GDM(P＜0.05).ROC analysis indicated that when LAR followed a high-to-rapid increase trajectory(T3),the area under the curve for predicting the progression to GDM was 0.808(95％CI:0.717-0.881).Conclusion There are different longitudinal change trajectories of LAR in the follow-up of pregnant women with borderline blood glucose.The high-rapid increase trajectory has certain predictive value for the progression to GDM,which can be used as an auxiliary index for clinical prediction of GDM,so as to guide individualized and stratified intervention.
Keywords：gestational diabetes mellitusborderline blood glucosepregnant womenLARlongitudinal changeprediction
Publication Date：2026-08-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 2995-3000 )