The correlation between peripheral blood inflammation markers and insulin resistance in patients with gestational diabetes mellitus

ZHENG Yuhong; ZHONG Hongwen; GU Jinghua; LIN Qing; LONG Tao; LIU Jiangmei; GAO Zhen

Abstract：Objective:To investigate the correlation between systemic immune-inflammation index(SⅡ),neutro-phil to lymphocyte ratio(NLR),derived neutrophil to lymphocyte ratio(d-NLR),platelet to lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR)and insulin resistance in patients with gestational diabetes mellitus(GDM).Analyzing their clinical value in the diagnosis and treatment of GDM to provide a basis for the early diagnosis and treatment of GDM in clinical practice.Methods:From January 2023 to December 2023,24～28 weeks of pregnancy were selected to visit the obstetrics and gynecology examination.The clinical data of 136 pregnant women at 24～28 weeks of pregnancy were collected.According to whether the results of oral 75 g glucose tolerance test(75 g OGTT)met the diagnostic criteria of GDM,they were divided into gestational diabetes group(68 cases,study group)and nor-mal pregnancy group(68 cases,control group).The blood routine analysis(CBC)of pregnant women in the two groups was detected,and the levels of SⅡ,NLR,d-NLR,PLR,LMR,fasting blood glucose(FPG),1 h postprandial blood glu-cose(1 h PG),2 h postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbAlc)and fasting insulin(FINS)were calculated.The homeostasis model was used to calculate the levels of insulin resistance index(HOMA-IR),insu-lin secretion index(HOMA-β),β cell function index(FBCI)and insulin sensitivity index(ISI),and statistical analysis was performed.Results:The levels of peripheral inflammatory index(SⅡ,NLR,d-NLR,PLR,LMR),blood glucose metabolism index(FPG,1 h PG,2 h PG,FINS),insulin resistance ang β cell function idex(HOMA-IR,HOMA-β and FBCI)in GDM pregnant women in the study group were significantly different from those in the NGT control group(P＜0.05).There was no significant difference in HbAlc and ISI levels between two groups(P＞0.05).The levels of SⅡ,d-NLR and NLR in GDM pregnant women were positively correlated with HOMA-IR and FBCI(P＜0.05),and negatively correlated with HOMA-β and ISI(P＜0.05).The level of PLR was positively correlated with HOMA-IR(P＜0.05),negatively correlated with HOMA-β(P＜0.05),and not correlated with FBCI and ISI(P＞0.05).LMR was positively correlated with FBCI(P＜0.05),negatively correlated with ISI(P＜0.05),and not correlated with HO-MA-IR and HOMA-β(P＞0.05).Conclusion:The levels of new peripheral blood inflammatory markers SⅡ,NLR,d-NLR,PLR and LMR in GDM patients are correlated with insulin resistance,suggesting that the monitoring of pe-ripheral blood inflammation markers levels has certain reference value for the prevention and treatment of GDM.