The Predictive Value of Serum Creatinine/Cystatin C Ratio for Preeclampsia in Patients with Gestational Diabetes Mellitus
HUI Jing
GUO Xiaoli
MA Yanling
LIU Jinhua
GAO Ani
Abstract：Objective To analyze the predictive value of the serum creatinine/cystatin C ratio(CCR)for the risk of preeclampsia(PE)in patients with gestational diabetes mellitus(GDM).Methods A total of 268 pregnant women with GDM who were treated in Yan'an People's Hospital from March 2022 to March 2024 were selected.According to the presence or absence of preeclampsia,the patients were divided into the PE group(n=72)and the non-PE group(n=196).CCR was calculated as the ratio of creatinine(Cr)to cystatin C(CysC).The predictive value of serum Cr,CysC,and CCR for PE in GDM patients was eval-uated by ROC curves.The influencing factors of PE in GDM patients were explored by multivariate logistic regression analysis.Results The levels of Cr and CysC in the PE group were higher than those in the non-PE group(P<0.05),but the CCR was lower than that in the non-PE group(P<0.05).The AUC(95%CI)of CCR for predicting PE in GDM patients was 0.904(0.850-0.955),which was significantly higher than that of Cr and CysC alone[0.845(0.796-0.892)and 0.761(0.714-0.809),respec-tively](Z=9.395,8.672,P<0.001).The pre-pregnancy body mass index(BMI),proportion of aspirin/heparin use,triglycerides,total cholesterol,homocysteine(Hcy),systolic blood pressure,diastolic blood pressure,and C-reactive protein in the PE group were all higher than those in the non-PE group(P<0.05).Multivariate analysis showed that elevated total cholesterol(OR=1.848,95%CI:1.309-2.609),elevated Hcy(OR=2.529,95%CI:1.383-4.626),elevated C-reactive protein(OR=2.401,95%CI:1.154-4.998),and decreased CCR(OR=3.080,95%CI:1.966-4.825)were independent risk factors for PE in GDM patients(P<0.05),and the use of aspirin/heparin(OR=0.525,95%CI:0.317-0.868)was an independent protective factor for PE in pa-tients with GDM(P<0.05).Conclusion The CCR level is decreased in GDM patients with PE.A low CCR level is a risk factor for PE in GDM patients and has a high predictive value for PE in GDM patients.
Keywords：Serum creatinine/cystatin C ratioGestational diabetes mellitusPreeclampsiaPredictive value
Publication Date：2025-05-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 64-69 )