Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: are they useful for predicting gestational diabetes mellitus during pregnancy?

Figures & data

Table 1 Demographic characteristics of and laboratory results from all of the patients

	Minimum–maximum	Mean ± SD
Age (years)	17–42	28.75±5.37
BMI (kg/m^2)	21–34	27.51±2.55
Gestational age (weeks)	24–30	26.14±2.09
Parity, n	0–6	1.06±1.07
Abortion, n	0–7	0.31±0.74
50 g OGTT (mg/dL)	59–255	141.61±31.0
Fasting glucose level (mg/dL)	69–128	83±9
Neutrophil count (cells/mL)	3,500–11,500	7,067.76±1,485.02
Lymphocyte count (cells/mL)	950–4,150	2,176.74±544.32
Hemoglobin (g/dL)	7.9–15.1	11.60±1.08
Platelet count (cells/μL)	103,000–425,000	241,771.65±57,669.61
NLR	0.16–8.45	3.45±1.15
PLR	47.47–323.58	116.71±37.43

Abbreviations: SD, standard deviation; BMI, body mass index; OGTT, oral glucose tolerance test; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio.

Table 2 Distribution of the patients according to the glucose tolerance test results

	GDM (n=144)	IGT (n=76)	OSP (n=238)	NGT (n=304)	P-value
Age (years)
Mean ± SD	30.97±4.84	29.78±4.31	28.65±5.71	27.51±5.22	0.001a,*
Minimum–maximum (median)	20–42 (30.5)	23–37 (30)	18–42 (29)	17–40 (27)
BMI (kg/m^2)
Mean ± SD	30.11±1.95	28.27±2.50	27.41±2.20	26.16±2.02	0.001a,*
Minimum–maximum (median)	25–34 (30)	24–34 (28)	21–34 (28)	22–30 (26)
Gestational age (weeks)
Mean ± SD	26.22±1.73	25.32±1.09	26.19±1.71	26.27±2.60	0.001a,*
Minimum–maximum (median)	24–30 (26)	24–28 (26)	24–29 (26)	24–30 (26)
Parity, n
Mean ± SD	1.15±0.98	1.20±1.17	1.04±1.20	0.99±0.98	0.141b
Minimum–maximum (median)	0–4 (1)	0–4 (1)	0–5 (1)	0–6 (1)
Abortion, n
Mean ± SD	0.44±0.77	0.21±0.47	0.43±1.02	0.17±0.43	0.001b,*
Minimum–maximum (median)	0–3 (0)	0–2 (0)	0–7 (0)	0–2 (0)
Ectopic pregnancy, n (%)
0	142 (98.6)	74 (97.4)	230 (96.6)	301 (99.0)	0.357c
1	2 (1.4)	2 (2.6)	6 (2.5)	3 (1.0)
2	0	0	2 (0.8)	0

Notes:

a One-way analysis of variance.

b Kruskal–Wallis test.

c Fisher–Freeman–Halton test.

* P<0.01.

Abbreviations: GDM, gestational diabetes mellitus; IGT, impaired glucose tolerance; OSP, only screen positive; NGT, normal glucose tolerance; SD, standard deviation; BMI, body mass index.

Table 3 Pairwise group comparisons of the glucose challenge test results

	P-values for the compared groups
	Groups 1 and 2	Groups 1 and 3	Groups 1 and 4	Groups 2 and 3	Groups 2 and 4	Groups 3 and 4
Agea	0.243	0.001*	0.001*	0.268	0.001*	0.078
BMIb	0.001*	0.001*	0.001*	0.012**	0.001*	0.001*
Gestational agea	0.001*	0.999	0.994	0.001*	0.001*	0.997
Parityc	0.875	0.051	0.071	0.183	0.260	0.552
Abortionc	0.030**	0.275	0.001*	0.149	0.442	0.001*
Ectopic pregnancyc	0.513	0.240	0.706	0.746	0.261	0.051
50 g OGTTa	0.001*	0.001*	0.001*	0.003*	0.001*	0.001*
Neutrophil countb	0.988	0.357	0.001*	0.768	0.001*	0.001*
Lymphocyte countc	0.992	0.810	0.002*	0.977	0.048**	0.008*
Hemoglobin levelb	0.093	0.600	0.001*	0.003*	0.001*	0.003*
Platelet countb	0.790	0.733	0.005*	0.998	0.367	0.039**
PLRa	0.619	0.602	0.924	0.992	0.824	0.826
NLRb	0.993	0.891	0.896	0.992	0.994	1.000

Notes: Groups 1, 2, 3, and 4 are the gestational diabetes mellitus, impaired glucose tolerance, only screen positive, and normal glucose tolerance (control) groups, respectively.

a Games–Howell test.

b Tukey’s honest significant difference test.

c Mann–Whitney U-test.

* P<0.01.

** P<0.05.

Abbreviations: BMI, body mass index; OGTT, oral glucose tolerance test; PLR, platelet-to-lymphocyte ratio; NLR, neutrophil-to-lymphocyte ratio.

Table 4 Laboratory measurements, NLR, and PLR of the patients with different glycemic tolerance status

	GDM (n=144)	IGT (n=76)	OSP (n=238)	NGT (n=304)	P-valuea
Fasting glucose level (mg/dL)
Mean ± SD	96.1±17	87.2±9	85.4±7	82.5±9.9	0.001*
Minimum–maximum (median)	82–128 (95)	78–115 (91)	76–96 (85)	69–88 (83)
50 g OGTT (mg/dL)
Mean ± SD	175.33±23.04	159.47±11.39	154.02±12.31	111.46±18.97	0.001*
Minimum–maximum (median)	134–255 (175)	140–191 (158.5)	119–190 (151)	59–176 (114)
Mean ± SD post-OGTT glucose level (mg/dL)
1 h	193.6±21.9	175.7±18.3	155±15.4		0.001*
2 h	169.1±21.3	131.1±27.5	120±12.5		0.001*
3 h	108.4±29.6	97.6±31.4	94±19.8		0.001*
WBC (cells/mL)
Mean ± SD	11,300±2,239	10,618±2,150	10,100±2,010	8,980±1,950	0.001*
Minimum–maximum (median)	6,720–14,100 (11,450)	6,685–13,900 (10,710)	6,590–13,750 (10,180)	6,100–12,100 (9,050)
Neutrophil count (cells/mL)
Mean ± SD	7,467±1,437	7,401±1,472	7,216±1,424	6,678±1,471	0.001*
Minimum–maximum (median)	4,200–11,100 (7,570)	4,150–10,900 (7,520)	3,990–11,000 (7,300)	3,500–10,300 (6,600)
Lymphocyte count (cells/mL)
Mean ± SD	2,274±599	2,252±497	2,223±484	2,074±557	0.001*
Minimum–maximum (median)	1,060–3,930 (2,200)	1,100–3,700 (2,225)	1,100–3,330 (2,240)	950–4,150 (1,940)
Hemoglobin level (g/dL)
Mean ± SD	11.79±1.08	12.14±1.00	11.65±1.05	11.34±1.06	0.001*
Minimum–maximum (median)	8.6–15.1 (11.7)	10.3–14.0 (12.1)	9.4–14.2 (11.7)	7.9–14.0 (11.4)
Platelet count (cells/μL)
Mean ± SD	252,222±47,012	244,684±57,862	246,004±60,593	237,790±58,821	0.003*
Minimum–maximum (median)	163,000–359,000 (243,500)	176,000–390,000 (23,700)	155,000–424,000 (246,000)	130,000–425,000 (231,000)
PLR
Mean ± SD	119.83±45.31	113.14±34.95	114.46±32.87	117.88±37.26	0.416
Minimum–maximum (median)	53.19–323.58 (108.6)	57.14–260.91 (109.3)	41.47–224.55 (111.7)	49.84–247.37 (111.3)
NLR
Mean ± SD	3.50±1.16	3.46±1.11	3.42±1.10	3.44±1.19	0.911
Minimum–maximum (median)	1.65–8.18 (3.3)	1.43–8.4 (3.3)	1.29–7.48 (3.2)	0.16–7.89 (3.3)

Notes:

a One-way analysis of variance.

* P<0.01.

Abbreviations: NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; GDM, gestational diabetes mellitus; IGT, impaired glucose tolerance; OSP, only screen positive; NGT, normal glucose tolerance; SD, standard deviation; OGTT, oral glucose tolerance test; h, hours; WBC, white blood cell.

Table 5 Demographic characteristics of and laboratory results from the patients with gestational diabetes mellitus, stratified according to diet management or insulin treatment

	Diet management (n=90)	Insulin treatment (n=54)	P-value
Age (years)
Mean ± SD	30.98±5.18	30.96±4.26	0.986a
Minimum–maximum (median)	20–42 (30)	20–42 (31)
BMI (kg/m^2)
Mean ± SD	29.91±1.74	30.44±2.24	0.114a
Minimum–maximum (median)	25–34 (30)	25–34 (31)
Gestational age (weeks)
Mean ± SD	26.27±1.71	26.13±1.77	0.647a
Minimum–maximum (median)	24–30 (26)	24–30 (26)
Parity
Mean ± SD	1.06±0.92	1.31±1.06	0.169b
Minimum–maximum (median)	0–3 (1)	0–4 (1)
Abortion, n
Mean ± SD	0.49±0.85	0.37±0.62	0.652b
Minimum–maximum (median)	0–3 (0)	0–2 (0)
Ectopic pregnancy
0	88 (97.8)	54 (100.0)	0.528c
1	2 (2.2)	0
Fasting blood glucose (mg/dL)
Mean ± SD	95.2±19	97.4±15	0.056
Minimum–maximum (median)	82–120 (94)	86–128 (96)
50 g OGTT (mg/dL)
Mean ± SD	171.11±17.09	182.35±29.34	0.004*
Minimum–maximum (median)	134–200 (175)	147–255 (176.5)
WBC (cells/mL)
Mean ± SD	10,730±2,130	10,950±2,160	0.285
Minimum–maximum (median)	6,680–13,900	6,950–14,100
Neutrophil count (cells/mL)
Mean ± SD	7,350.88±1,383.45	7,662.59±1,516.91	0.209
Minimum–maximum (median)	4,260–11,100 (7,600)	3,900–11,300 (7,500)
Lymphocyte count (cells/mL)
Mean ± SD	2,249.88±585.53	2,314.90±626.80	0.359
Minimum–maximum (median)	1,060–3,930 (2,200)	1,060–3,730 (2,300)
Hemoglobin level (g/dL)
Mean ± SD	11.74±1.15	11.88±0.96	0.470
Minimum–maximum (median)	8.6–15.1 (11.68)	10.3–15.1 (11.8)
Platelet count (cells/μL)
Mean ± SD	255,644±49,408	246,518±42,554	0.261
Minimum–maximum (median)	163,000–359,000 (258,000)	165,000–343,000 (240,000)
NLR
Mean ± SD	3.48±1.15	3.55±1.19	0.724
Minimum–maximum (median)	1.65–8.18 (3.2)	1.70–8.02 (3.5)
PLR
Mean ± SD	121.58±43.49	116.92±48.49	0.553
Minimum–maximum (median)	66.67–323.58 (114.5)	53.19–323.58 (108.6)

Notes:

a Student’s t-test.

b Mann–Whitney U-test.

c Fisher’s exact test.

* P<0.01.

Abbreviations: BMI, body mass index; OGTT, oral glucose tolerance test; WBC, white blood cell; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SD, standard deviation.