Low-Grade Inflammation in Gestational Diabetes Mellitus and Its Correlation with Maternal Insulin Resistance and Fetal Growth Indices

Figures & data

Figure 1 Comparison between gestational diabetes and normal glucose tolerant pregnancies regarding chronic low grade inflammation indices. (A) Neutrophil-to-lymphocyte index. (B) Platelet-to-lymphocyte index. (Mann–Whitney’s test).

Abbreviations: NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; GDM, gestational diabetes mellitus; NGT, normal glucose-tolerant.

Table 1 Relationships Between Maternal Characteristics and Low-Grade Inflammation in Gestational Diabetes

	Low-Grade Inflammatory-GDM (n=96)	Non-Low-Grade Inflammatory-GDM (n=152)	p
Age, years	31 (28–35)	30 (27–34)	0.222
SBP, mmHg	110 (106–120)	110 (100–120)	0.005
BMI, kg/m^2	26.4±3.6	25.0±3.0	0.001
Parity, times	2 (1–3)	2 (1–4)	0.796
HbA1c, %	5.4 (5.1–5.6)	5.3 (5.1–5.5)	0.026
QUICKI	0.33±0.04	0.34±0.04	0.039
Triglyceride, mmol/L	2.7 (2.1–3.5)	2.7 (2.1–3.6)	0.912
Cholesterol, mmol/L	5.7±1.0	6.1±1.2	0.076

Notes: t-test for indepent variables and Mann–Whitney test were employed for comparing two means and two medians, respectively.

Abbreviations: GDM, gestational diabetes mellitus; SBP, systolic blood pressure; BMI, body mass index; QUICKI, Quantitative Insulin Sensitivity Check Index.

Table 2 Relationships Between Low-Grade Inflammatory Indices and Fetal Growth Indices in the Third Trimester in Gestational Diabetes

	Low-Grade Inflammatory-GDM (n=96)	Non-Low-Grade Inflammatory-GDM (n=152)	p
BPD, mm	79.5 (75.0–83.5)	80.5 (74.0–85.0)	0.018
AC, mm	261 (242.8–294.8)	276.0 (242.8–305.3)	0.008
FL, mm	57.5 (52.3–63.0)	57.5 (51.0–63.0)	0.016
EFW, g	1577.0 (1303.8–2191.0)	1766.5 (1197.8–2306.3)	0.007
AFI, mm	133.0 (96.8–168.3)	146.0 (121.5–169.3)	0.396
HC, mm	286.5 (265.3–310.5)	294.5 (270.0–316.0)	0.044

Note: Mann–Whitney test was employed for comparing two medians.

Abbreviations: GDM, gestational diabetes mellitus; BPD, biparietal diameter; AC, abdominal circumference; FL, femur length; EFW, estimated fetal weight; AFI, amniotic fluid index; HC, head circumference.

Table 3 Correlations Between Low-Grade Inflammation Indices and Maternal and Fetal Growth Indices

	BMI	G0	G2	CRP	HOMA2-IR (Insulin)	McAuley	QUICKI	Mathews
Maternal NLR
M1	−0.07	−0.11	−0.13*	0.21**	0.05	−0.03	−0.02	0.01
M2			−0.17	0.33^¶
Maternal PLR
M1	−0.06	−0.01	−0.08	0.24^¶	0.12	−0.09	−0.08	0.11
M2				0.004^¶
Maternal CRP
M1	0.24	0.08	−0.11		0.24^¶	−0.18**	−0.19**	0.26^¶
M2					0.13**	−0.03	−0.001	0.29**

Notes: *p <0.05; **p <0.01; ^¶p <0.001. NLR, PLR, and CRP: Model (M)1 = Pearson correlation without any adjustments. M2 = NLR adjusted with maternal BMI and maternal FPG; PLR adjusted with maternal BMI, maternal FPG, maternal age, and maternal parities, CRP adjusted with maternal BMI, maternal FPG, maternal age, and maternal parity.

Abbreviations: BMI, Body Mass index (kg/m²); G0, fasting plasma glucose (mmol/L); G2, 2-hour post oral glucose tolerant test plasma glucose (mmol/L); NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; CRP, C-reactive protein; HOMA2-IR, Homeostasis Model Assessment-2-Insulin resistance; QUICKI, Quantitative Insulin Sensitivity Check Index.

Table 4 Correlations Between Low-Grade Inflammation Indices and Fetal Growth Indices

	BPD	AC	FL	EFW	AFI	HC
Maternal NLR
M1	0.003	−0.06	0.04	−0.15*	0.03	−0.09
M2				−64.4*
Maternal PLR
M1	−0.17*	−0.16*	−0.10	−0.22**	−0.05	−0.22**
M2	−0.02**	−0.06*		−1.1**		−0.06**
Maternal CRP
M1	−0.13	−0.16*	−0.09	−0.15*	−0.08	−0.16*
M2		−5.5^¶		−85.3^¶		−5.0^¶

Notes: *p <0.05; **p <0.01; ^¶p <0.001. NLR, PLR, and CRP: Model (M)1 = Pearson correlation without any adjustments. M2 = NLR adjusted with maternal BMI and maternal FPG; PLR adjusted with maternal BMI, maternal FPG, maternal age, and maternal parity, CRP adjusted with maternal BMI, maternal FPG, maternal age, and maternal parities.

Abbreviations: BPD, biparietal diameter (mm); AC, abdominal circumference (mm); FL, femur length (mm); EFW, estimated fetal weight (gram); AFI, amniotic fluid index (mm); HC, head circumference (mm); NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; CRP, C-reactive protein (mg/L).