Gestational diabetes mellitus and inflammatory biomarkers of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio: a systematic review and meta-analysis

Abstract

Purpose

To evaluate the association between two inflammatory biomarkers of neutrophil -lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) with gestational diabetes mellitus (GDM).

Methods and materials

Systematic search was performed up to June 2020 in databases such as PubMed, Embase, Scopus, Web of Science, and Google scholar. The random-effects model was utilised to combine the weighted mean differences (WMDs) and their 95% confidence intervals (CIs).

Results

Out of a total of 849 articles, sixteen studies were eligible. Our findings indicated higher NLR (WMD = 0.48, 95% CI: 0.25, 0.71) and PLR (WMD = 8.22, 95% CI: −0.50, 16.94) values in pregnancies diagnosed with GDM compared with non-GDM control pregnancies. However, the difference in PLR value did not reach a statistically significant level (Z = 1.85, p = 0.065). In meta-regression analysis, we found no significant influence of total sample size [for NLR (B= −0.0, p = 0.13), for PLR (B= −0.02, p = 0.55)] and publication year [for NLR (B= −0.02, p = 0.61), for PLR (B = 0.89, p = 0.75)] on association between NLR and PLR with GDM.

Conclusion

The current meta-analysis is the first, to our knowledge, to show that NLR value is significantly associated with GDM. However, PLR showed no significant association with GDM.

Keywords:

• Neutrophil
• platelet
• NLR
• PLR
• pregnancy
• GDM
• diabetes

Author contributions

KH was involved in study design, search in databases, quality assessment, study selection, data extraction, manuscript drafting, and critical discussion. AH, NH and KH was involved in study design, quality assessment, data analysis, and critical discussion. RT, STH and SAP contribute in quality assessment, data analysis, critical discussion, and manuscript drafting. KH and SAP contributed in interpreting data, manuscript drafting and revising manuscript. All authors read and approved the final manuscript.

Disclosure statement

The authors declare that they have no competing interests.