Blood Cell Parameters From Early to Middle Pregnancy and Risk of Gestational Diabetes Mellitus

Yi-Xiang Ye; Yi Wang; Ping Wu; Xue Yang; Linjing Wu; Yuwei Lai; Jing Ouyang; Yanqin Li; Peishan Li; Yayi Hu; Yi-Xin Wang; Xingyue Song; Shijiao Yan; Chuanzhu Lv; Gang Liu; An Pan; Xiong-Fei Pan

doi:10.1210/clinem/dgad336

Blood Cell Parameters From Early to Middle Pregnancy and Risk of Gestational Diabetes Mellitus

J Clin Endocrinol Metab. 2023 Nov 17;108(12):e1702-e1711. doi: 10.1210/clinem/dgad336.

Authors

Yi-Xiang Ye¹, Yi Wang¹, Ping Wu¹, Xue Yang^{2

3}, Linjing Wu¹, Yuwei Lai¹, Jing Ouyang¹, Yanqin Li⁴, Peishan Li⁴, Yayi Hu⁵, Yi-Xin Wang⁶, Xingyue Song⁷, Shijiao Yan^{8

9}, Chuanzhu Lv^{9

10

11}, Gang Liu¹², An Pan¹, Xiong-Fei Pan^{13

14

15

16}

Affiliations

¹ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
² Section of Epidemiology and Population Health, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
³ Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
⁴ Department of Obstetrics, Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan 610200, China.
⁵ Department of Obstetrics and Gynecology, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
⁶ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA.
⁷ Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China.
⁸ School of Public Health, Hainan Medical University, Haikou, Hainan 571199, China.
⁹ Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences, Hainan Medical University, Haikou, Hainan 571199, China.
¹⁰ Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan 610072, China.
¹¹ Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan 571199, China.
¹² Department of Nutrition & Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
¹³ Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
¹⁴ West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
¹⁵ Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan 610200, China.
¹⁶ Center for Epidemiology and Population Health, Integrated Traditional Chinese and Western Medicine Institute & Chengdu Integrated Traditional Chinese and Western Medicine Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.

PMID: 37279929
DOI: 10.1210/clinem/dgad336

Abstract

Context: Chronic low-grade inflammation may play a crucial role in the pathogenesis of gestational diabetes mellitus (GDM). However, prospective studies on the relations of inflammatory blood cell parameters during pregnancy with GDM are lacking.

Objective: To prospectively investigate the associations of inflammatory blood cell parameters in both early and middle pregnancy, and their change patterns from early to middle pregnancy, with GDM risk.

Methods: We used data from the Tongji-Shuangliu Birth Cohort. Inflammatory blood cell parameters (white blood cells [WBC], neutrophils, lymphocytes, monocytes, neutrophil to lymphocyte ratio [NLR], and platelets) were assayed before 15 weeks and between 16 and 28 weeks of gestational age. Logistic regression was used to evaluate the associations between inflammatory blood cell parameters and GDM.

Results: Of the 6354 pregnant women, 445 were diagnosed with GDM. After adjustment for potential confounders, WBC, neutrophils, lymphocytes, monocytes, and NLR in early pregnancy were positively associated with GDM risk (odds ratios [95% CI] for extreme-quartile comparison were 2.38 [1.76-3.20], 2.47 [1.82-3.36], 1.40 [1.06-1.85], 1.69 [1.27-2.24], and 1.51 [1.12-2.02], respectively, all P for trend ≤ .010). Similarly, higher levels of WBC, neutrophils, monocytes, and NLR in middle pregnancy were associated with increased risk of GDM (all P for trend ≤ .014). Stable high levels (≥ median in both early and middle pregnancy) of WBC, neutrophils, monocytes, and NLR were positively associated with GDM risk (all P ≤ .001).

Conclusion: Increased WBC, neutrophils, monocytes, and NLR in both early and middle pregnancy and their stable high levels from early to middle pregnancy were associated with higher GDM risk, highlighting that they might be clinically relevant for identifying individuals at high risk for GDM.

Keywords: gestational diabetes mellitus; inflammation; longitudinal association; pregnancy.

MeSH terms

Blood Glucose
Diabetes, Gestational*
Female
Humans
Inflammation / complications
Neutrophils
Pregnancy
Pregnancy Trimester, First
Prospective Studies

Substances

Blood Glucose

Abstract

MeSH terms

Substances

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