Inflammatory Indices in First Trimester as Predictors of Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes

IF 2.5 3区医学 Q3 IMMUNOLOGY

American Journal of Reproductive Immunology Pub Date : 2025-04-17 DOI:10.1111/aji.70070

Yu Sun, Cuihua Shen, Jia Li, Wei Kang, Xin Li, Wei Fan

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引用次数: 0

Abstract

Objectives

To explore the association between systemic inflammatory markers (systemic inflammation response index [SIRI], systemic immune inflammation index [SII], interleukin [IL]-33, and soluble tumorigenicity 2 [sST2]) and gestational diabetes mellitus (GDM), as well as adverse pregnancy outcomes (APOs), and to assess the impact of glycemic control on these relationships.

Methods

A total of 777 participants were included, comprising 476 women with GDM and 301 without. Clinical characteristics, inflammatory markers, and pregnancy outcomes were analyzed. Logistic regression was employed to assess the risk of GDM and APOs associated with elevated inflammatory indices and glycemic control. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curves.

Results

Women with GDM exhibited significantly higher levels of SII, SIRI, IL-33, and sST2. Multivariate logistic regression demonstrated that SII, SIRI, IL-33, and sST2 were independent predictors of GDM. Moreover, the highest tertiles of SII, SIRI, and IL-33 were strongly associated with APO risk. ROC analysis revealed that SII had the highest predictive value for GDM (AUC 0.763), while IL-33 had the greatest predictive accuracy for APOs (AUC 0.669). Effective glycemic control was associated with reduced inflammatory marker levels (SII, aOR 3.9; SIRI, aOR 3.7; IL-33, aOR 2.4) and a decreased risk of APOs and large-for-gestational-age (LGA) infants in women with GDM.

Conclusions

Elevated SII, SIRI, IL-33, and sST2 are significant predictors of GDM and APOs, with SII being the most robust predictor of GDM and IL-33 for APOs. Glycemic control reduces inflammation and may improve pregnancy outcomes in women with GDM.

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妊娠早期炎症指数作为妊娠期糖尿病和不良妊娠结局的预测因子

目的探讨全身炎症标志物（全身炎症反应指数[SIRI]、全身免疫炎症指数[SII]、白细胞介素[IL]-33、可溶性致瘤性2 [sST2]）与妊娠期糖尿病（GDM）及不良妊娠结局（APOs）的关系，并评价血糖控制对这些关系的影响。方法共纳入777例受试者，其中GDM患者476例，非GDM患者301例。分析临床特征、炎症指标和妊娠结局。采用Logistic回归评估GDM和apo与炎症指数升高和血糖控制相关的风险。采用受试者工作特征（ROC）曲线评价诊断效果。结果GDM患者SII、SIRI、IL-33和sST2水平明显升高。多因素logistic回归分析显示SII、SIRI、IL-33和sST2是GDM的独立预测因子。此外，SII、SIRI和IL-33的最高分位数与APO风险密切相关。ROC分析显示，SII对GDM的预测值最高（AUC 0.763）， IL-33对APOs的预测值最高（AUC 0.669）。有效的血糖控制与炎症标志物水平降低相关(SII, aOR 3.9；SIRI, aOR 3.7；IL-33, aOR 2.4)和降低GDM妇女apo和大胎龄（LGA）婴儿的风险。结论SII、SIRI、IL-33和sST2升高是GDM和apo的重要预测因子，其中SII是GDM和IL-33 apo最可靠的预测因子。血糖控制可以减少炎症，并可能改善GDM妇女的妊娠结局。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.