Leuko-Glycemic Index and Liver Fibrosis Markers in Gestational Diabetes Prediction: A Novel Perspective

Abstract

Objective

This study investigates the potential role of the Leuko-Glycemic Index (LGI) and liver fibrosis markers, specifically the Fibrosis-4 Index (FIB-4) and Aspartate Aminotransferase/Platelet Ratio Index (APRI), in predicting gestational diabetes mellitus (GDM) and its association with adverse neonatal outcomes.

Methods

A retrospective cohort study was conducted at Ankara Etlik City Hospital, including 1173 pregnant women, of whom 576 (49.1%) were diagnosed with GDM and 597 (50.9%) served as controls. LGI, APRI, and FIB-4 scores were calculated using first- and second-trimester laboratory data. Statistical analyses, including logistic regression and receiver operating characteristic (ROC) curve analysis, were performed to assess their predictive value for GDM and neonatal outcomes.

Results

LGI was significantly lower in the GDM group during both the first and second trimesters (p < 0.001). ROC analysis demonstrated that LGI had a statistically modest discriminative ability for GDM (AUC = 0.583 and 0.609 for the first and second trimesters, respectively, p < 0.001). However, FIB-4 and APRI indices were not significant predictors of GDM. First-trimester APRI scores were significantly associated with adverse neonatal outcomes (AUC = 0.607, p = 0.004).

Conclusion

LGI was identified as a potential predictive marker for GDM, supporting its role as an inflammation-related index in GDM risk assessment. While APRI scores in the first trimester correlated with adverse neonatal outcomes, FIB-4, and APRI indices were not effective predictors of GDM. Further prospective studies with larger cohorts are needed to confirm these findings and explore the clinical applicability of LGI in early GDM screening.