Novel Hematological Inflammatory Indices in Early Pregnancy: The Predictive Value of the Cumulative Inflammatory Index and Mean Corpuscular Volume/Lymphocyte for Gestational Diabetes Mellitus

IF 2.5 3区医学 Q3 IMMUNOLOGY

American Journal of Reproductive Immunology Pub Date : 2026-06-01 DOI:10.1111/aji.70264

Deniz OLUKLU, Fatma OLUKLU, Selma SUREN, Aysegül GENCER, Taylan ONAT

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引用次数: 0

Abstract

Aim

To evaluate the predictive value of first and second trimester hematological inflammatory indices—including the novel cumulative inflammatory index (IIC) and mean corpuscular volume-to-lymphocyte ratio (MCVL)—for the subsequent development of gestational diabetes mellitus (GDM). Additionally, the study will assess whether these markers differ between GDM subgroups managed with diet alone versus insulin therapy.

Methods

This case-control study enrolled 150 pregnant women, with 75 diagnosed with GDM and 75 serving as healthy controls. Hematological inflammatory indices—namely, NLR, MLR, PLR, dNLR, AISI, SII, SIRI, IIC, and MCVL—were calculated from first- and second-trimester complete blood count parameters.

Results

First-trimester inflammatory indices (NLR, MLR, PLR, dNLR, AISI, SII, SIRI, IIC, and MCVL) were significantly elevated in the GDM group compared to controls (all p < 0.05). NLR demonstrated the highest discriminative accuracy (AUC 0.782; 95% CI: 0.709–0.855), followed by SIRI (AUC 0.778) and IIC (AUC 0.775). Among GDM patients, 22 (29.3%) required insulin therapy. Insulin-treated patients exhibited significantly higher SIRI_1 than diet-managed patients (p = 0.025), and showed a substantially elevated inflammatory burden across multiple second-trimester indices. First-trimester fasting glucose was positively correlated with several second-trimester inflammatory indices, including AISI_1 (r = 0.351, p = 0.002) and SII_2 (r = 0.342, p = 0.003).

Conclusion

First-trimester hematological inflammatory indices, including the novel IIC and MCVL, are associated with subsequent development of GDM. Furthermore, these indices offer moderate predictive accuracy when derived from routine antenatal blood tests. The clinical usefulness of these findings necessitates prospective validation in larger, multicenter cohorts.

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妊娠早期新的血液学炎症指标：累积炎症指数和平均红细胞体积/淋巴细胞对妊娠糖尿病的预测价值

目的：评价妊娠早期和中期血液学炎症指标（包括新型累积炎症指数（IIC）和平均红细胞体积/淋巴细胞比（MCVL））对妊娠糖尿病（GDM）后续发展的预测价值。此外，该研究将评估这些标志物在单独饮食与胰岛素治疗的GDM亚组之间是否存在差异。方法：本病例对照研究纳入了150名孕妇，其中75名诊断为GDM， 75名作为健康对照。根据妊娠早期和中期全血细胞计数参数计算血液学炎症指标，即NLR、MLR、PLR、dNLR、AISI、SII、SIRI、IIC和mcv。结果：GDM组妊娠早期炎症指数（NLR、MLR、PLR、dNLR、AISI、SII、SIRI、IIC、MCVL）较对照组显著升高（p < 0.05）。NLR表现出最高的判别准确率（AUC 0.782; 95% CI: 0.709-0.855），其次是SIRI （AUC 0.778）和IIC （AUC 0.775）。在GDM患者中，22例（29.3%）需要胰岛素治疗。胰岛素治疗的患者的SIRI_1明显高于饮食管理的患者（p = 0.025），并且在多个妊娠中期指标中显示出明显升高的炎症负担。妊娠早期空腹血糖与妊娠中期多项炎症指标AISI_1 （r = 0.351, p = 0.002）、SII_2 （r = 0.342, p = 0.003）呈正相关。结论：妊娠早期血液学炎症指标，包括新型IIC和MCVL，与GDM的后续发展相关。此外，这些指标提供适度的预测准确性时，来自常规产前血液检查。这些发现的临床有效性需要在更大的多中心队列中进行前瞻性验证。

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.