Prediction of Gestational diabetes: Role of neutrophil to lymphocyte ratio at booking visit

Introduction: Gestational Diabetes Mellitus (GDM) affect up to approximately 10% of all pregnancies. Various markers of inflammation have been shown to predict the future diabetes risk and Neutrophil Lymphocyte Ratio (NLR) level is significantly correlated with metabolic syndrome criteria. However, very few studies investigated any possible association between NLR and development of GDM. Objectives • To compare the NLR among GDM group and control group. • To identify an optimal cut-off value of NLR in predicting GDM. Methods: A longitudinal observational study in all pregnant women who are in their first trimester at antenatal clinic, Teaching Hospital, Kandy for six months was carried out with a Full Blood Count at the first trimester and Oral Glucose Tolerance Test (OGTT) at the 24-28 weeks of gestation. Sample size was 361 and non-probability convenient sampling technique was applied. Results: Mean NLR value was 3.16 (SD=1.84) and the difference between GDM and non GDM mothers was not significant. Left upper most value for NLR of the ROC curve is 1.32 and when it is used as the cut off value the sensitivity is 99.6% and the specificity is 21.2%. Conclusions and recommendations: NLR positively correlates with the OGTT values done at 24-28 weeks of gestation, which can be used as a predictor at early booking visit. There is no significant difference between the mean value of participants with or without GDM. Prediction of GDM by NLR should be further studied in a well-targeted study population with wide methodology.