Cellular Inflammatory Markers and Castelli Risk Indices in Women with Gestational Diabetes Mellitus
Abstract
Background: The clinical importance of early identification of potential predictors of cardiovascular events in women with gestational diabetes mellitus (GDM) cannot be overemphasized. This study aimed to determine the plasma levels of Castelli risk indices (CRI) and selected cellular inflammatory markers in women with GDM.
Methods: A total of 40 pregnant women, consisting of 11 women with GDM and 29 women without GDM, were randomly enrolled into this case-control study using the convenient sampling method. Venous blood samples were taken. The plasma lipid profiles were determined using the spectrophotometric methods. White blood cell differential was counted using a microscope. Plasma levels of CRI-I, CRI-II, low-density lipoprotein cholesterol (LDL-C), neutrophil-lymphocyte ratio (NLR), and monocyte lymphocyte ratio (MLR) were calculated using the appropriate formula. Student’s t-test, Mann Whitney U, Chi-square, and Spearman’s rho correlations were used for statistical analysis. P<0.05 was considered statistically significant.
Results: The CRI-I [6.58(6.06–7.60) vs 3.42(2.83–3.89)], CRI-II [4.59(4.17–5.28 vs 1.82(1.36–2.16)) and NLR (3.72±0.52 vs 2.63±0.61) were significantly higher in women with GDM. Likewise, the mean age (34.18±3.49), gestational weight (92.82±11.23), fasting plasma glucose (FPG) (98.45±6.24), total cholesterol (TC) (310.92(290.81–360.78)), triglyceride (TG) (232.86(221.28–256.00), LDL-C (214.85(206.24–239.80), and neutrophil count (76.36±2.58) were significantly higher in women with GDM (p<0.05). In contrast, HDL-C (45.56(44.90–51.34), lymphocytes (20.82±2.14), and monocytes counts (2.73±1.10) were significantly lower in women with GDM. However, there was no difference in the MLR between the two groups.
Conclusion: The CRI-I, CRI-II, and NLR are significantly elevated in women with GDM. Dyslipidemia and systemic inflammation are associated with GDM, which are forerunners of cardiovascular diseases.
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- American Diabetes Association Professional Practice Committee. 15. Management of diabetes in pregnancy: standards of medical care in diabetes—2022. Diabetes Care. 2022;45(Suppl_1):S232–43.
- Gyasi-Antwi P, Walker L, Moody C, Okyere S, Salt K, Anang L, et al. Global prevalence of gestational diabetes mellitus: a systematic review and meta-analysis. New American J Med. 2020;1(3):1–10.
- Cho NH, Shaw J, Karuranga S, Huang Y, da Rocha Fernandes J, Ohlrogge A, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271-81.
- Olumodeji AM, Okere RA, Adebara IO, Ajani GO, Adewara OE, Ghazali SM, et al. Implementing the 2013 WHO diagnostic criteria for gestational diabetes mellitus in a Rural Nigerian Population. Pan Afr Med J. 2020;36:208.
- Feng Y, Feng Q, Qu H, Song X, Hu J, Xu X, et al. Stress adaptation is associated with insulin resistance in women with gestational diabetes mellitus. Nutr Diabetes. 2020;10(1):4.
- Noctor E, Crowe C, Carmody LA, Saunders JA, Kirwan B, O’Dea A, et al. Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria. Eur J Endocrinol. 2016;175(4):287–97.
- Ama Moor VJ, Ndongo Amougou S, Ombotto S, Ntone F, Wouamba DE, Ngo Nonga B. Dyslipidemia in patients with a cardiovascular risk and disease at the University Teaching Hospital of Yaoundé, Cameroon. Int J Vasc Med. 2017;2017:6061306.
- Akpinar O, Bozkurt A, Acartürk E, Seydaoğlu G. A new index (CHOLINDEX) in detecting coronary artery disease risk. Anadolu Kardiyol Derg. 2013;13(4):315–9.
- Edwards MK, Blaha MJ, Loprinzi PD. Atherogenic index of plasma and triglyceride/high-density lipoprotein cholesterol ratio predict mortality risk better than individual cholesterol risk factors, among an older adult population. Mayo Clin Proc. 2017;92(4):680–1.
- Cai G, Shi G, Xue S, Lu W. The atherogenic index of plasma is a strong and independent predictor for coronary artery disease in the Chinese Han population. Medicine (Baltimore). 2017;96(37):e8058.
- Ray S, Talukdar A, Sonthalia N, Saha M, Kundu S, Khanra D, et al. Serum lipoprotein ratios as markers of insulin resistance: a study among non-diabetic acute coronary syndrome patients with impaired fasting glucose. Indian J Med Res. 2015;141(1):62–7.
- Pantham P, Aye ILH, Powell TL. Inflammation in maternal obesity and gestational diabetes mellitus. Placenta. 2015;36(7):709–15.
- Liu W, Lou X, Zhang Z, Chai Y, Yu Q. Association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume with the risk of gestational diabetes mellitus. Gynecol Endocrinol. 2021;37(2):105–7.
- World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. Geneva: World Health Organization; 2013.
- Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499–502.
- Chodick G, Tenne Y, Barer Y, Shalev V, Elchalal U. Gestational diabetes and long-term risk for dyslipidemia: a population-based historical cohort study. BMJ Open Diabetes Res Care. 2020;8(1):e000870.
- Li G, Wei T, Ni W, Zhang A, Zhang J, Xing Y, et al. Incidence and risk factors of gestational diabetes mellitus: a prospective cohort study in Qingdao, China. Front Endocrinol (Lausanne). 2020;11:636.
- Hedderson MM, Gunderson EP, Ferrara A. Gestational weight gain and risk of gestational diabetes mellitus. Obstet Gynecol. 2010;115(3):597–604.
- Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci. 2018;19(11):3342.
- Farias DR, Franco-Sena AB, Vilela A, Lepsch J, Mendes RH, Kac G. Lipid changes throughout pregnancy according to pre-pregnancy BMI: results from a prospective cohort. BJOG. 2016;123(4):570–8.
- Savvidou M, Nelson SM, Makgoba M, Messow CM, Sattar N, Nicolaides K. First-trimester prediction of gestational diabetes mellitus: examining the potential of combining maternal characteristics and laboratory measures. Diabetes. 2010;59(12):3017–22.
- Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG. 2015;122(5):643–51.
- Shen H, Liu X, Chen Y, He B, Cheng W. Associations of lipid levels during gestation with hypertensive disorders of pregnancy and gestational diabetes mellitus: a prospective longitudinal cohort study. BMJ Open. 2016;6(12):e013509.
- Xenoulis PG, Levinski MD, Suchodolski JS, Steiner JM. Association of hypertriglyceridemia with insulin resistance in healthy Miniature Schnauzers. J Am Vet Med Assoc. 2011;238(8):1011–6.
- Barter PJ. The causes and consequences of low levels of high density lipoproteins in patients with diabetes. Diabetes Metab J. 2011;35(2):101–6.
- Khosrowbeygi A, Shiamizadeh N, Taghizadeh N. Maternal circulating levels of some metabolic syndrome biomarkers in gestational diabetes mellitus. Endocrine. 2016;51(2):245–55.
- Wang J, Zhu Q-W, Cheng X-Y, Sha C-X, Cui Y-B. Clinical significance of neutrophil–lymphocyte ratio and monocyte–lymphocyte ratio in women with hyperglycemia. Postgrad Med. 2020;132(8):702–8.
- Vokalova L, Van Breda SV, Ye XL, Huhn EA, Than NG, Hasler P, et al. Excessive neutrophil activity in gestational diabetes mellitus: could it contribute to the development of preeclampsia? Front Endocrinol (Lausanne). 2018;9:542.
- Kang Q, Li W, Yu N, Fan L, Zhang Y, Sha M, et al. Predictive role of neutrophil-to-lymphocyte ratio in preeclampsia: A meta-analysis including 3982 patients. Pregnancy Hypertens. 2020;20:111–8.
- Hessami K, Tabrizi R, Homayoon N, Hashemi A, Heydari ST, Pourhoseini SA. Gestational diabetes mellitus and inflammatory biomarkers of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio: a systematic review and meta-analysis. Biomarkers. 2021;26(6):491–8.
DOI: https://doi.org/10.15850/amj.v10n4.3069
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