Association between Systemic Inflammation in the First Trimester and the Risk of Gestational Diabetes Mellitus

doi:10.3870/j.issn.1672-0741.25.10.033

Abstract

Abstract: Objective To evaluate the impact of the first-trimester systemic immune-inflammation index(SII)and systemic inflammation response index(SIRI)on gestational diabetes mellitus(GDM),subtypes of GDM,and blood glucose levels. Methods A retrospective cohort study was conducted,involving 34,171 pregnant women from the electronic medical record system of Guangdong Women and Children Hospital from 2015 to 2024.GDM patients and their subtypes were diagnosed via the 75 g oral glucose tolerance test.A modified Poisson regression model,multinomial Logistic regression model and linear regression model were used to explore the associations of the SII and SIRI with GDM,subtypes of GDM and blood glucose levels,respectively.A restricted cubic spline(RCS)model was applied to explore the possible nonlinear relationships between SII,SIRI and GDM as well as blood glucose levels. Results After adjusting for covariates,a modified Poisson regression model revealed that an elevated ln-transformed SII(RR=1.30,95%CI:1.23-1.37)and SIRI(RR=1.21,95%CI:1.16-1.27)were associated with an increased risk of developing GDM.The multinomial logistic regression model revealed that elevated ln-transformed SII and SIRI were associated with an increased risk of developing GDM-isolated post-load hyperglycemia(GDM-IPH)(SII:OR=1.36,95%CI:1.26-1.47;SIRI:OR=1.27,95%CI:1.19-1.36)and GDM-combined hyperglycemia(GDM-CH)(SII:OR = 1.82,95%CI:1.49-2.21;SIRI:OR = 1.47,95%CI:1.25-1.73),but elevated SII and SIRI did not have statistically significant effect on the risk of developing GDM-isolated fasting hyperglycemia(GDM-IFH)(SII:OR=1.22,95%CI:0.99-1.51;SIRI:OR=1.09,95%CI:0.92-1.30).The RCS results revealed that the ln-transformed SII exhibited a J-shaped dose-response relationship with fasting and 1-hour blood glucose levels and a linear dose-response relationship with 2-hour blood glucose levels,whereas the ln-transformed SIRI exhibited a linear dose-response relationship with 1- and 2-hour blood glucose levels. Conclusion Elevated SII and SIRI in the first trimester are significantly associated with an increased risk of GDM and its GDM-IPH and GDM-CH subtypes.The results provide new inflammatory markers for early risk identification and subtype-specific management of GDM.

Key words: systemic immune-inflammation index, systemic inflammation response index, first trimester, gestational diabetes mellitus, blood glucose level

CLC Number:

R587.1

Liu Binghai, Guo Wenwen, Yan Lianyan et al. Association between Systemic Inflammation in the First Trimester and the Risk of Gestational Diabetes Mellitus[J]. Acta Medicinae Universitatis Scientiae et Technologiae Huazhong, 2026, 55(1): 53-60.

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