Association between inflammatory biomarkers and gestational diabetes mellitus in women aged 20–44: a cross-sectional analysis of NHANES 2007–2018

Inflammation exerts an essential role in gestational diabetes mellitus (GDM), but the relationship between peripheral blood inflammatory markers and GDM remains unclear. The purpose of this study was to explore the relationship between inflammatory markers and GDM in US adults. Data were extracted from the National Health and Nutrition Examination Survey. Five inflammatory markers were derived from complete blood count. Survey-weighted multivariable logistic regression models were used to assess the association between inflammatory markers and GDM. Restricted cubic splines and subgroup analyses were conducted to validate the stability of the results. Finally, a total of 2363 women aged 20–44 were included based on specific criteria, with 229 self-reported GDM cases (9.69%). The increased lymphocyte–monocyte ratio (LMR) was associated with the higher risk of GDM, aOR = 1.82 (CI:1.30–2.56). Compared with the lowest tertile, the highest tertile group of LMR showed a significantly increased risk of GDM, aOR = 2.24 (CI: 1.28–2.85). Conversely, the highest tertile group of systemic inflammation response index (SIRI) was negatively associated with GDM, aOR = 0.61 (95% CI: 0.40–0.94). And high platelet–lymphocyte ratio (PLR) levels are related to a lower risk of GDM. No non-linear relationships were observed. Furthermore, subgroup analysis revealed that the association between LMR, SIRI, and GDM remained consistent with the overall results. Our study indicated that LMR, PLR, and SIRI may be potential predictors of GDM. Further large-scale prospective study is needed to investigate the role of LMR, PLR and SIRI in GDM.

炎症在妊娠糖尿病（gestational diabetes mellitus, GDM）中发挥着关键作用，但外周血炎症标志物与GDM之间的关联仍不明确。本研究旨在探讨美国成年人群中炎症标志物与GDM的关联。研究数据提取自美国国家健康与营养调查（National Health and Nutrition Examination Survey, NHANES）。从全血细胞计数（complete blood count, CBC）中衍生得到5种炎症标志物。本研究采用调查加权多变量logistic回归模型（multivariable logistic regression model），评估炎症标志物与GDM之间的关联。通过限制性立方样条分析（restricted cubic splines）与亚组分析（subgroup analysis），验证研究结果的稳定性。最终，基于特定纳入标准，共纳入2363名年龄在20~44岁的女性，其中自我报告的GDM病例共229例，占比9.69%。淋巴细胞-单核细胞比值（lymphocyte-monocyte ratio, LMR）升高与GDM发病风险升高相关，调整后比值比（adjusted odds ratio, aOR）=1.82，95%置信区间（confidence interval, CI）为1.30~2.56。与最低三分位组相比，LMR最高三分位组的GDM发病风险显著升高，aOR=2.24，95% CI为1.28~2.85。反之，全身炎症反应指数（systemic inflammation response index, SIRI）最高三分位组与GDM发病风险呈负相关，aOR=0.61，95% CI为0.40~0.94。血小板-淋巴细胞比值（platelet-lymphocyte ratio, PLR）升高则与GDM发病风险降低相关。未观察到非线性关联。此外，亚组分析显示，LMR、SIRI与GDM的关联与总体研究结果保持一致。本研究表明，LMR、PLR及SIRI或可成为GDM的潜在预测标志物。未来仍需开展大规模前瞻性研究，以进一步阐明LMR、PLR及SIRI在GDM发病中的作用。