Gestasyonel Diabetes Mellitus Riskinin Belirlenmesi: İlk İki Trimesterde Ölçülen Tam Kan Sayımı Değişkenlerinin Rolünün Değerlendirilmesi

Öz

Amaç: Gestasyonel diyabetes mellitus (GDM) riskini öngörmede birinci ve ikinci trimester tam kan sayımı (CBC) parametrelerinin değerini değerlendirmek. Gereç ve Yöntem: Bu retrospektif vaka kontrol çalışması, Ocak 2017 ile Aralık 2018 tarihleri arasında XXX gerçekleştirildi. GDM'li gebeler ve sağlıklı gebelerden oluşan çalışma grubunun CBC ve biyokimya sonuçları, CBC parametrelerinden hesaplanan çeşitli indeksler ve diğer veriler tıbbi kayıtlardan elde edildi. Bulgular: Yaş (p<0,001), açlık kan glukozu (p<0,001), eritrosit sayısı (RBC) (p<0,001), hemoglobin (p=0,015), hematokrit (p<0,001), eritrosit dağılım genişliği (RDW) (p=0,001), RDW-trombosit oranı (p<0,001) ve 75 g OGTT testleri için tüm glukoz seviyeleri (tümü için p<0,001) GDM'li kadınlarda kontrollere kıyasla daha yüksekti. GDM'li gebelerde trombosit sayısı (p=0,002), trombosit/lenfosit oranı (p=0,006) ve trombosit/MPV oranı (p=0,021) sağlıklı gebelere göre daha düşüktü. Yüksek yaş (p<0,001), yüksek RBC (p=0,002) ve yüksek RDW-trombosit oranı (p<0,001) GDM için anlamlı bağımsız risk faktörleri olarak bulundu. GDM’nin öngörülmesinde, eğri altında kalan alan (AUC) değerleri en yüksek olan parametreler RBC (AUC:0,619, %95GA: 0,566-0,673; p<0,001) ve RDW-trombosit oranı (AUC:0,610, %95GA: 0,556-0,663; p<0,001) idi. RBC %57,0 duyarlılık ve %63,4 özgüllük gösterdi ve RDW-trombosit oranı %31,7 duyarlılık ve %89,2 özgüllük gösterdi. Sonuç: Gebeliğin erken döneminde saptanan artmış RBC ve artmış RDW-trombosit oranı, GDM riskinin artmasının bağımsız prediktörleridir. GDM riskinin erken belirleyicilerini değerlendiren kapsamlı prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Gestasyonel diyabet
• Risk
• Tam kan sayımı

Determining the Risk of Gestational Diabetes Mellitus: Evaluation of the Role of Complete Blood Count Variables Measured in the First Two Trimesters

Öz

Objective: To evaluate the value of first and second trimester complete blood count (CBC) parameters in predicting the risk of gestational diabetes mellitus (GDM). Materials and Method: This study was carried out from January 2017 to December 2018 at the XXX. The CBC and biochemistry results, various indices calculated from CBC parameters, and other data of the study group consisting of pregnant women with and without GDM were obtained from medical records. Results: Age (p<0.001), fasting glucose (p<0.001), red blood cell count (RBC) (p<0.001), hemoglobin (p=0.015), hematocrit (p<0.001), red cell distribution width (RDW) (p=0.001), RDW-to-platelet ratio (p<0.001), and all glucose levels for 75 g OGTT tests (p<0.001 for all) were higher in women with GDM compared to controls. Platelet count (p=0.002), platelet-to-lymphocyte ratio (p=0.006) and platelet-to-MPV ratio (p=0.021) were lower in pregnant women with GDM compared to those without. We found high age (p<0.001), high RBC (p=0.002) and high RDW-to-platelet ratio (p<0.001) were independently associated with GDM. For the prediction of GDM, the area under curve (AUC) values were highest for RBC (AUC:0.619, 95%CI: 0.566-0.673; p<0.001) and RDW-to-platelet ratio (AUC:0.610, 95%CI: 0.556-0.663; p<0.001). RBC showed 57.0% sensitivity and 63.4% specificity, while RDW-to-platelet ratio demonstrated 31.7% sensitivity and 89.2% specificity. Conclusion: Increased RBC and increased RDW-to-platelet ratio measured in the early period of pregnancy are independent predictors of higher GDM risk. Comprehensive prospective studies assessing early determinants of GDM risk are needed.

Anahtar Kelimeler

• Gestational Diabetes
• Risk
• Complete blood count

Kaynakça

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