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Pregestasyonel Diyabetes Mellitusta Glikoz-Potasyum Oranına Dayalı Perinatal Sonuçların Tahmini

Yıl 2026, Cilt: 8 Sayı: 1, 56 - 64, 28.02.2026
https://doi.org/10.52827/hititmedj.1758977
https://izlik.org/JA22ZP64NH

Öz

Amaç: Birinci trimester glukoz-potasyum oranı (GPR) değerinin tip 2 diyabetes mellitus tanılı gebe kadınlarda olumsuz perinatal sonuç öngörüsündeki değerini araştırmaktır.
Gereç ve Yöntemler: Tip 2 diyabete sahip gebeler ve kontrol grubunun verileri retrospektif olarak değerlendirildi. Gruplar arasında demografik veriler, laboratuvar parametreleri, GPR değeri ve perinatal sonuçlar iki grup arasında karşılaştırıldı. Alıcı işletim eğrisi (ROC) analizleri ile, GPR indeksinin kompozit olumsuz perinatal sonuç (CAPO) öngörüsündeki gücü değerlendirildi.
Bulgular: Tip 2 diyabete sahip 69 gebe ve sağlıklı kontrol olarak 138 gebe olmak üzere çalışmaya 207 hasta dahil edildi. Vaka grubunda kontrol grubuna göre kompozit olumsuz perinatal sonuçlar anlamlı olarak daha yüksek bulundu. Yapılan ROC eğrisi analizinde GPR indeksinin CAPO’yu öngörmede anlamlı bir performansa sahip olduğu gösterildi (AUC: 0,769, %95 CI 0,696-0,842, p<0,001; duyarlılık: %61,2, özgüllük: %87,5). Bunlara ek olarak GPR indeksinin en sık izlenen fetal, neonatal ve maternal komplikasyonları öngörme kapasitesi ROC analizleri ile değerlendirildi. (Preterm eylem için AUC: 0,763, %95 CI 0,629-0,897, p<0,001; NICU için AUC: 0,772, %95 CI 0,668 - 0,875, p<0,001; disregüle diyabet için AUC: 0,733, %95 CI 0,542 - 0,923, p=0,013).
Sonuç: Mevcut çalışma, tip 2 diyabetli gebelerde birinci trimester GPR indeksinin hem perinatal hem de maternal olumsuz sonuçları öngörmek için kullanılabileceğini göstermiştir.

Kaynakça

  • Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract 2022;183:109119.
  • American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2025. Diabetes Care 2025;48(Supplement_1):S27–49.
  • Jensen DM, Korsholm L, Ovesen P, et al. Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes. Diabetes Care 2009;32(6):1046–1048.
  • Radojičić O, Pažitná L, Dobrijević Z, et al. Serum Glycome as a Diagnostic and Prognostic Factor in Gestational Diabetes Mellitus. Biochemistry (Mosc) 2024;89(1):148–158.
  • Okutucu G, Tanacan A, Kara S, et al. Association of Systemic Inflammatory Indices and Last Trimester APRI Score With Perinatal Outcomes in Pregnant Women With Pregestational Diabetes-A Prospective Observational Study. Am J Reprod Immunol 2024;92(5):e70018.
  • Yan X, Wu D, Xu X, et al. Relationship between serum glucose-potassium ratio and 90-day outcomes of patients with acute ischemic stroke. Heliyon 2024;10(17):e36911.
  • Zhou W, Liu Y, Wang Z, Mao Z, Li M. Serum glucose/potassium ratio as a clinical risk factor for predicting the severity and prognosis of acute traumatic spinal cord injury. BMC Musculoskelet Disord 2023;24(1):870.
  • Shibata A, Matano F, Saito N, et al. Serum Glucose-To-Potassium Ratio as a Prognostic Predictor for Severe Traumatic Brain Injury. J Nippon Med Sch 2021;88(4):342–346.
  • Wang J, Zhu QW, Cheng XY, Sha CX, Cui YB. Clinical significance of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in women with hyperglycemia. Postgrad Med 2020;132(8):702–708.
  • Zeng M, He Y, Li M, et al. Association between maternal pregestational glucose level and adverse pregnancy outcomes: a population-based retrospective cohort study. BMJ Open 2021;11(9):e048530.
  • American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 201: Pregestational Diabetes Mellitus. Obstet Gynecol 2018;132(6):e228–248.
  • Malaza N, Masete M, Adam S, Dias S, Nyawo T, Pheiffer C. A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes. Int J Environ Res Public Health 2022;19(17):10846.
  • Sobngwi E, Boudou P, Mauvais-Jarvis F, et al. Effect of a diabetic environment in utero on predisposition to type 2 diabetes. Lancet 2003;361(9372):1861–1865.
  • Krieger Y, Walfisch A, Sheiner E. Surgical site infection following cesarean deliveries: trends and risk factors. J Matern Fetal Neonatal Med 2017;30(1):8–12.
  • Shub A, Lappas M. Pregestational diabetes in pregnancy: Complications, management, surveillance, and mechanisms of disease-A review. Prenat Diagn 2020;40(9):1092–1098.
  • Lowe LP, Metzger BE, Lowe WL, et al. Inflammatory mediators and glucose in pregnancy: results from a subset of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. J Clin Endocrinol Metab 2010;95(12):5427–5434.
  • Remesar X, Alemany M. Dietary Energy Partition: The Central Role of Glucose. Int J Mol Sci 2020;21(20):7729.
  • Kovesdy CP, Appel LJ, Grams ME, et al. Potassium Homeostasis in Health and Disease: A Scientific Workshop Cosponsored by the National Kidney Foundation and the American Society of Hypertension. Am J Kidney Dis 2017;70(6):844–858.
  • McTaggart JS, Clark RH, Ashcroft FM. The role of the KATP channel in glucose homeostasis in health and disease: more than meets the islet. J Physiol 2010;588(Pt 17):3201–3209.
  • Marik PE, Bellomo R. Stress hyperglycemia: an essential survival response! Crit Care Med 2013;41(6):e93-94.
  • Wu XY, Zhuang YK, Cai Y, et al. Serum glucose and potassium ratio as a predictive factor for prognosis of acute intracerebral hemorrhage. J Int Med Res 2021;49(4):3000605211009689.
  • Fujiki Y, Matano F, Mizunari T, et al. Serum glucose/potassium ratio as a clinical risk factor for aneurysmal subarachnoid hemorrhage. J Neurosurg 2018;129(4):870–875.
  • Geurtsen ML, van Soest EEL, Voerman E, Steegers EAP, Jaddoe VWV, Gaillard R. High maternal early-pregnancy blood glucose levels are associated with altered fetal growth and increased risk of adverse birth outcomes. Diabetologia 2019;62(10):1880–1890.
  • Lemaitre M, Ternynck C, Bourry J, Baudoux F, Subtil D, Vambergue A. Association Between HbA1c Levels on Adverse Pregnancy Outcomes During Pregnancy in Patients With Type 1 Diabetes. J Clin Endocrinol Metab 2022;107(3):1117-1125.
  • Ye W, Luo C, Huang J, Li C, Liu Z, Liu F. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ 2022;377:e067946.
  • Oguntibeju OO. Type 2 diabetes mellitus, oxidative stress and inflammation: examining the links. Int J Physiol Pathophysiol Pharmacol 2019;11(3):45–63.
  • Eiden, Lee E. Neuropeptide–catecholamine interactions in stress. Advances in Pharmacology 2013;68:399-404.
  • Udensi UK, Tchounwou PB. Potassium Homeostasis, Oxidative Stress, and Human Disease. Int J Clin Exp Physiol 2017;4(3):111–122.

Predicting Perinatal Outcomes Based on the Glucose-Potassium Ratio in Pregestational Diabetes Mellitus

Yıl 2026, Cilt: 8 Sayı: 1, 56 - 64, 28.02.2026
https://doi.org/10.52827/hititmedj.1758977
https://izlik.org/JA22ZP64NH

Öz

Objective: The objective of the present study is to investigate first-trimester glucose-potassium ratio (GPR) values as a predictor of adverse perinatal outcomes in pregnant women with type 2 diabetes mellitus.
Materials and Methods: A retrospective study was conducted comparing pregnant women with type 2 diabetes mellitus to a control group. The study analyzed demographic data, laboratory parameters, GPR values, and perinatal outcomes between the two groups. Receiver Operating Characteristic (ROC) analyses were performed to assess the predictive value of the GPR index for Composite Adverse Perinatal Outcomes (CAPO).
Results: The study's sample population comprised 207 patients. The study population included 69 pregnant women with type 2 diabetes mellitus and 138 healthy pregnant controls. The composite adverse perinatal outcomes were significantly higher in the case group than in the control group. ROC curve analysis demonstrated that the GPR index had significant predictive performance for CAPO (AUC: 0.769, 95%CI 0.696-0.842, p<0.001; sensitivity: 61.2%; specificity: 87.5%). Furthermore, the predictive capacity of the GPR index for the most common fetal, neonatal, and maternal complications was also evaluated through ROC analyses (AUC for preterm labor: 0. 763, 95%CI 0.629-0.897, p<0.001; AUC for NICU: 0.772, 95%CI 0.668 - 0.875, p<0.001; AUC for dysregulated diabetes: 0.733, 95%CI 0.542 - 0.923, p=0.013).
Conclusion: The present study demonstrated that the first trimester GPR index can serve as a prognostic tool for adverse perinatal and maternal outcomes in pregnant women with type 2 diabetes mellitus.

Kaynakça

  • Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract 2022;183:109119.
  • American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2025. Diabetes Care 2025;48(Supplement_1):S27–49.
  • Jensen DM, Korsholm L, Ovesen P, et al. Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes. Diabetes Care 2009;32(6):1046–1048.
  • Radojičić O, Pažitná L, Dobrijević Z, et al. Serum Glycome as a Diagnostic and Prognostic Factor in Gestational Diabetes Mellitus. Biochemistry (Mosc) 2024;89(1):148–158.
  • Okutucu G, Tanacan A, Kara S, et al. Association of Systemic Inflammatory Indices and Last Trimester APRI Score With Perinatal Outcomes in Pregnant Women With Pregestational Diabetes-A Prospective Observational Study. Am J Reprod Immunol 2024;92(5):e70018.
  • Yan X, Wu D, Xu X, et al. Relationship between serum glucose-potassium ratio and 90-day outcomes of patients with acute ischemic stroke. Heliyon 2024;10(17):e36911.
  • Zhou W, Liu Y, Wang Z, Mao Z, Li M. Serum glucose/potassium ratio as a clinical risk factor for predicting the severity and prognosis of acute traumatic spinal cord injury. BMC Musculoskelet Disord 2023;24(1):870.
  • Shibata A, Matano F, Saito N, et al. Serum Glucose-To-Potassium Ratio as a Prognostic Predictor for Severe Traumatic Brain Injury. J Nippon Med Sch 2021;88(4):342–346.
  • Wang J, Zhu QW, Cheng XY, Sha CX, Cui YB. Clinical significance of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in women with hyperglycemia. Postgrad Med 2020;132(8):702–708.
  • Zeng M, He Y, Li M, et al. Association between maternal pregestational glucose level and adverse pregnancy outcomes: a population-based retrospective cohort study. BMJ Open 2021;11(9):e048530.
  • American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 201: Pregestational Diabetes Mellitus. Obstet Gynecol 2018;132(6):e228–248.
  • Malaza N, Masete M, Adam S, Dias S, Nyawo T, Pheiffer C. A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes. Int J Environ Res Public Health 2022;19(17):10846.
  • Sobngwi E, Boudou P, Mauvais-Jarvis F, et al. Effect of a diabetic environment in utero on predisposition to type 2 diabetes. Lancet 2003;361(9372):1861–1865.
  • Krieger Y, Walfisch A, Sheiner E. Surgical site infection following cesarean deliveries: trends and risk factors. J Matern Fetal Neonatal Med 2017;30(1):8–12.
  • Shub A, Lappas M. Pregestational diabetes in pregnancy: Complications, management, surveillance, and mechanisms of disease-A review. Prenat Diagn 2020;40(9):1092–1098.
  • Lowe LP, Metzger BE, Lowe WL, et al. Inflammatory mediators and glucose in pregnancy: results from a subset of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. J Clin Endocrinol Metab 2010;95(12):5427–5434.
  • Remesar X, Alemany M. Dietary Energy Partition: The Central Role of Glucose. Int J Mol Sci 2020;21(20):7729.
  • Kovesdy CP, Appel LJ, Grams ME, et al. Potassium Homeostasis in Health and Disease: A Scientific Workshop Cosponsored by the National Kidney Foundation and the American Society of Hypertension. Am J Kidney Dis 2017;70(6):844–858.
  • McTaggart JS, Clark RH, Ashcroft FM. The role of the KATP channel in glucose homeostasis in health and disease: more than meets the islet. J Physiol 2010;588(Pt 17):3201–3209.
  • Marik PE, Bellomo R. Stress hyperglycemia: an essential survival response! Crit Care Med 2013;41(6):e93-94.
  • Wu XY, Zhuang YK, Cai Y, et al. Serum glucose and potassium ratio as a predictive factor for prognosis of acute intracerebral hemorrhage. J Int Med Res 2021;49(4):3000605211009689.
  • Fujiki Y, Matano F, Mizunari T, et al. Serum glucose/potassium ratio as a clinical risk factor for aneurysmal subarachnoid hemorrhage. J Neurosurg 2018;129(4):870–875.
  • Geurtsen ML, van Soest EEL, Voerman E, Steegers EAP, Jaddoe VWV, Gaillard R. High maternal early-pregnancy blood glucose levels are associated with altered fetal growth and increased risk of adverse birth outcomes. Diabetologia 2019;62(10):1880–1890.
  • Lemaitre M, Ternynck C, Bourry J, Baudoux F, Subtil D, Vambergue A. Association Between HbA1c Levels on Adverse Pregnancy Outcomes During Pregnancy in Patients With Type 1 Diabetes. J Clin Endocrinol Metab 2022;107(3):1117-1125.
  • Ye W, Luo C, Huang J, Li C, Liu Z, Liu F. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ 2022;377:e067946.
  • Oguntibeju OO. Type 2 diabetes mellitus, oxidative stress and inflammation: examining the links. Int J Physiol Pathophysiol Pharmacol 2019;11(3):45–63.
  • Eiden, Lee E. Neuropeptide–catecholamine interactions in stress. Advances in Pharmacology 2013;68:399-404.
  • Udensi UK, Tchounwou PB. Potassium Homeostasis, Oxidative Stress, and Human Disease. Int J Clin Exp Physiol 2017;4(3):111–122.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Esra Karatas 0000-0003-3474-2398

Özgür Kara 0000-0002-4204-0014

Dilek Sahin 0000-0001-8567-9048

Gönderilme Tarihi 5 Ağustos 2025
Kabul Tarihi 1 Ocak 2026
Yayımlanma Tarihi 28 Şubat 2026
DOI https://doi.org/10.52827/hititmedj.1758977
IZ https://izlik.org/JA22ZP64NH
Yayımlandığı Sayı Yıl 2026 Cilt: 8 Sayı: 1

Kaynak Göster

AMA 1.Karatas E, Kara Ö, Sahin D. Predicting Perinatal Outcomes Based on the Glucose-Potassium Ratio in Pregestational Diabetes Mellitus. Hitit Medical Journal. 2026;8(1):56-64. doi:10.52827/hititmedj.1758977