İlk Trimesterde Sistemik İmmün-İnflamasyon İndeksini Kullanarak Gestasyonel Diabetes Mellitus'u Tahmin Etme

Yıl 2022, Cilt: 12 Sayı: 5, 617 - 620, 30.09.2022

Munire Funda Cevher Akdulum , Erhan Demirdağ , Safarova Sahila , Mehmet Erdem , Ahmet Erdem

https://doi.org/10.16899/jcm.1148179

Öz

Amaç: Gestasyonel diyabetes mellitus (GDM) inflamatuar bir hastalıktır ve gebelik komplikasyonlarını artırır. GDM'nin erken tanınması, komplikasyonları önlemek için kritik öneme sahiptir. Sistemik İmmün-İnflamasyon İndeksi (SII), inflamatuar yanıtı gösteren bir indeks olup, GDM ile ilişkili olabilir. Bu çalışmanın amacı, GDM ve SII arasındaki ilişkiyi özellikle ilk trimesterdeki SII'nin GDM'yi tahmin edip edemeyeceğini belirlemektir.
Gereç ve Yöntem: Çalışma, Ocak 2021 ile Ocak 2022 tarihleri ​​arasında retrospektif kohort çalışması olarak dizayn edildi. Çalışmaya 100 gebe dahil edildi. Çalışma grubu GDM tanısı almış 50 gebeyi içermektedir. Kontrol grubu ise GDM tanısı almamış kalan 50 gebeden oluşturuldu. Hastaların ilk trimesterde ilk ziyaretlerindeki hemogram değerlerinden SII değerleri hesaplandı.
Bulgular: SII, trombosit sayısı, nötrofil sayısı, fT3, apgar 1. dk ve apgar 5. dk ölçümleri açısından GDM ve kontrol grupları arasında istatistiksel olarak anlamlı fark vardı (p<0,05). GDM'yi öngörmek için SII düzeyi cut-off değeri 607,32 olarak belirlendi.
Sonuç: Çalışmada GDM'li kişilerde SII anlamlı olarak daha yüksek bulundu. Basit bir hemogram tetkiki ile SII hesaplanarak gebeliğin ilk trimesterinde GDM'yi predikte etmek için kullanılabilir. İlk trimesterdeki riskli hastalar diyetlerini düzenleyerek, hamilelik sırasında oluşabilecek diyabet komplikasyonlarını azaltabilirler.

Anahtar Kelimeler

Sistemik İmmun-İnflamasyon İndeksi, gestasyonel diyabetes mellitus, Gebelik

Predicting Gestational Diabetes Mellitus Using The Systemic Immune-Inflammation Index in The First Trimester

Öz

Aims: Gestational diabetes mellitus (GDM) is an inflammatory disorder. GDM raises the risk of pregnancy complications. Early recognition of GDM is critical to prevent complications. Systemic Immune-Inflammation Index (SII) is an index that shows the inflammatory response, we hypothesized that it might be associated to GDM. The purpose of this study was to determine the relationship between GDM and SII, as well as whether SII in the first trimester can predict GDM.
Material and Method: This retrospective cohort study was conducted between January 2021 and January 2022. 100 pregnant women were included in the study. The study group included 50 pregnant women who had been diagnosed with GDM. The control group consisted of the remaining 50 pregnant women who had not been diagnosed with GDM. SII values were calculated from the hemogram values of the patients at the first visit in the first trimester.
Results: There was a statistically significant difference between GDM and control groups in terms of SII, platelet, neutrophil, fT3, apgar 1 min and apgar 5 min measurements (p<0.05). The SII level cut-off value for predicting GDM was determined to be 607.32.
Conclusion: SII was found to be significantly higher in people with GDM in the study. It can be used to predict GDM in the first trimester of pregnancy by calculating SII with a simple hemogram. By regulating their diet, patients in the first trimester can reduce the complications of diabetes that can occur during pregnancy.

Anahtar Kelimeler

systemic immune inflamation, gestational diabetes mellitus, pregnancy

Kaynakça

• Seshiah V, Das AK, Balaji V, et al. Gestational diabetes mellitus--guidelines. J Assoc Physicians India 2006;54:622-8.
• Teh WT, Teede HJ, Paul E, Harrison CL, Wallace EM, Allan C. Risk factors for gestational diabetes mellitus: implications for the application of screening guidelines. Aust N Z J Obstet Gynaecol 2011;51:26-30.
• Moses RG, Knights SJ, Lucas EM, et al. Gestational diabetes: is a higher cesarean section rate inevitable?. Diabetes Care 2000;23:15-7.
• Remsberg KE, McKeown RE, McFarland KF, Irwin LS. Diabetes in pregnancy and cesarean delivery. Diabetes Care 1999;22:1561-7.
• Farrar D, Simmonds M, Bryant M, et al. Hyperglycaemia and risk of adverse perinatal outcomes: systematic review and meta-analysis. BMJ 2016;354:i4694.
• Franzago M, Fraticelli F, Di Nicola M, et al. Early Subclinical Atherosclerosis in Gestational Diabetes: The Predictive Role of Routine Biomarkers and Nutrigenetic Variants. J Diabetes Res 2018;2018:9242579.
• Zhu Y, Zhang C. Prevalence of Gestational diabetes and risk of progression to type 2 diabetes: a global perspective. Curr Diab Rep 2016;16:7.
• Buchanan TA. Pancreatic B-cell defects in gestational diabetes: implications for the pathogenesis and prevention of type 2 diabetes. J Clin Endocrinol Metab 2001;86:989-93.
• Pantham P, Aye IL, Powell TL. Inflammation in maternal obesity and gestational diabetes mellitus. Placenta 2015;36:709-15.
• Aktulay A, Engin-Ustun Y, Ozkan MS, et al. Gestational diabetes mellitus seems to be associated with inflammation. Acta Clin Croat 2015;54:475-8.
• Sargın MA, Yassa M, Taymur BD, Celik A, Ergun E, Tug N. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: are they useful for predicting gestational diabetes mellitus during pregnancy?. Ther Clin Risk Manag 2016;12:657-65.
• Basu J, Datta C, Chowdhury S, Mandal D, Mondal NK, Ghosh A. Gestational diabetes mellitus in a tertiary care hospital of Kolkata, India: prevalence, pathogenesis and potential disease biomarkers. Exp Clin Endocrinol Diabetes 2020;128:216-23.
• Tanacan A, Uyanik E, Unal C, Beksac MS. A cut-off value for systemic immune-inflammation index in the prediction of adverse neonatal outcomes in preterm premature rupture of the membranes. J Obstet Gynaecol Res 2020;46:1333-41.
• Turgut E, Yildirim M, Sakcak B, Ayhan SG, Tekin OM, Sahin D. Predicting miscarriage using systemic immune-inflammation index. J Obstet Gynaecol Res 2022;48:587-92.
• Huang H, Liu Q, Zhu L, et al. Prognostic Value of Preoperative Systemic Immune-Inflammation Index in Patients with Cervical Cancer. Sci Rep 2019;9:3284.
• Sugimoto J, Romani AM, Valentin-Torres AM, et al. Magnesium decreases inflammatory cytokine production: a novel innate immunomodulatory mechanism. J Immunol 2012;188:6338-46.
• Suzuki-Kakisaka H, Sugimoto J, Tetarbe M, Romani AM, Ramirez Kitchen CM, Bernstein HB. Magnesium sulfate increases intracellular magnesium reducing inflammatory cytokine release in neonates. Am J Reprod Immunol 2013;70:213-20.
• Wang J, Zhou D, Dai Z, Li X. Association between systemic immune-inflammation index and diabetic depression. Clin Interv Aging 2021;16:97-105.
• Pordzik J, Jakubik D, Jarosz-Popek J, et al. Significance of circulating microRNAs in diabetes mellitus type 2 and platelet reactivity: bioinformatic analysis and review. Cardiovasc Diabetol 2019;18:113.