妊娠期糖尿病患者孕晚期NLR、RDW与产后6~12周糖代谢的相关性

Relationship between neutrophil lymphocyte ratio,red blood cell distribution width,and glucose metabolism in gestational diabetes mellitus patients at 6-12 weeks postpartum

目的探讨妊娠期糖尿病患者孕晚期红细胞分布宽度(RDW)、中性粒细胞与淋巴细胞比值(NLR)与产后6~12周糖代谢的相关性。方法回顾性选取2019年12月至2020年11月于佛山市顺德区龙江医院产检并已生产6~12周复诊的妊娠期糖尿病患者83例。根据患者产后6~12周的糖代谢情况分组,43例糖代谢异常者纳入观察组,其中糖尿病组20例,糖尿病前期组23例,40例糖代谢正常者纳入对照组。比较三组患者孕36~40周的RDW、NLR,于产后6~12周比较三组患者的空腹胰岛素(FINS)、空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)水平,并采用Pearson相关性分析法分析孕晚期RDW、NLR与产后6~12周糖代谢水平的相关性。结果糖尿病组患者的NLR、RDW分别为(2.76±0.34)%、(14.91±2.14)%,糖尿病前期组患者分别为(2.68±0.41)%、(14.35±2.31)%,明显高于对照组的(2.01±0.13)%、(12.15±1.07)%,差异均有统计学意义(P<0.05);糖尿病组患者的FINS、FBG、HOMA-IR水平分别为(13.24±2.42)mU/L、(6.45±1.36)mmol/L、5.49±1.24,糖尿病前期组患者分别为(13.15±2.47)mU/L、(6.37±1.41)mmol/L、5.53±1.27,明显高于对照组的(8.75±1.84)m U/L、(4.17±1.04)mmol/L、1.56±0.35,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,糖尿病组和糖尿病晚期组患者孕晚期的NLR、RDW与产后6~12周的FINS、FBG、HOMA-IR水平均呈正相关(P<0.05)。结论妊娠期糖尿病患者产后糖代谢异常者孕晚期NLR、RDW水平显著升高,与产后糖代谢情况呈明显正相关,可将NLR、RDW联合检测作为妊娠糖尿病患者产后糖代谢异常的预测指标。

Objective To investigate the relationship between red blood cell distribution width(RDW),neutrophil lymphocyte ratio(NLR)and glucose metabolism in patients with gestational diabetes mellitus(GDM)at 6—12 weeks postpartum.Methods A total of 83 patients with GDM were examined in Longjiang Hospital of Shunde District of Foshan City between December 2019 and November 2020 and returned for visit at 6 to 12 weeks after delivery.According to the glucose metabolism of patients at 6—12 weeks after delivery,43 patients with abnormal glucose metabolism were included in the observation group,including 20 patients with diabetes(diabetes group),23 patients with pre-diabetes(pre-diabetes group),and 40 patients with normal glucose metabolism were included in the control group.RDW and NLR were compared at 36—40 weeks of gestation among diabetes group,pre-diabetes group,and the control group.Fasting insulin(FINS),fasting blood glucose(FBG),and insulin resistance index(HOMA-IR)were compared at 6—12 weeks of postpartum.Pearson correlation analysis was used to analyze the correlation between RDW and NLR of the third trimester of pregnancy and glucose metabolism level at 6—12 weeks of postpartum.Results The NLR and RDW were(2.76±0.34)%and(14.91±2.14)%in diabetes group,(2.68±0.41)%and(14.35±2.31)%in pre-diabetes group,which were significantly higher than(2.01±0.13)%and(12.15±1.07)%in control group(P<0.05).The levels of FINS,FBG,and HOMA-IR were(13.24±2.42)mU/L,(6.45±1.36)mmol/L,5.49±1.24 in diabetes group,(13.15±2.47)mU/L,(6.37±1.41)mmol/L,5.53±1.27 in pre-diabetes group,which were significantly higher than(8.75±1.84)mU/L,(4.17±1.04)mmol/L,1.56±0.35 in control group(P<0.05).Pearson correlation analysis showed that NLR and RDW in the third trimester of pregnancy in diabetes group and the advanced-diabetes group were positively correlated with the FINS,FBG,and HOMA-IR levels at 6—12 weeks postpartum(P<0.05).Conclusion The levels of NLR and RDW in GDM patients with abnormal postpartum glucose metabolism are significantly increased in the third trimester,which is significantly positively correlated with postpartum glucose metabolism.The combined detection of NLR and RDW can be used as a predictor of abnormal postpartum glucose metabolism in GDM patients.