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Decoding inflammation: first-trimester biomarkers as predictive tools for gestational diabetes

Samet Kırat1

  • 1Kafkas University, Faculty of Medicine, Department of Gynecology and Obstetrics - Kars, Turkey.

Revista Da Associacao Medica Brasileira (1992)
|July 1, 2026
PubMed

Insights

First-trimester inflammatory markers like the platelet-lymphocyte ratio (PLR) show promise for predicting gestational diabetes mellitus (GDM). Elevated PLR, neutrophil-lymphocyte ratio (NLR), and Systemic Immune-Inflammation Index (SII) are associated with GDM risk.

Area of Science:

  • Obstetrics and Gynecology
  • Hematology
  • Inflammation Research

Background:

  • Gestational diabetes mellitus (GDM) is a pregnancy complication linked to adverse maternal and neonatal outcomes.
  • Early identification of GDM risk is crucial for timely intervention and improved pregnancy outcomes.

Purpose of the Study:

  • To evaluate several hematologic inflammatory markers measured in the first trimester as early predictive biomarkers for gestational diabetes mellitus (GDM).
  • To assess the diagnostic performance of these markers in predicting GDM.

Main Methods:

  • A retrospective cohort study involving 588 pregnant women (294 with GDM and 294 matched controls).
  • Collection of demographic, obstetric, and first-trimester hematologic data.

Main Results:

  • Systemic Immune-Inflammation Index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were significantly higher in women with GDM.
  • Hemoglobin-albumin-lymphocyte-thrombocyte (HALT) and Aggregate Systemic Inflammation Index (ASII) were significantly lower in women with GDM.
  • PLR demonstrated the strongest predictive ability for GDM (AUC=0.679), followed by NLR (AUC=0.645) and SII (AUC=0.610).

Conclusions:

  • PLR, NLR, and SII are promising biomarkers for early GDM prediction in the first trimester.
  • These findings underscore the role of inflammation in GDM pathophysiology.
  • Routine hematologic markers can aid in GDM risk stratification.
Abstract

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