Can the First Trimester Mean Platelet Volume and Mean Platelet Volume/Lymphocyte Ratio Predict Gestational Diabetes Mellitus?

Abstract

OBJECTIVE: This study aimed to evaluate whether there were differences in the first-trimester inflammatory markers: NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio), MPV (mean platelet volume), and MPVLR (MPV-to-lymphocyte ratio), between cases with and without gestational diabetes mellitus (GDM).

STUDY DESIGN: The study was designed by examining the first-trimester hemogram parameters of cases who underwent GDM screening. The primary outcome was to determine the differences and effectiveness of NLR, PLR, MPV, and MPVLR values in the first trimester between study groups before the diagnosis of GDM.

RESULTS: A total of 878 cases were analyzed in the study. Patients were divided into two groups based on the 75-gram oral glucose tolerance test (OGTT). The study groups consisted of cases with GDM (n=127) and without GDM (n=751). While leukocyte count was found to be marginally higher in the GDM group (8.6±2.2 x103/mm3 vs. 9.0±2.4 x103/mm3, p=0.047), NLR and PLR values did not differ between the groups. Although a minimal increase in MPV values was observed in the GDM group, it did not reach statistical significance (10.0±1.1 fL vs. 9.9±1.0 fL, p=0.785). Similarly, MPVLR values were comparable between the groups. However, the ROC analysis revealed MPVLR as the most effective marker for GDM detection (AUC: 0.537).

CONCLUSION: Simple and cost-effective inflammatory markers examined in the first trimester may provide insights into predicting GDM. NLR, PLR, and MPV values stand out in this regard. Additionally, the newly examined MPVLR in GDM cases suggests its potential as a more effective predictor than these markers in our study.