Can second trimester monocyte to high-density lipoprotein ratio predict insulin requirement in gestational diabetes mellitus?

Abstract

Aim: Monocyte to high-density lipoprotein ratio is a new marker of chronic inflammation and oxidative stress, which plays a role in gestational diabetes. Here, we aimed to evaluate the second-trimester monocyte to high-density lipoprotein ratio in gestational diabetes and to assess the predictive role of insulin requirement and delivery mode in gestational diabetes. Material and Methods: A total of 45 gestational diabetes patients and 45 healthy pregnant were included in this retrospective study. The gestational diabetes group was divided into two subgroups: diet-controlled (n=15) and requiring insulin (n=30). Demographic and obstetrics characteristics, complete blood count, and biochemical analysis results were compared between groups. The predictive role of monocyte to high-density lipoprotein ratio for gestational diabetes, insulin requirement, and delivery mode was evaluated by receiver operating curve analysis. Results: The monocyte to high-density lipoprotein ratio was higher in gestational diabetes (p<0.001). Also, it was higher in insulin-requiring diabetes as compared to the controlled diabetes group (p=0.021). Monocyte to high-density lipoprotein ratio was correlated with fasting glucose (r=0.469, p=0.001) and 50-gram testing first-hour levels (r=0.595, p<0.001). Monocyte to high-density lipoprotein ratio >8.2 discriminated gestational diabetes with 91.1% sensitivity and 80% specificity (AUC=0.922, p<0.001), while >9.1 predicted insulin requirement with 86.7% sensitivity and 66.7% specificity (AUC=0.713,p=0.032). It did not predict cesarean section in gestational diabetes (p=0.21).<br /> Discussion: The second-trimester monocyte to high-density lipoprotein ratio might be a cheap and available marker for detecting gestational diabetes and the insulin requirement in gestational diabetes mellitus.