Predictive significance of correlations among body mass index, C-reactive protein, glycosylated hemoglobin and gestational diabetes mellitus

Abstract

Objective To explore the correlations among the body mass index (BMI), levels of C-reactive protein (CRP), glycosylated hemoglobin (HbA1c) and gestational diabetes mellitus (GDM) of pregnant women, as well the predictive values of these 3 indexes for GDM. Methods A total of 100 pregnant women with GDM were selected as research subjects and included in GDM group, who received intervention treatment and gave birth in Nanjing Integrated Traditional Chinese and Western Medicine Hospital from December 2016 to December 2018. Meanwhile, a total of 60 healthy pregnant women who had prenatal examinations and gave birth at the same hospital were selected and included in control group. The levels of fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 h PPG), BMI, CRP and HbA1c of pregnant women, also the incidence rates of indexes of perinatal outcomes of pregnant women were statistically compared between two groups by independent-samples t test and chi-square test. The correlation among BMI, CRP, HbA1c, respectively, with FPG and 2 h PPG of the pregnant women in GDM group were analyzed by Pearson correlation analysis. This study was in line with World Medical Association Declaration of Helsinki revised in 2013 and all participants confirmed and signed consent forms for clinical trials. Results ① The levels of FPG, 2 h PPG, BMI, CRP and HbA1c of pregnant women in GDM group were (7.8±1.0) mmol/L, (11.0±1.6) mmol/L, (25.8±1.2) kg/m2, (12.8±2.9) mg/L and (8.5±1.7)%, respectively, which were all much higher than those of (5.6±0.6) mmol/L, (7.6±1.1) mmol/L, (22.2±1.1) kg/m2, (7.7±2.4) mg/L and (4.0±1.0)% in control group, and the differences were statistically significant (t=14.139, 13.394, 17.455, 10.726, 16.705, all P<0.001). ② Pearson correction analysis showed those indexes of BMI, CRP and HbA1c of GDM pregnant women had positive correlation with FPG and 2 h PPG, respectively, (r=0.438, 0.408, P<0.001; r=0.389, 0.410, P<0.001; r=0.413, 0.442, P<0.001). ③ The incidence rates of preterm birth, premature rupture of membranes, polyhydramnios, deliver macrosomia, fetal distress and postpartum hemorrhage of pregnant women in GDM group were 21.1%, 23.3%, 22.2%, 17.8%, 16.7%, 12.2%, respectively, which were all much higher than those of 6.0%, 8.0%, 6.0%, 4.0%, 4.0%, 2.0% in control group, and the differences were statistically significant (χ2=5.542, P=0.019; χ2=5.152, P=0.023; χ2=6.161, P=0.013; χ2=5.446, P=0.020; χ2=4.834, P=0.028; χ2=4.286, P=0.038). The 1-minute Apgar score of newborns birthed by pregnant women in GDM group was (7.1±0.7) scores, which was lower than that of (8.3±1.0) scores in control group, and the difference was statistically significant (t=8.469, P<0.001). Conclusions The levels of BMI, CRP and HbA1c of pregnant women are associated with the occurrence of GDM, and early monitoring of these 3 indexes are recommended to predict GDM earlier. Key words: Body mass index; C-reactive protein; Hemoglobin A, glycosylated; Diabetes, gestational; Pregnant women