Fluctuation trend of inflammatory indexes related to gestational diabetes mellitus from second trimester to third trimester of pregnancy

Abstract Objective: to explore the changes of serum inflammatory bodies (NLRP3), interleukin-1 receptor antagonist (IL-1Ra) and thioredoxin binding protein-2 (TBP-2) in pregnant women at 24 and 36 weeks of pregnancy and their correlation with gestational diabetes mellitus (GDM) and neonatal weight. Materials and methods: in this study, 65 pregnant women with gestational diabetes who were diagnosed with gestational diabetes mellitus in our hospital from December 2022 to June 2023 were randomly selected as GDM group, and 65 pregnant women without gestational diabetes mellitus at the same gestational week were selected as normal group (nude 65). The pregnancy information and serum samples of pregnant women at 24 and 36 weeks of gestation were collected. The levels of NLRP3, IL-1Ra and TBP-2 were measured by enzyme linked immunosorbent assay (ELISA) to explore their changes during pregnancy. The changes of NLRP3, IL-1Ra and TBP-2 at 24 and 36 weeks of pregnancy in GDM pregnant women and their correlation with GDM were analyzed. Results: in the general data, pre-pregnancy BMI, neonatal weight, gestational hypertension and macrosomia were associated with gestational diabetes mellitus, and the difference was statistically significant. Statistical analysis showed that there was no significant change in NLRP3, IL-1Ra and TBP-2 in normal group, but in GDM group, the expression level of IL-1Ra increased, while the expression level of NLRP3 and TBP-2 decreased in serum samples at 24 and 36 weeks of pregnancy, but the changes of NLRP3, IL-1Ra and TBP-2 were positively correlated with each other at 36 weeks of gestation. The levels of NLRP3, IL-1Ra and TBP-2 in pregnant women in normal group were lower than those in GDM group, and the birth weight of newborns increased with the increase of NLRP3 and TBP-2 and decreased with IL-1Ra. The results of multivariate logistic regression analysis showed that NLRP3 was an independent influencing factor of GDM. The ROC curve analysis of GDM predicted by NLRP3 at 24 weeks of pregnancy showed that NLRP3 had good predictive value for GDM (AUC=0.720,95%CI was 0.630-0.809), and the combination of NLRP3, IL-1Ra and TBP-2 also had good predictive value for GDM. Conclusion: the changes of NLRP3, IL-1Ra and TBP-2 run through the 24 and 36 weeks of pregnancy, so they play an important role in predicting gestational diabetes mellitus and neonatal weight.