Investigation The Predictive Value Of Tumor Necrosis Factor-?,Interleukin-6,high Sensitive C-reactive Protein,body Mass Index For Gestational Diabetes Mellitus

ObjectiveTo investigate the predictive value of serum tumor necrosis factor-?(TNF-?),interleukin-6(IL-6),high sensitive C-reactive protein(hs-CRP),body mass index(BMI)screening at gestational 8~12 weeks for gestational diabetes mellitus(GDM).Methods518 pregnant women undergo antenatal examination in ZhuCheng maternal and child care service hospital from January of 2015 to May of 2015,at gestational 8~12weeks,serum levels of tumor necrosis factor-?(TNF-?),interleukin-6(IL-6),high sensitive C-reactive protein(hs-CRP)and body mass index(BMI)were measured.At gestational 24~28 weeks,oral glucose tolerance test was performed in these pregnant women.They were divided into gestational diabetes mellitus(GDM)group including106 patients and normal group including 412 patients according to the result of OGTT.The women were then monitored to delivery,TNF-?,IL-6,hs-CRP and BMI were compared between groups to analyze the relationship between the upper subjects and gestational diabetes mellitus.All statistical analyses were carried out with spss13.0software.P<0.05 was considered statistically significant.Results1.TNF-?,IL-6,hs-CRP and BMI were compared between GDM group and normal group.The TNF-?,IL-6,hs-CRP level and BMI of these women at gestational 8~12weeks in GDM group were higher than those in normal group,there was significant difference between groups.(P<0.05)2.Multivariate logistic regression analysis revealed that TNF-?(OR=1.039,95%CI1.006-1.072,P=0.038),IL-6(OR=1.042,95%CI 1.008-1.076,P=0.032),hs-CRP(OR1.034,95%CI 1.002-1.068,P=0.039),BMI(OR=1.077,95%CI 1.015-1.144,P=0.014).TNF-?,IL-6,hs-CRP and BMI in early pregnancy were dangerous factor for GDM.3.Receiver operating characteristic(ROC)curve was used to determine the value of TNF-?,IL-6,hs-CRP and BMI.The area under ROC curve for TNF-? to predict GDMwas 0.598.The area under ROC curve for IL-6 to predict GDM was 0.599.The area under ROC curve for hs-CRP to predict GDM was 0.588.The area under ROC curve for BMI to predict GDM was 0.601.4.In the prediction of GDM,the area under ROC curve for TNF-? with IL-6 was0.639.The area under ROC curve for TNF-? with IL-6,hs-CRP to predict GDM was0.642.The area under ROC curve for TNF-? with IL-6,hs-CRP,BMI was 0.678.5.In the prediction of GDM,there was no difference between the values of IL-6,hs-CRP,BMI for GDM alone and the value of TNF-? alone(P>0.05).The values of TNF-? with IL-6,TNF-? with IL-6 and hs-CRP,TNF-? with IL-6,hs-CRP and BMI were significantly higher than the value of TNF-? alone(P<0.05).Conclusions1.TNF-?,IL-6,hs-CRP and BMI screening in early pregnancy were the influential factor of GDM.2.The value of TNF-?,IL-6,hs-CRP,BMI screening in early pregnancy for GDM alone has a lower predictive value.3.In the prediction of GDM,the values of TNF-? with IL-6,TNF-? with IL-6 and hs-CRP,TNF-? with IL-6,hs-CRP and BMI were significantly higher than the value of the upper subjects alone.