{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:49:27Z","timestamp":1782276567005,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the predictive value of first and second trimester hematological inflammatory indices\u2014including the novel cumulative inflammatory index (IIC) and mean corpuscular volume\u2010to\u2010lymphocyte ratio (MCVL)\u2014for the subsequent development of gestational diabetes mellitus (GDM). Additionally, the study will assess whether these markers differ between GDM subgroups managed with diet alone versus insulin therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This case\u2010control study enrolled 150 pregnant women, with 75 diagnosed with GDM and 75 serving as healthy controls. Hematological inflammatory indices\u2014namely, NLR, MLR, PLR, dNLR, AISI, SII, SIRI, IIC, and MCVL\u2014were calculated from first\u2010 and second\u2010trimester complete blood count parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      First\u2010trimester inflammatory indices (NLR, MLR, PLR, dNLR, AISI, SII, SIRI, IIC, and MCVL) were significantly elevated in the GDM group compared to controls (all\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). NLR demonstrated the highest discriminative accuracy (AUC 0.782; 95% CI: 0.709\u20130.855), followed by SIRI (AUC 0.778) and IIC (AUC 0.775). Among GDM patients, 22 (29.3%) required insulin therapy. Insulin\u2010treated patients exhibited significantly higher SIRI_1 than diet\u2010managed patients (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.025), and showed a substantially elevated inflammatory burden across multiple second\u2010trimester indices. First\u2010trimester fasting glucose was positively correlated with several second\u2010trimester inflammatory indices, including AISI_1 (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.351,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002) and SII_2 (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.342,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>First\u2010trimester hematological inflammatory indices, including the novel IIC and MCVL, are associated with subsequent development of GDM. Furthermore, these indices offer moderate predictive accuracy when derived from routine antenatal blood tests. The clinical usefulness of these findings necessitates prospective validation in larger, multicenter cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aji.70264","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:36:16Z","timestamp":1780313776000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Novel Hematological Inflammatory Indices in Early Pregnancy: The Predictive Value of the Cumulative Inflammatory Index and Mean Corpuscular Volume\/Lymphocyte for Gestational Diabetes Mellitus"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9050-2041","authenticated-orcid":false,"given":"Deniz","family":"OLUKLU","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology, Sincan Training and Research Hospital Health Sciences University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7707-7574","authenticated-orcid":false,"given":"Fatma","family":"OLUKLU","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Turkish Ministry of Health Ankara City Hospital, Health Sciences University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2756-9829","authenticated-orcid":false,"given":"Selma","family":"SUREN","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology, Sincan Training and Research Hospital Health Sciences University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6958-6172","authenticated-orcid":false,"given":"Ayseg\u00fcl","family":"GENCER","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sincan Training and Research Hospital, Health Sciences University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8920-1444","authenticated-orcid":false,"given":"Taylan","family":"ONAT","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sincan Training and Research Hospital, Health Sciences University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.10.012"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvaf043"},{"issue":"210","key":"e_1_2_9_4_1","first-page":"1","article-title":"Screening and Diagnosing Gestational Diabetes Mellitus","author":"Hartling L.","year":"2012","journal-title":"Evidence Report\/ Technology Assessment"},{"issue":"1","key":"e_1_2_9_5_1","first-page":"S282","article-title":"15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes\u20102024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19113342"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4694"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15442"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.2147\/DMSO.S445927","article-title":"The Association of Hematological Parameters in Early and Middle Pregnancy With the Risk of Gestational Diabetes Mellitus","volume":"17","author":"Duo Y.","year":"2024","journal-title":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aji.70069"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-physiol-021909-135846"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000212758"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.70024"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-025-07267-y"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/1354750X.2021.1926542"},{"issue":"4","key":"e_1_2_9_16_1","first-page":"441","article-title":"The Clinical Significance of Complete Blood Count, Neutrophil\u2010to\u2010Lymphocyte Ratio, and Monocyte\u2010to\u2010Lymphocyte Ratio in Gestational Diabetes Mellitus","volume":"19","author":"Liu G.","year":"2023","journal-title":"Acta Endocrinologica"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2020.1780579"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/aji.70070"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2021.2015762"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000003236"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S474154"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1477092"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12123118"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S541879"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.38136\/jgon.1362074"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.peptides.2018.01.005"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-021-06785-0"}],"container-title":["American Journal of Reproductive Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aji.70264","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aji.70264","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aji.70264","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:37:35Z","timestamp":1782275855000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aji.70264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/aji.70264"],"URL":"https:\/\/doi.org\/10.1111\/aji.70264","archive":["Portico"],"relation":{},"ISSN":["1046-7408","1600-0897"],"issn-type":[{"value":"1046-7408","type":"print"},{"value":"1600-0897","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70264"}}