{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:49:25Z","timestamp":1782730165764,"version":"3.54.5"},"reference-count":25,"publisher":"FapUNIFESP (SciELO)","issue":"4","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: Gestational diabetes mellitus is a pregnancy complication associated with adverse maternal and neonatal outcomes. The aim of this study was to evaluate the hemoglobin-albumin-lymphocyte-thrombocyte, Aggregate Systemic Inflammation Index, Systemic Inflammatory Response Index, Systemic Immune-Inflammation Index, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and monocyte-lymphocyte ratio measured in the first trimester as early predictive biomarkers for gestational diabetes mellitus.  METHODS: This retrospective cohort study included 588 pregnant women: 294 women with gestational diabetes mellitus and 294 matched controls. Demographic, obstetric, and first-trimester hematologic data were collected.  RESULTS: Systemic Immune-Inflammation Index (p&lt;0.001), neutrophil-lymphocyte ratio (p&lt;0.001), and platelet-lymphocyte ratio (p&lt;0.001) levels were significantly higher in those with gestational diabetes mellitus, while hemoglobin-albumin-lymphocyte-thrombocyte (p=0.001) and Aggregate Systemic Inflammation Index (p=0.020) levels were significantly lower than in those without gestational diabetes mellitus. Platelet-lymphocyte ratio (area under the curve=0.679; sensitivity 62.9%, specificity 63.3%) emerged as the strongest inflammatory marker for predicting gestational diabetes mellitus. Neutrophil-lymphocyte ratio (area under the curve=0.645) and Systemic Immune-Inflammation Index (area under the curve=0.610) demonstrated moderate discriminatory ability, whereas hemoglobin-albumin-lymphocyte-thrombocyte (area under the curve=0.422) and Aggregate Systemic Inflammation Index (area under the curve=0.444) showed weak diagnostic performance for gestational diabetes mellitus. In contrast, Systemic Inflammatory Response Index (area under the curve=0.466) and monocyte-lymphocyte ratio (area under the curve=0.475) were not significantly different between groups and lacked clinical relevance.  CONCLUSION: Platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and Systemic Immune-Inflammation Index are promising biomarkers for early gestational diabetes mellitus prediction in the first trimester. These findings support the role of inflammation in gestational diabetes mellitus pathophysiology and highlight the value of routine hematologic markers in risk stratification.<\/jats:p>","DOI":"10.1590\/1806-9282.20251962","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:42:13Z","timestamp":1782729733000},"source":"Crossref","is-referenced-by-count":0,"title":["Decoding inflammation: first-trimester biomarkers as predictive tools for gestational diabetes"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7262-4320","authenticated-orcid":false,"given":"Samet","family":"K\u0131rat","sequence":"first","affiliation":[{"name":"Kafkas University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.22159\/ajpcr.2024.v17i3.49594","article-title":"Association of risk factors with prevalence of gestational diabetes mellitus.","author":"Shaikh MN","year":"2024","journal-title":"Asian J Pharmaceutical Clin Res"},{"issue":"4","key":"ref2","first-page":"442","article-title":"Gestational diabetes mellitus prevalence and correlates in North West, Nigeria.","volume":"116","author":"Ladan AA","year":"2024","journal-title":"J Nat Med Assoc"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.2147\/IJGM.S408856","article-title":"Low-grade inflammation in gestational diabetes mellitus and its correlation with maternal insulin resistance and fetal growth indices.","volume":"16","author":"Xuan Nguyen K","year":"2023","journal-title":"Int J Gen Med"},{"issue":"13","key":"ref4","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.2174\/1871530323666230427104724","article-title":"Periostin acts as a bridge between gestational diabetes mellitus (GDM) and chronic inflammation to modulate insulin resistance by modulating PPAR\u03b1\/NF-\u03baB\/TNF-\u03b1 signaling pathway.","volume":"23","author":"Ji Q","year":"2023","journal-title":"Endocr Metab Immune Disord Drug Targets"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"104000","DOI":"10.1016\/j.jri.2023.104000","article-title":"Evidence of tissue specific alterations in inflammatory profiles in Gestational Diabetes Mellitus.","volume":"159","author":"McCarthy CM","year":"2023","journal-title":"J Reprod Immunol"},{"issue":"2","key":"ref6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.24321\/2278.2044.202218","article-title":"Role of insulin resistance in gestational diabetes mellitus: a literature review.","volume":"11","author":"Ara I","year":"2022","journal-title":"Chettinad Health City Med J"},{"issue":"2","key":"ref7","doi-asserted-by":"crossref","first-page":"354","DOI":"10.3390\/biomedicines12020354","article-title":"Sterile inflammatory response and surgery-related trauma in elderly patients with subtrochanteric fractures.","volume":"12","author":"Moldovan F","year":"2024","journal-title":"Biomedicines"},{"issue":"11","key":"ref8","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.3390\/diagnostics14111112","article-title":"Correlation between peripheric blood markers and surgical invasiveness during humeral shaft fracture osteosynthesis in young and middle-aged patients.","volume":"14","author":"Moldovan F","year":"2024","journal-title":"Diagnostics (Basel)"},{"issue":"2","key":"ref9","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1002\/ijgo.15442","article-title":"Can system inflammation response index or systemic immune inflammation index predict gestational diabetes mellitus in the first trimester? A prospective observational study.","volume":"166","author":"Yildiz EG","year":"2024","journal-title":"Int J Gynaecol Obstet"},{"issue":"23","key":"ref10","doi-asserted-by":"crossref","first-page":"6982","DOI":"10.3390\/jcm11236982","article-title":"The predictive role of maternal biological markers and inflammatory scores NLR, PLR, MLR, SII, and SIRI for the risk of preterm delivery.","volume":"11","author":"Hrubaru I","year":"2022","journal-title":"J Clin Med"},{"issue":"7","key":"ref11","doi-asserted-by":"crossref","first-page":"e98","DOI":"10.2337\/dc10-0719","article-title":"International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy: response to Weinert.","volume":"33","author":"Metzger BE","year":"2010","journal-title":"Diabetes Care"},{"issue":"2","key":"ref12","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1080\/09513590.2020.1780579","article-title":"Association of neutrophil to 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