Decreased Monocyte Count Is Associated With Gestational Diabetes Mellitus Development, Macrosomia, and Inflammation.

Abstract

CONTEXT:

The immune system plays a central role in the pathophysiology of gestational diabetes mellitus (GDM). Monocytes, the main innate immune cells, are especially important in the maintenance of a normal pregnancy.

OBJECTIVE:

Here, we investigated the potential effect of monocytes in GDM.

METHODS:

Monocyte count was monitored throughout pregnancy in 214 women with GDM and 926 women without in a case-control and cohort study. Circulating levels of inflammatory cytokines, placenta-derived macrophages, and their products were measured.

RESULTS:

Throughout pregnancy, monocyte count was significantly decreased in women with GDM, and was closely associated with glucose level, insulin resistance, and newborn weight. First-trimester monocyte count outperformed that of the second and third trimester as a risk factor and diagnostic predictor of GDM and macrosomia both in the case-control and cohort study. In addition, our cohort study showed that as first-trimester monocyte count decreased, GDM and macrosomia incidence, glucose level, and newborn weight increased in a stepwise manner. Risk of GDM started to decrease rapidly when first-trimester monocyte count exceeded 0.48 × 109/L. Notably, CD206 and interleukin 10 (IL-10) were significantly lower, whereas CD80, CD86, tumor necrosis factor α (TNF-α), and interleukin 6 (IL-6) were higher both in GDM placental tissue and peripheral blood. First-trimester monocyte count was positively related to IL-10 and CD206, but negatively related to CD80, CD86, TNF-α, and IL-6.

CONCLUSION:

Decreased monocyte count throughout pregnancy was closely associated with the development of GDM, macrosomia, and the chronic inflammatory state of GDM. First-trimester monocyte count has great potential as an early diagnostic marker of GDM.

• Authors: Xinmei Huang, Bingbing Zha, Manna Zhang, Yue Li, Yueyue Wu, Rui Zhang, Li Sheng, Jiong Xu, Zhiyan Yu, Cuijun Gao, Zaoping Chen, Heyuan Ding, Ling Ma, Yanquan Zhang, Shufei Zang, Tie-Ning Zhang, Jun Liu
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 107 Issue 1 Pg. 192-204 (01 01 2022) ISSN: 1945-7197 [Electronic] United States
• PMID: 34478541 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Blood Glucose

Topics

• Adult
• Birth Weight (immunology)
• Blood Glucose (analysis)
• Case-Control Studies
• Diabetes, Gestational (blood, diagnosis, epidemiology, immunology)
• Female
• Fetal Macrosomia (epidemiology, immunology)
• Humans
• Incidence
• Infant, Newborn
• Inflammation (blood, epidemiology, immunology)
• Leukocyte Count
• Monocytes (immunology)
• Pregnancy
• Pregnancy Trimester, First (blood)
• Risk Assessment (methods)
• Risk Factors
• Young Adult