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    Benefits of the Neutrophil-to-Lymphocyte Ratio for the Prediction of Gestational Diabetes Mellitus in Pregnant Women
    (Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2014) Yilmaz, H.; Celik, H. T.; Namuslu, M.; Inan, O.; Onaran, Y.; Karakurt, F.; Ayyildiz, A.
    Aims: There is growing consensus in the literature that inflammation plays a central role in the pathophysiology of obesity, Type 2 Diabetes Mellitus (T2DM), Gestational Diabetes Mellitus (GDM) and cardiovascular complications. Measuring the neutrophil-to-lymphocyte ratio (NLR) provides a simple inexpensive method for the assessment of inflammatory status. We investigated the predictive value of pre-procedural (before the oral glucose tolerance test (OGTT)) NLR on the development of GDM in pregnancy. Methods: 42 women with GDM and 68 women without GDM were included in the study. Complete Blood Count and biochemical tests were followed by a diagnostic 4-point 100-g-OGTT within 2 weeks. GDM was diagnosed by the Carpenter and Coustan criteria. The NLR was calculated from the data. Results: The mean NLR level was significantly higher in GDM women (3.00 +/- 0.83 vs. 2.26 +/- 0.43 p < 0.001, respectively). In ROC analysis, NLR > 2.93 had 76.2 % sensitivity and 94.1 % specificity in predicting GDM. Logistic regression analysis showed that elevated NLR (OR: 5.512, 95 % CI: 1.352-22.475, p = 0.017) was an independent variable for predicting GDM in pregnancy. Conclusions: An elevated NLR level is a powerful and independent predictor of GDM. The results of this study suggested that inflammation plays a central role in the pathogenesis of GDM.
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    Increased levels of galectin-3 were associated with prediabetes and diabetes: new risk factor?
    (Springer, 2015) Yilmaz, H.; Cakmak, M.; Inan, O.; Darcin, T.; Akcay, A.
    Purpose Galectin-3 (Gal-3) is a marker of cardiac fibrosis and predicts incident heart failure. Gal-3-deficient mice are resistant to multiple low-dose streptozotocin-induced diabetes. Recent experimental studies suggested an important role for Gal-3 in the regulation of adiposity, metaflammation and type 2 diabetes. This study aimed to examine the relationship between Gal-3 and newly diagnosed prediabetes and diabetes. Methods Gal-3 concentrations were measured in 118 participants and 56 age-and sex-matched healthy controls. All subjects underwent a 75-g oral glucose tolerance test and were stratified into normal, prediabetic, and diabetes mellitus subgroups. DM was defined as a plasma glucose level >= 126 mg/dL in the fasting state or >= 200 mg/dL in the second hour after glucose loading. Impaired fasting glucose was defined as an FPG level of 100-125 mg/dL, and impaired glucose tolerance was defined as a 2-h plasma glucose level of 140-199 mg/dL. Results Sixty-one patients had prediabetes (Group 1), 57 had diabetes (Group 2), and 56 had neither diabetes nor prediabetes (Group 3). Gal-3 levels correlated with FPG (r = 0.787, P < 0.01), 2hPG (r = 0.833, P < 0.01), CRP (r = 0.501, P < 0.01), and HOMA-IR (r = 0.518, P < 0.01). Gal-3 levels were higher in Group 2 than in Groups 1 and 3 [1,053.9 (358.1) and 744.1 (119.3) vs. 481.7 (175.4) pg/mL; P < 0.001]. Gal-3 is an independent predictor of diabetes in multivariate logistic analysis. In ROC analysis, a Gal-3 cutoff value of 803.55 pg/mL diagnoses diabetes with a sensitivity of 80.7 % and a specificity of 85.5 % (AUC = 0.912). Conclusions Gal-3 is a promising biomarker for detecting prediabetes and diabetes.