Decreased monocyte count in first-trimester tied to gestational diabetes risk: Study
China: Monocyte count in the first trimester has great potential as an early diagnostic marker of gestational diabetes mellitus (GDM), suggests a recent study in The Journal of Clinical Endocrinology and Metabolism (JCEM).
The study found decreased monocyte count throughout pregnancy to be closely related to the development of gestational diabetes, macrosomia, and the chronic inflammatory state of GDM.
Prior to the study, it is known that the immune system plays an important role in the pathophysiology of gestational diabetes. Monocytes which are the main innate immune cells are especially important for the maintenance of a normal pregnancy. In the study, Xinmei Huang, Fudan University, Shanghai, China, and colleagues investigated the potential effect of monocytes in GDM.
The researchers monitored monocyte count 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.
Based on the study, the researchers found the following:
- Throughout pregnancy, monocyte count was significantly decreased in women with GDM, and 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 in both the case-control and cohort study.
- The 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 × 10 9/L.
- CD206 and IL-10 were significantly lower, while CD80, CD86, TNF-α and IL-6 were higher in both 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.
"Our findings inferred that reduced monocyte count throughout pregnancy was closely-associated with the development of GDM, macrosomia and the chronic inflammatory state of GDM," wrote the authors. This implies that first-trimester monocyte count has great potential as an early diagnostic marker of GDM.
The study titled, "Decreased Monocyte Count is Associated with Gestational Diabetes Mellitus Development, Macrosomia and Inflammation," is published in The Journal of Clinical Endocrinology and Metabolism.