Estimation of C-reactive Protein and Neutrophil Lymphocyte Ratio in Cord blood from Gestational Diabetic Sudanese Women

Abstract

Introduction: Diabetes mellitus is defined as a metabolic disorder in which a person experiences high levels of blood sugar either due to insufficient insulin production (Type I) or sensitivity (Type II). Gestational Diabetes Mellitus (GDM) develops during pregnancy (usually in late second trimester) when the maternal insulin production can no longer cope with increasing adiposity and insulin resistance (due to increased placental lactogen, estrogen, and prolactin). The offspring of GDM mothers have increased risks of developing obesity, type 2 diabetes, and cardiovasular disease. Pregnancy induces an inflammatory state, and worsening of insulin resistance during pregnancy is further exacerbated by obesity and gestational weight gain, and may result in GDM. The imbalance in expression of pro-inflammatory and anti-inflammatory markers may contribute directly to impaired glucose homeostasis. C-reactive protein and Neutrophil Lymphocyte Ratio used as markers of subclinical inflammation in cord blood of newborn in mothers with gestational diabetes mellitus. Materials and Methods :This is a cross sectional descriptive study carried out in Khartoum state at Sudan University of Science and Technology , in the period from March 2018 to June 2018. 30 women diagnosed by GDM and 30 matched control group were recruited in this study. EDTA cord blood samples were collected from cases and controls for CRP, and NLR .Data was analyzed by SPSS version 20, and expressed as means, tables and figures. Results:The CRP results among cases and controls were (<2.5mg/L). The mean of neutrophil in newborn’s cord blood from women with Gestational diabetes was (41.43±7.82%), while the mean of neutrophil in newborn’s cord blood from women with normal pregnancy was (48.33±9.65%). The mean of lymphocyte in newborn’s cord blood in women with Gestational Diabetes was (52.47±6.425%), while the mean of lymphocyte in newborn’s cord blood in women with normal pregnancy was (40.07±7.57%). The mean of NLR in newborn’s cord blood in women with Gestational Diabetic was (0.81±0.25), while the mean of NLR in newborn’s cord Blood in women with normal pregnancy was(1. 29±0.5). Conclusion:CRP was no significantly different in newborn's Cord blood of GDM pregnent wonen and normal pregnant women. Significant decreased in NLR in cord blood of new born from GDM women. Significant increased in lymphocyte in cord blood of gestational diabetes mellitus women. Asignificant reverse association between fasting blood glucose level of GDM and neutrophil .