Correlation Between Serum D-dimer Andrisk of Gestational Diabetes Mellitus

This study has been carried out to investigate the correlation between serum D-dimer and the risk of gestational diabetes mellitus (GDM). A total of 308 pregnant women treated in our hospital from January 2018 to January 2020 were retrospectively analyzed. According to the diagnostic criteria for GDM, they were divided into normal blood glucose group (n=145) and GDM group (n=163). The level of serum D-dimer was measured by enzyme-linked immunosorbent assay at 5-12, 13-23, 24-28 and 29-37 weeks of pregnancy. The pregnant women who did not have GDM at 5-12 and 13-23 weeks of pregnancy but were diagnosed with GDM at and after 24 weeks of pregnancy were assigned to GDM-A group (n=18) and GDM-B group (n=26), respectively. The related factors affecting the occurrence of GDM was analyzed by multivariate logistic regression. The optimal threshold of D-dimer for the occurrence of GDM was predicted via receiver operating characteristic (ROC) curve. The level of serum D-dimer in GDM group was significantly higher than that in normal blood glucose group at 5-12, 13-23 and 24-28 weeks of pregnancy (P<0.05). The level of serum D-dimer at 24-28 weeks of pregnancy was negatively correlated with OGTT 0-min insulin (r=-0.756, P<0.05) and HOMA-IR (r=-0.693, P<0.05), but positively correlated with LDL-C (r=0.759, P<0.05). After adjustment of confounding factors such as pregnancy age, pre-pregnancy body mass index, Acanthosis nigricans and triglyceride, the level of serum D-dimer at 13-23 weeks of pregnancy was still an independent risk factor for the occurrence of GDM at and after 24 weeks of pregnancy (OR=0.731, 95% CI=0.503-0.760, P<0.05). Moreover, in GDM-B group, the level of serum D-dimer at 13-23 weeks of pregnancy could better predict the occurrence of GDM at and after 24 weeks of pregnancy, and the area under the ROC curve was 0.731.