Diagnostic value of serum soluble CD40 ligand in gestational diabetes mellitus
Objective To investigate the value of serum soluble CD40 ligand(sCD40L)for gestational diabetes mellitus(GDM)and adverse pregnancy outcomes.Methods A total of 100 pregnant women with GDM who received regular prenatal check-up and delivered in Zhongshan Torch Development Zone People's Hospital from January to December 2023 were included in GDM group,and 50 pregnant women with normal blood glucose levels who received regular prenatal check-up and delivered in the hospital during the same period were included in normal control group.Clinical data of two groups were collected and pregnancy outcomes were followed up.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of sCD40L in GDM,and multifactor Logistic regression model was used to explore the risk factors of GDM.Results Serum sCD40L levels in GDM group were significantly higher than those in normal control group at different time points during pregnancy(P<0.05).ROC curve showed that the best cutoff values of serum sCD40L level in the first and second trimesters in assisting the diagnosis of GDM were 0.975ng/ml and 1.195ng/ml,the area under the curve was 0.812 and 0.878,and the sensitivity was 73.08%and 78.43%,the specificity was 78.05%and 80.00%,respectively.Multivariate Logistic regression showed that age 30-39 years old,family history of diabetes mellitus,higher fasting blood glucose in first trimester,higher sCD40L in first trimester and second trimester were all independent risk factors for GDM(P<0.05).The levels of serum sCD40L in the first,second and third trimesters of GDM women with adverse pregnancy outcome were significantly higher than those in GDM women with normal pregnancy outcome(P<0.05).Conclusion Serum sCD40L levels are abnormally increased in pregnant women with GDM and adverse pregnancy outcomes,and serum sCD40L levels in first and second trimesters may have early warning value for GDM.