NGAL与子痫前期、GDM孕妇糖代谢和脂代谢的相关性

目的：探讨血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平与正常妊娠孕妇、妊娠糖尿病（GDM）患者、子痫前期血糖正常患者及GDM合并子痫前期患者糖脂代谢的关系。方法：选取在本院妇产科建立产前定期体检档案的单胎妊娠正常孕妇（NC组）55例、GDM组55例、子痫前期组55例以及GDM＆子痫前期组35例为研究对象，对比分析各组血清NGAL、空腹血糖（FPG）、肌酐（Scr）、乳酸脱氢酶（LD）、体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、24h尿蛋白、空腹胰岛素（FINS）、胰岛抵抗指数（HOMA—IR）的差异，采用Spearman相关分析及Logistic多因素分析影响血清NGAL水平的相关因素。结果：GDM＆子痫前期组血清NGAL水平高于NC组、GDM组及子痫前期组，差异有统计学意义（P〈0．05）。子痫前期组血清NGAL水平高于GDM组，差异有统计学意义（P〈0．05）。校正年龄、孕周后，孕妇血清NGAL水平与孕期BMI水平、SBP、DBP、FPG、AST、甘油三脂（TG）、总胆固醇（TC）、Scr、IR、HOMA-IR、LDH、24h尿蛋白呈正相关，而与HCL—C呈负相关。经Logistic多元回归分析可知，SBP、DBP、24h尿蛋白、HOMA—IR是血清NGAL独立危险因素。结论：GDM与子痫前期患者血清NGAL水平升高可能与血管内皮功能失调及糖脂代谢异常有关，从而提示血清NGAL可能参与GDM及子痫前期的病理生理过程中。

Correlation between NGAL and glucose and lipid metabolism in preeclampsia,and GDM pregnant women

Objective To investigate the correlation between levels of serum neutrophil gelatinase-assoeiated lipoealin （NGAL） and blood glucose and lipid metabolism in healthy pregnant women, preeclampsia, and GDM pregnant women. Methods： A total of 55 healthy women with singleton pregnancies （NC group）, 55 cases of GDM pregnant women, 55 cases of preeclampsia and 35 cases of GDM preeclampsia group were selected in this study. The levels of serum NGAL, fasting plasma glucose （FPG）, ereatinine （Scr）, lactate dehydrogenase （LD）, body mass index （BMI）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, 24h urine protein, fasting insulin （FINS）, insulin resistance index difference （HOMA-IR） were compared. Spearman correlation analysis and Logistic multivariate were used to analyze the correlation between the detected parameters and NGAL level. Results： The NGAL level of GDM - preeclampsia group was significantly higher than that in NC group, GDM group and preeclampsia group, the difference was statistically significant （P-0.05）. The NGAL level of pre- eclampsia group was higher than the GDM group, the difference was statistically significant （P%0.05）. The NGAL level were positively corrected with age, gestational age, pregnancy BMI, SBP, DBP, FPG, AST, TG, TC, Scr, IR, HOMA-IR, LDH, and 24h-urine protein level and was negatively correlated with HCL-C. The SBP, DBP, 24h urine protein, HOMA-IR serum NGAL were independent risk factor of NGAL. Conclusion： GDM and preeclampsia serum NGAL levels were significantly elevated in patients with endothelial dysfunction which may be associated with metabolic and lipid abnormalities suggesting that serum NGAL may be involved in the pathophysiology process of GDM and pre-eclampsia development.