中性粒细胞明胶酶相关脂质运载蛋白与子痫前期及妊娠期糖尿病孕妇糖代谢和脂代谢指标的相关性  

Serum level of neutrophil gelatinase-associated lipocalin in preeclampsia with gestational diabetes mellitus

作　　者：段冬梅[1] 牛建民[1] 朱斌 林小红[1] 

机构地区：[1]广州医学院附属广东省妇女儿童医院产科,510010 [2]广州市番禺区妇幼保健院产科

出　　处：《中华围产医学杂志》2012年第4期222-227,共6页Chinese Journal of Perinatal Medicine

摘　　要：目的通过测定正常妊娠孕妇、子痫前期糖代谢正常患者、妊娠期糖尿病（gestationaldiabetesmellitus，GDM）患者及子痫前期合并GDM患者血清中性粒细胞明胶酶相关脂质运载蛋白（neutrophilgelatinase～associatedlipocalin，NGAL）水平，探讨NGAL与子痫前期、GDM孕妇糖代谢和脂代谢的相关性。方法选取2009年12月至2010年11月在广州医学院附属广东省妇女儿童医院定期产前检查并分娩的单胎正常妊娠孕妇、子痫前期糖代谢正常患者及GDM患者各77例，子痫前期合并GDM患者32例。测定所有研究对象血清NGAL、空腹血糖、空腹胰岛素、脂代谢参数、尿酸、肌酐、乳酸脱氢酶及24h尿蛋白等指标，测量血压，计算体重指数（bodymassindex，BMI），用稳态模型评估法计算胰岛素抵抗指数（homeostasismodelassessmentforinsulinresistance，HOMA_IR）评价胰岛素敏感性。正态分布资料用单因素方差分析及Student’St检验进行比较，非正态分布资料用Kruskal—WallisH检验和Mann-WhitneyU检验进行比较。采用Spearman相关分析和多元逐步回归法进一步分析。结果子痫前期合并GDM组孕妇血清NGAI。水平高于子痫前期糖代谢正常组[（70．82±20．02）ng／ml与（56．17±18．22）ng／ml，t=3．65，P〈O．01]、GDM组[（43．99±14．82）ng／ml，t=5．97，P〈O．01]及正常妊娠组[（17．80土5．78）ng／ml，t=14．76，P〈0．01）；子痫前期糖代谢正常组血清NGAL水平高于GDM组（t=5．90，P〈0．01）；子痫前期合并GDM组和子痫前期糖代谢正常组中，子痫前期重度组血清NGAL水平均高于子痫前期轻度组[（76．44士28．06）ng／ml与（60．15±4-25．86）ng／ml，t=2．82，P〈0．05；（61．61±37．14）ng／ml与（46．30±13．97）ng／ml，t=4．74，P〈O．oi]。校正孕周、孕妇年龄后血清NGAL水平与孕前BMI（r=0．335，P〈0．01）、入组BMI（r=0．427，P〈0．01）、入组收缩压（r=0�Objective To investigate the relationship of serum neutrophil gelatinase-associated lipocalin （NGAL） levels among preeclamptic women with or without gestational diabetes mellitus （GDM）, GDM and healthy pregnant controls. Methods This study included 263 singleton pregnant women who visited the antenatal chinics in Guangdong Women and Children＇s Hospital and Health Instutite Affiliated to Guangzhou Medical College from December 2009 to November 2010, 77 healthy pregnant women, 77 women with preeclampsia, 77 women with GDM and 32 women complicated with both preeclampsia and GDM. Blood pressure, height and body weight of all subjects were measured. Peripheral blood samples were collected to detect serum NGAL, parameters of glycolipid metabolism, 24-hour urine protein content, uric acid, creatinine and lactate dehydrogenase. Maternal levels of serum NGAL were quantified by enzyme-linked immunosorbent assay. Meanwhile, body mass index （BMI） and homeostasis model assessment {or insulin resistance （HOMA-IR） were calculated. Data under normal distribution were analyzed with one-way ANOVA and Student＇s t test, and those under abnormal distribution were compared with Kruskal-Wallis H or Mann-Whitney U test. Results The preeclampsia with GDM group had higher serum NGAL level [（70.82±20.02） ng/ml] as compared with preeclampsia group F（56.17±18.22） ng/ml] , GDM group [（43.99 ± 14.82） ng/ml] and healthy pregnant control group [（17.80±5.78） ng/ml] , t= 3.65,5.97,14.76, P〈0.01, respectively. The NGAL levels in preeclampsia group without GDM were higher than in GDM group （t=5.90, P〈0.01）. In both the preeclampsia with and without GDM groups, NGAL levels in patients with severe preeclampsia were higher than in the mild ones [（76.44±28.06） ng/mlor（60.15±25.86） ng/ml, t=2.82,P〈0.05%（61.61±37.14） ng/ml or （46.30±13.97） ng/ml, t=4.74,P〈0.01）. After adjusted by gestational weeks and maternal age, NGAL level was positively correlated with BMI before pregnancy （r=

关 键 词：先兆子痫 糖尿病 妊娠 急相蛋白质类 原癌基因蛋白质类 脂笼蛋白质类 

分 类 号：R714.25[医药卫生—妇产科学]