谷氨酸和尿液α1-微球蛋白水平与GDM患者肾损伤及妊娠结局的关联  

Association of glutamic acid and urinaryα1-microglobulin levels with kidney injury and pregnancy outcomes in patients with GDM

作　　者：严梅[1] 伍班名 YAN Mei;WU Banming(Department of Obstetrics,Yibin Second People's Hospital,Sichuan Yibin 644000,China;Department of Emergency,Yibin Second People's Hospital,Sichuan Yibin 644000,China)

机构地区：[1]宜宾市第二人民医院产科,四川宜宾644000 [2]宜宾市第二人民医院急诊科,四川宜宾644000

出　　处：《中国妇幼健康研究》2025年第4期91-96,共6页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨妊娠期糖尿病(GDM)患者血清谷氨酸(Glu)、尿液α1-微球蛋白(α1-MG)水平与早期肾损伤及妊娠结局的相关性。方法选择2021年7月至2023年7月于宜宾市第二人民医院收治的106例GDM孕妇为GDM组,根据患者是否发生早期肾损伤分为损伤组和未损伤组,另选择同期产前检查健康的孕妇102例作为对照组,检测患者及健康孕妇血清Glu及尿液α1-MG。根据GDM患者的妊娠结局分为妊娠结局不良组和妊娠结局良好组,检测尿微量白蛋白(U-mAlb)、血清尿素(Urea)、尿酸(UA)、血肌酐(Scr)、β2-微球蛋白(β2-MG)水平。采用pearson法分析血清Glu、尿液α1-MG水平与肾功能指标的相关性,采用受试者工作特征曲线(ROC)分析血清Glu、尿液α1-MG对不良妊娠结局的预测价值。结果GDM组较对照组血清Glu和尿液α1-MG水平均升高(t=20.052、31.426,P<0.001),损伤组较未损伤组血清Glu、尿液α1-MG水平及肾功能指标均升高(t=9.122、7.501、21.568、2.875、7.525、8.715、7.089,P<0.05)。在发生异位妊娠、先兆流产、宫内发育受限的GDM患者中,血清Glu和尿液α1-MG高表达患者比例高于低表达患者比例(χ^(2)=6.362、7.102、5.754、6.278、4.624、8.820,P<0.05)。妊娠结局不良组较妊娠结局良好组血清Glu和尿液α1-MG水平均升高(t=6.802、7.054,P<0.001)。血清Glu、尿液α1-MG及联合预测患者发生不良妊娠结局的曲线下面积分别为0.883、0.855、0.961,二者联合优于单独预测价值(Z=2.453、2.981,P<0.05)。结论GDM患者的血清Glu和尿液α1-MG水平均与早期肾损伤和妊娠结局有关。Objective To investigate the correlation between serum glutamic acid(Glu)and urinaryα1-microglobulin(α1-MG)levels with early kidney injury and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 106 pregnant women diagnosed with GDM at Yibin Second People's Hospital from July 2021 to July 2023 were included as the GDM group.These patients were further divided into a kidney injury group and a non-injury group based on the presence of early kidney injury.Additionally,102 healthy pregnant women undergoing prenatal check-ups during the same period were selected as the control group.Serum Glu and urinaryα1-MG levels were measured in all participants.GDM patients were also categorized into a poor pregnancy outcome group and a favorable pregnancy outcome group,and their urinary microalbumin(U-mAlb),serum urea(Urea),uric acid(UA),serum creatinine(Scr),andβ2-microglobulin(β2-MG)levels were assessed.The Pearson method was used to analyze the correlation between serum Glu,urinaryα1-MG,and renal function indicators.The receiver operating characteristic(ROC)curve was employed to assess the predictive value of serum Glu and urinaryα1-MG for adverse pregnancy outcomes.Results Compared to the control group,the GDM group showed significantly higher serum Glu and urinaryα1-MG levels(t=20.052 and 31.426,respectively,P<0.001).The kidney injury group exhibited higher serum Glu,urinaryα1-MG levels,and renal function indicators than the non-injury group(t=9.122,7.501,21.568,2.875,7.525,8.715 and 7.089,respectively,P<0.05).Among GDM patients with ectopic pregnancy,threatened miscarriage,or intrauterine growth restriction,the proportion of patients with high Glu andα1-MG expression was significantly higher than that of those with low expression(χ^(2)=6.362,7.102,5.754,6.278,4.624 and 8.820,respectively,P<0.05).The poor pregnancy outcome group had significantly higher serum Glu and urinaryα1-MG levels compared to the favorable outcome group(t=6.802 and 7.054,respectively,P<0.001).The area

关 键 词：妊娠期糖尿病 谷氨酸 Α1-微球蛋白 早期肾损伤 妊娠结局 

分 类 号：R173[医药卫生—妇幼卫生保健]