【摘要】 目的观察妊娠期糖尿病(GDM)并发子痫前期(PE)孕妇血清脂质运载蛋白2(LCN-2)、晚期氧化蛋白产物(AOPP)的水平变化,并探讨其意义。方法选择2016年3月～2018年12月住院分娩的孕妇217例,其中GDM-PE 82例(GDM-PE组),GDM 85例(GDM组),正常孕妇50例(对照组)。采用ELISA法检测血清LCN-2、AOPP水平,全自动生化分析仪检测甘油三酯(TG)、游离脂肪酸(FFAs)、尿酸(UA)、24 h尿蛋白水平,稳态模型法计算胰岛素抵抗指数(HOMA-IR),对相关指标进行Pearson相关性分析。结果 GDM-PE组、GDM组血清LCN-2、AOPP、FFAs水平高于对照组(P均<0.05),且GDM-PE组高于GDM组(P<0.05);GDM-PE组血清TG、UA、24 h尿蛋白和HOMA-IR水平高于GDM组、对照组(P均<0.05);但GDM组、对照组TG、UA和HOMA-IR水平比较差异无统计学意义(P均>0.05);GDM-PE重度者血清LCN-2、AOPP、TG、FFAs、UA、HOMA-IR和24 h尿蛋白水平均高于GDM-PE轻度者(P均<0.05);Pearson相关性分析结果显示,血清LCN-2与TG、FFAs、UA、HOMA-IR、24 h尿蛋白呈正相关(r分别为0.597、0.682、0.635、0.697、0.588,P均<0.05),血清AOPP与TG、FFAs、UA、HOMA-IR、24 h尿蛋白呈正相关(r分别为0.368、0.587、0.712、0.728、0.451,P均<0.05),且血清LCN-2与AOPP水平呈正相关(r=0.651,P<0.05)。结论 GDM-PE患者血清LCN-2与AOPP水平均升高,血清LCN-2和AOPP水平与患者血脂代谢紊乱、胰岛素抵抗密切相关;检测血清LCN-2和AOPP水平对于早期预测GDM-PE和肾功能损害及病情判断有一定意义。更多还原

【Abstract】 Objective To observe the changes and clinical significance of serum lipocalin-2(LCN-2) and advanced oxidation protein product(AOPP) in pregnant women with gestational diabetes mellitus(GDM) complicated with preeclampsia(PE). Methods Totally 217 pregnant women who delivered in hospital from March 2016 to December 2018 were selected, including 82 cases of women with GDM-PE(GDM-PE group), 85 cases of women with GDM(GDM group), and 50 cases of normal pregnant women(control group). The serum levels of LCN-2 and AOPP were detected by ELISA, the levels of triglyceride(TG), free fatty acid(FFAs), uric acid(UA), 24-hour urinary protein were measured by automatic biochemical analyzer, homeostasis model was used to calculate the insulin resistance index(HOMA-IR), and the correlation analysis of the relevant indicators was carried out. Results The serum levels of LCN-2, AOPP and FFAs in the GDM-PE group and GDM group were higher than those in the control group(all P<0.05), and the levels of LCN-2, AOPP, and FFAs in the GDM-PE group were higher than those in the GDM group(all P<0.05). The levels of serum TG, UA, 24-hour urinary protein, and HOMA-IR in the GDM-PE group were higher than those in the GDM group and control group(all P<0.05). However, there were no significant differences in the levels of TG, UA, or HOMA-IR between the GDM group and control group(all P>0.05). The serum levels of LCN-2, AOPP, TG, FFAs, UA, HOMA-IR, and 24-hour urinary protein in patients with severe GDM-PE were higher than those in patients with mild GDM-PE(all P<0.05). Pearson correlation analysis showed that the serum LCN-2 was positively correlated with TG, FFAs, UA, HOMA-IR and 24-hour urinary protein(r=0.597, 0.682, 0.635, 0.697, 0.588; all P<0.05). Serum AOPP was positively correlated with TG, FFAs, UA, HOMA-IR and 24-hour urinary protein(r=0.368, 0.587, 0.712, 0.728, 0.451, all P<0.05), and serum LCN-2 was positively correlated with AOPP(r=0.651, P<0.05). Conclusions The serum LCN-2 and AOPP of GDM-PE patients increase, and the serum LCN-2 and AOPP of GDM-PE patients are closely related to the disorder of lipid metabolism and insulin resistance. Detecting the level of serum LCN-2 and AOPP has certain significance in early prediction of GDM-PE and renal function damage and judgment of disease.更多还原