CAJ | 학술논문

目的探讨早孕期血清中性粒细胞明胶酶相关脂质运载蛋白（ NGAL）水平与妊娠期糖尿病（ GDM）发病的关联。方法筛选具有妊娠期糖尿病的危险因素的产妇共198例进行前瞻性研究，结果共诊断97例GDM设为GDM组，其余101例为GDM高危组，匹配100例正常分娩的孕妇为健康对照组。于整个孕周检测血清NGAL水平，早孕期检测空腹血糖等指标，采用稳态模型评估胰岛素抵抗指数（ HOMA-IR）。结果中孕期 NGAL水平显著高于早孕期。GDM组早、中、晚孕期NGAL水平均显著高于GDM高危组和健康对照组。GDM组早孕期空腹血糖、空腹胰岛素HOMA-IR和血清NGAL水平均显著高于健康对照组。早孕期NGAL在发生GDM的患者和存在GDM高因素的人群相比有统计学差异，而空腹血糖、空腹胰岛素和HOMA-IR在两者之间无统计学差异。逐步回归分析发现HOMA-IR及总胆固醇是血清NGAL独立的协变量。结论早孕期对存在GDM高危因素的孕妇进行血清NGAL检测对GDM发生具有一定预测作用，NGAL与胰岛素抵抗和血脂水平存在一定关联。
목적탐토조잉기혈청중성립세포명효매상관지질운재단백（ NGAL）수평여임신기당뇨병（ GDM）발병적관련。방법사선구유임신기당뇨병적위험인소적산부공198례진행전첨성연구，결과공진단97례GDM설위GDM조，기여101례위GDM고위조，필배100례정상분면적잉부위건강대조조。우정개잉주검측혈청NGAL수평，조잉기검측공복혈당등지표，채용은태모형평고이도소저항지수（ HOMA-IR）。결과중잉기 NGAL수평현저고우조잉기。GDM조조、중、만잉기NGAL수평균현저고우GDM고위조화건강대조조。GDM조조잉기공복혈당、공복이도소HOMA-IR화혈청NGAL수평균현저고우건강대조조。조잉기NGAL재발생GDM적환자화존재GDM고인소적인군상비유통계학차이，이공복혈당、공복이도소화HOMA-IR재량자지간무통계학차이。축보회귀분석발현HOMA-IR급총담고순시혈청NGAL독립적협변량。결론조잉기대존재GDM고위인소적잉부진행혈청NGAL검측대GDM발생구유일정예측작용，NGAL여이도소저항화혈지수평존재일정관련。
Objective To explore serum level of neutrophil gelatinase associated lipocaln( NGAL)during early pregnancy and its rela-tionship with gestational diabetes. Methods A total of 198 patients with risk factors for gestational diabetes were screened for this prospective study. A total of 97 cases of GDM were allocated in GDM group,and other 101 cases were listed as GDM risk group,and 100 pregnant women were matched as healthy normal controls. Serum levels of NGAL were examined throughout the whole gestational period,and serum levels of fasting glucose etc were detected in the period of early pregnancy. Homeostasis model assessment had been used for evaluation of insulin resistance index ( HOMA-IR). Results Serum level of NGAL in mid-gestational period was significantly higher than that in early period of pregnancy. In ear-ly,mid and late periods of pregnancy of GDM group,serum levels of NGAL were significantly higher than those with presence of risk factors in GDM group and healthy control group. In early pregnancy,serum levels of NGAL,fasting insulin and HOMA-IR in GDM group were significantly higher than those of control group. In period of early pregnancy,serum level of NGAL was significantly different in GDM patients compared with those presence of risk factors for GDM group,but the difference in fasting glucose,fasting insulin and HOMA-IR was not statistically significant between these two groups. Stepwise regression analysis showed HOMA-IR and TC were independent covariates to serum level of NGAL. Conclu-sion In period of early pregnancy,the detection of serum level of NGAL in patients with GDM risk factors has certain prediction effect for the presence of GDM. Serum level of NGAL has certain correlation with insulin resistance and blood level of lipids.