妊娠期糖尿病孕妇血清TRF、LN、α1-MG预测早期肾损伤价值

Value of the levels of serum transferring, laminin, and α1-microglobulin of pregnant women with gestational diabetes mellitus for predicting their early renal injury

目的:探讨妊娠期糖尿病(GDM)孕妇外周血转铁蛋白(TRF)、层粘连蛋白(LN)和α1-微球蛋白(α1-MG)表达水平及预测早期肾损伤价值.方法:选择2019年10月—2021年10月本院就诊的GDM孕妇135例为GDM组,根据肾损伤发生情况分为肾损伤组和无肾损伤组,产前检查健康孕妇46例为对照组,对比3组基线资料,检测入院时TRF、LN和α1-MG表达水平及肾功能指标,分析其表达差异及相关性,采用受试者工作曲线(ROC)分析TRF、LN、α1-MG水平对GDM孕妇早期肾损伤的诊断价值.结果:肾损伤组、无肾损伤组、对照组血清TRF水平依次降低,LN和α1-MG水平依次升高,肾功能指标依次降低(均P<0.05);Pearson相关性分析,GDM合并肾损伤孕妇血清TRF水平与肾功能指标水平呈负相关,LN和α1-MG水平与肾功能指标水平呈正相关(均P<0.05);ROC结果显示,血清TRF、LN、α1-MG水平单独及联合诊断GDM发生早期肾损伤的AUC分别为0.866、0.625、0.906和0.975,联合诊断价值更高.结论:GDM孕妇血清TRF、LN和α1-MG水平与患者早期肾损伤关系密切,联合检测可为临床诊断早期肾损伤提供血清学指标.

Objective: To explore the expression levels of peripheral blood transferring(TRF),laminin(LN),and α1-microglobulin(α1-MG) of pregnant women with gestational diabetes mellitus(GDM), and to study their values for predicting the early renal injury of these women. Methods: 135 pregnant women with GDM were selected and were divided into group A(women with renal injury) and group B(women without renal injury) according to the occurrence of renal injury between October 2019 and October 2021. In addition, 46 healthy pregnant women who had undergone antenatal examination during the same period were enrolled in group C. The baseline data, and the expression levels of TRF,LN, and α1-MG, and the renal function indicators levels at admission of the women were compared among the three groups. The differences of the expression levels of TRF,LN, and α1-MG, and the renal function indicators of the women in the three groups were analyzed. Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of the levels of TRF,LN, and α1-MG of the women with GDM for their early renal injury. Results: The serum TRF level and the values of renal function indexes of the women in group A, group B, and group C had decreased gradually, but the LN and α 1-Mg levels of the women in group A, group B, and group C had increased gradually(all P<0.05). Pearson correlation analysis showed that the serum TRF level of the pregnant women with GDM and renal function injury was negatively correlated with their renal function indexes values, and the levels of LN and α 1-Mg levels the pregnant women with GDM and renal function injury were positively correlated with their renal function indexes values(all P<0.05). ROC results showed that the area under of the curve(AUC) of the serum TRF level,LN level,α1-MG level,or the combination of the levels of TRF,LN,α1-MG of the women with GDM for diagnosing their early renal function injury were 0.866,0.625,0.906,or 0.975,respectively,and the combination of the levels of TRF,LN,α1-MG had the higher diagnostic value for early renal function injury of the women.Conclusion:The expression levels of the serum TRF,LN andα1-MG of the pregnant women with GDM are closely related to their early renal injury,and the combination of the levels of TRF,LN,α1-MG detection can be used as the serological indicators for early renal injury of the women.