Diagnosis Of Urinary MALB??2MG?TRF And RBP Combined Detection For GDM With Early Renal Injury

Objective:Gestational diabetes mellitus,one of pregnancy specific diseases,Its incidence is increasing year by year.GDM has great harm to mother and child,lead to maternal and neonatal both short-term and long-term complications.The incidence of good intervention can significantly reduce maternal complications,so early diagnosis,early intervention,early treatment is of great significance.Based on the combined detection,this study urinary albumin,beta2 microglobulin,transferrin and retinol binding protein of early renal injury markers,analysis the diagnosic significance and clinical application of gestational diabetes early renal injury.Methods:Choose 100 patients for the study,From January 2016 to December 2016,inclouding 50 Normal pregnant women cases and 50 gestational diabetes mellitus cases.According to diagnostic standard of the eighth edition of the obstetrics and gynecology,which compiled by Xie Xing and Gou Wenli.All women in two groups had no history of chronic hypertension,vaginal bleeding,PCOS,PROM,diabetes mellitus,renal disease hepatic disease and immunological disease.All samples were collected without using any drugs affect kidney function.There was nosignificant difference between the two groups in age,gestational weeks and other general data(P>0.05).The urine samples from hospitalized pregnant women were collected within 24 hours.Examined the content of urinary MALB,U?2MG,TRF,RBP and using theROC(receiver operating characteristic)curve to evaluate the cut-off data of biomarkers,which indicates the best sensitivity and specificity.Established database,then using the SPSS 21.0 statistical package process the data.Between the two groups,using T test analysis its variance Among the groups,mean comparison in two groups was conducted with variance analysis.According to the data obtained from experiments,we used SPSS 21.0 system to make graphs,and chose ?=0.05 as the inspection level,P<0.05 indicate its statically significance.Results:1.Compared with normal pregnancy group,the UMALB concentration in gestational diabetes mellitus group was significantly higher.(P<0.05);2.Compared with normal pregnancy group,the U?2MG concentration in gestational diabetes mellitus group was significantly higher.(P<0.05);3.Compared with normal pregnancy group,the URBP concentration in gestational diabetes mellitus group was higher(P<0.05);4.Compared with normal pregnancy group,the UTRF concentration in gestational diabetes mellitus group was significantly higher.(P<0.05);5.Use ROC curves evaluated UMALB,U?2MG,URBP,UTRF four indicators,showed that the area under the curve of UMALB was 0.708;the area under the curve of U?2MG 0.820;the area under the curve of URBP was 0.829;UTRF area under the curve was 0.741.Results showed URBP had the highest value in the diagnosis of early renal injury in gestational diabetes mellitus,U?2MG,UMALB,UTRF diagnostic value were descend in gradually with followed;6.UMALB,U?2MG,URBP,UTRF were sensitive bio-markers to predict gestational diabetes mellitus with early renal injury.When two or three bio-markers combined,sensitivity and specificity were increased.Conclusion:1.Compared with the normal group,the level of UMALB,U?2MG,UTRF and URBP in pregnant women with gestational diabetes mellitus were significantly increased.Description UMALB,U?2MG,UTRF and URBP levels are highly correlated with gestational diabetes mellitus of kidney damage.2.ROC curve results showed that URBP and U?2MG in predicting gestational diabetes mellitus of kidney damage in pregnancy is higher than the value of the UMALB and UTRF,the best cutoff value based on its sensitivity and specificity results have certain guiding significance for clinical work.3.Compared with single index,when two or three bio-markers were combined,sensitivity and specificity have the advantage.While triple combinations is better than double combinations.This result indicated that the combined detection of early renal damage has more diagnostic value and clinical applications,helping determine kidney injury site and using of drugs in clinical.