Study On The Relationship Of Serum Lipocalin-2 To Gestational Diabetes Complicated By Preeclampsia

Objectives Lipocalin-2 was recently described as a novel adipokine associated with inflammation, obesity, insulin resistance and atherosclerosis. The present study aims at examining lipocalin-2 serum levels in gestational diabetes mellitus(GDM) complicated by preeclampsia(PE) compared with GDM, healthy pregnant controls and its relationship with clinical and biochemical measures of glucose, and lipid metabolism.Methods The study included three groups: 30 women with GDM complicated by PE, 40 women with GDM and 80 healthy pregnant controls. The three groups were carefully matched for maternal age, gestational age, and preconceptional body mass index(BMI). All subjects underwent body measurement including body weight, height, systolic blood pressure, diastolic blood pressure and answered an questionaire by which preconceptional weight was acquired, then BMI was calculated. Peripheral blood samples were collected from them to detect the fasting blood glucose(FBG), fasting insulin(FINS), blood lipids. The maternal levels of serum lipocalin-2 were determined by enzyme-linked immunosorbent assay. Using homeostasis model assessment (HOMA -IR) estimated insulin resistance: HOMA-IR=FBG*FINS/22.5.Results 1. Between the three groups, serum lipocalin-2 concentrations in GDM complicated by PE were the significantly highest, and serum lipocalin-2 concentrations in GDM were significantly higher than these in control. GDM complicated by PE vs GDM [53.89(42.11-76.74) ng/ml vs 42.18(32.39-55.49) ng/ml, P<0.05]; GDM complicated by PE vs Control [53.89(42.11-76.74) ng/ml vs 28.65(22.78-35.38) ng/ml, P<0.001]; GDM vs control [42.18(32.39-55.49) ng/ml vs 28.65(22.78-35.38) ng/ml, P<0.001]. 2. Gain of weitht, systolic blood pressure, diastolic blood pressure, fasting blood glucose, fasting insulin, HOMA-IR, triglycerides and free fat acid in GDM complicated by PE were significantly higher than that in other two groups, and all that in GDM were significantly higher than that in control. 3. Serum lipocalin-2 concentrations were positively correlated with gain of weight, systolic blood pressure, diastolic blood pressure, fasting blood glucose, fasting insulin, HOMA-IR, triglycerides. Multiple linear stepwise analysis showed that serum lipocalin-2 concentrations were independently correlated with the systolic blood pressure and HOMA-IR.Conclusions 1. Gain of weight, IR, abnormal carbohydrate and lipid metabolism in GDM complicated by PE were more severe than that in GDM. 2. Serum lipocalin-2 levels grow significantly higher in GDM complicated by preeclampsia, and serum lipocalin-2 levels were correlated with gain of weight in pregnancy, IR and carbohydrate and lipid metabolism. Lipocalin-2 may contributes to the pathogenesis of GDM complicated by PE.