Moyake Naledi, Buchmann Eckhart, Crowther Nigel J
Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa.
Department of Obstetrics and Gynaecology, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
J Obstet Gynaecol Res. 2016 Nov;42(11):1483-1488. doi: 10.1111/jog.13088. Epub 2016 Aug 24.
Neutrophil gelatinase-associated lipocalin (NGAL) is an emerging biomarker for early diagnosis of acute kidney injury (AKI). This study investigated the use of urinary NGAL as a marker of AKI in women with pre-eclampsia.
Urine and serum samples were collected over 24 h from 78 healthy and 109 pre-eclamptic women, with baseline samples taken at admission to the maternity unit; NGAL was assayed in serial urine samples.
Baseline neutrophil gelatinase-associated lipocalin did not differ significantly between women who were healthy, those with pre-eclampsia, or with AKI (P = 0.55 for trend). When the pre-eclamptic group was divided into those with eclampsia (median, 60.5 ng/mL; IQR, 23.4-173 ng/mL; n = 19), uncomplicated pre-eclampsia (median, 18.8 ng/mL; IQR, 7.5-52.8 ng/mL; n = 48; P < 0.05 vs eclampsia), imminent eclampsia (median, 30.7 ng/mL; IQR, 13.9-49.3 ng/mL; n = 22) and pre-eclampsia with acute kidney injury (median, 60.3 ng/mL; IQR, 23.5-159 ng/mL, n = 14), however, NGAL level did differ. On multivariate regression analysis, the only significant correlate of NGAL level was the presence of eclampsia (beta = 0.22, P < 0.05). On receiver operating characteristic curve analysis, baseline NGAL did not discriminate between subjects with or without AKI (area under the curve, 0.61; 95%CI: 0.43-0.78; P = 0.12).
Neutrophil gelatinase-associated lipocalin level at baseline and over a 24-h period does not provide a suitable diagnostic test for AKI in pre-eclamptic subjects.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是一种用于急性肾损伤（AKI）早期诊断的新兴生物标志物。本研究调查了尿NGAL作为子痫前期女性AKI标志物的应用情况。
收集78名健康女性和109名子痫前期女性24小时内的尿液和血清样本，在进入产科病房时采集基线样本；对系列尿液样本进行NGAL检测。
健康女性、子痫前期女性或AKI女性的基线中性粒细胞明胶酶相关脂质运载蛋白无显著差异（趋势P = 0.55）。然而，当将子痫前期组分为子痫患者（中位数，60.5 ng/mL；四分位间距，23.4 - 173 ng/mL；n = 19）、无并发症子痫前期患者（中位数，18.8 ng/mL；四分位间距，7.5 - 52.8 ng/mL；n = 48；与子痫相比P < 0.05）、先兆子痫患者（中位数，30.7 ng/mL；四分位间距，13.9 - 49.3 ng/mL；n = 22）和伴有急性肾损伤的子痫前期患者（中位数，60.3 ng/mL；四分位间距，23.5 - 159 ng/mL，n = 14）时，NGAL水平存在差异。多因素回归分析显示，NGAL水平的唯一显著相关因素是子痫的存在（β = 0.22，P < 0.05）。在受试者工作特征曲线分析中，基线NGAL无法区分有或无AKI的受试者（曲线下面积，0.61；95%可信区间：0.43 - 0.78；P = 0.12）。
基线及24小时内的中性粒细胞明胶酶相关脂质运载蛋白水平不能为子痫前期受试者的AKI提供合适的诊断检测。
