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Abstract To investigate the value of the urinary liver type fatty acid binding protein (L-FABP) and neutrophil gelatina SE associated lipocalin (NGAL) levels combined with and the value of urinary albumin creatinine ratio (ACR) of the women with gestational diabetes mellitus (GDM) for diagnosing their early renal impairment. Methods: A total of 120 pregnant women with GDM were selected and were divided into group A (36 women with kidney injury) and group B (84 women without renal injury) according to the occurrence of early renal impairment of the pregnant women from January 2018 to December 2019. In addition, 100 healthy pregnant women who underwent standardized pregnancy test were selected in group C during the same period. The middle samples of the morning urine from the women in the three groups were collected for detecting the levels of urine L-FABP, NGAL and CAR. The values of the levels of urine L-FABP, NGAL and CAR of the women for diagnosing their early renal impairment was analyzed. Results: The levels of urinary L-FABP, NGAL, and ACR of the women in group C, group B, and group A had increased gradually (P<0.05). Pearson correlation analysis showed that the levels of L-FABP, NGAL, ACR of the women were positively correlated with their urinary microalbumin level (r=0.612, 0.624, 0.702, all P<0.05). Receiver operating characteristic curve analysis showed that the AUC, the optimal cut-off value, the sensitivity, and the specificity of l-FABP level of the pregnant women with GDM for diagnosing their early renal impairment were 0.855, >53.12 ng/mL, 74.8%, and 87.2%, respectively. The AUC, the optimal cutoff value, the sensitivity, and the specificity of NGAL level of the pregnant women with GDM for diagnosing their early renal impairment were 0.812, >3.74μg/ml， 70.2%，and 90.4%, respectively. The AUC, the optimal cutoff value, the sensitivity, and the specificity of ACR level of the pregnant women with GDM for diagnosing their early renal impairment were 0.834,≥35.71 mg/g, 90.2%，and 85.4%， respectively. The sensitivity, the specificity, and AUC of the combination of L-FABP, NGAL, and ACR levels of the pregnant women with GDM for diagnosing their early renal impairment were 96.7%，99.4%，and 0.979，respectively. Conclusion: The levels of urinary L-FABP, NGAL, and ACR of the pregnant women with GDM and early renal impairment are abnormal increase. The combined detections of urinary L-FABP, NGAL, and ACR for diagnosing early renal impairment has higher efficiency, which is helpful to early diagnose, timely intervention, and reduce the renal injury.
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