Neutrophil gelatinase‑associated lipocalin (NGAL) levels in twin pregnancy and association with gestational diabetes

Gestational diabetes mellitus (GDM) is the most common metabolic complication of pregnancy, afecting up to 4–8% of pregnancies. The incidence of GDM in twin pregnancies is higher compared to singleton pregnancies. Neutrophil gelatinase-associated lipocalin (NGAL), also known as lipocalin-2 (LCN-2), is a 25-kDa glycoprotein, frst identifed as a matrix protein of specifc granules of human neutrophils. NGAL is also expressed in many other human tissues and has a pleiotropic efect on immune function, cellular metabolism, homeostasis, and hormone function. Some clinical studies have demonstrated that the serum NGAL levels of patients with type 2 diabetes mellitus were signifcantly correlated with insulin resistance. A recent meta-analysis has demonstrated that serum NGAL levels were higher in pregnancies subsequently complicated by pre-eclampsia when compared to a control group. positive association has been demonstrated between serum NGAL levels in the first trimester of pregnancy e the risk of developing GDM later in pregnancy that NGAL is an early predictive biomarker of GDM, which could help guide the clinical practice of antenatal care. In conclusion, this is the frst study to measure NGAL in each trimester of gestation in women with twin pregnancies and to compare serum levels of this protein between women with or without GDM. The level of NGAL in the second trimester was signifcantly increased compared to the control group. Further in-depth research studies involving larger sample sizes within each group, and incorporating additional biomarkers are necessary to confrm this preliminary data and clarify the role of NGAL in gestational diabetes