目的 探讨妊娠晚期合并高甘油三酯血症（HTG）患者不良妊娠结局（APO）的影响因素及血清镍纹样蛋白（Metrnl）水平的变化。 方法 将2023年10月至2025年3月在妇产科分娩的260例妊娠晚期孕妇分为HTG组（n = 113）和非HTG组（n = 147），比较两组间一般资料、血清Metrnl、临床指标及APO，分析APO的影响因素。 结果 HTG组APO、母体不良结局和妊娠期糖尿病（GDM）发生率均明显高于非HTG组（P < 0.05），血清Metrnl、HDL-C均明显低于非HTG组（P < 0.05），TG、FPG、UA、TyG、TYG-BMI、UA-S/D均明显高于非HTG组（P < 0.05）。TG是APO的独立危险因素（OR = 1.426）；较低水平的血清Metrnl是所有孕妇APO、母体不良结局和GDM的独立危险因素（OR = 0.997、0.998、 0.997），也是HTG组APO、母体不良结局和GDM的独立危险因素（OR = 0.994、0.995、 0.993）。血清Metrnl水平预测HTG组孕妇APO的AUC为0.632（P < 0.05）；联合妊娠风险评估预测HTG组孕妇APO的AUC为0.758（P < 0.05）。 结论 妊娠晚期合并HTG的患者更容易出现APO，表现为母体不良结局、GDM增多，较低水平的血清Metrnl是孕妇APO、母体不良结局和GDM的独立危险因素。血清Metrnl水平联合妊娠风险评估对HTG孕妇APO有一定预测价值。

Objective To investigate the factors associated with adverse pregnancy outcomes （APO） and the changes in serum Meteorin-like protein （Metrnl） levels in pregnant women with hypertriglyceridemia （HTG） during late pregnancy. Methods From October 2023 to March 2025， 260 women in late pregnancy were recruited and then divided into an HTG group （n = 113） and a non-HTG group （n = 147）. General characteristics， serum Metrnl levels， clinical indicators， and the incidence of APO were compared between the two groups. Subsequently， risk factors for APO were further analyzed. Results The HTG group exhibited significantly higher incidences of APO， adverse maternal outcomes， and gestational diabetes mellitus （GDM） when compared to the non-HTG group （P < 0.05）. Serum Metrnl and HDL-C levels were notably lower in the HTG group （P < 0.05）， whereas TG， FPG， UA， TyG， TYG-BMI， and UA-S/D were significantly higher （P < 0.05）. TG was recognized as an independent risk factor for APO （OR = 1.426）； Low serum Metrnl levels were independent risk factors for APO， adverse maternal outcomes， and GDM among all pregnant women （OR = 0.997； 0.998； 0.997）， as well as specifically in the HTG group （OR = 0.994； 0.995； 0.993）. The area under the curve （AUC） for predicting APO in the HTG group using serum Metrnl levels was 0.632 （P < 0.05）； The AUC for predicting APO in the HTG group using the combination with pregnancy risk assessment was 0.758 （P < 0.05）. Conclusions Patients with HTG in late pregnancy are at a higher risk of experiencing APO， especially adverse maternal outcomes and GDM. Reduced serum Metrnl levels serve as an independent risk factor for APO， adverse maternal outcomes， and GDM in these pregnant women. The combination of serum Metrnl levels with pregnancy risk assessment demonstrates predictive value for APO in patients with HTG.