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Objective:To investigate the changes and clinical significance of body mass index (BMI), blood lipid and fat soluble vitamin levels in patients with different types of severe preeclampsia.Methods:Sixty-eight pregnant women with severe preeclampsia who received antenatal examination in Lishui Maternal and Child Health Care Hospital, China from February 2017 to February 2019 were included in the study group. According to the onset time, the pregnant women were divided into an early onset group (≤ 34 weeks of gestation, n = 38) and a late onset group (> 34 weeks of gestation, n = 30). An additional 50 healthy pregnant women who concurrently received antenatal examination in the same hospital were included in the control group. Serum levels of triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), vitamin A (VA), vitamin E (VE) and vitamin D 3 (VD 3) were determined in all pregnant women. Logistic regression was used to analyze severe preeclampsia-related influential factors. Results:There were no significant differences in age, number of births and number of pregnancies among the three groups (all P > 0.05). BMI and serum levels of VA, VE, TC, TG, and LDL-C were (22.99 ± 4.39) kg/m 2, (0.48 ± 0.08) ng/mL, (11.91 ± 1.74) ng/mL, (4.93 ± 0.34) mmol/L, (1.57 ± 0.26) mmol/L, (2.68 ± 0.27) mmol/L, respectively, which were significantly higher than those in the control group [(20.68 ± 3.68) kg/m 2, (0.40 ± 0.07) ng/mL, (10.32 ± 2.56) ng/mL, (4.12 ± 0.67) mmol/L, (1.25 ± 0.32) mmol/L, (2.15 ± 0.32) mmol/L, t = 3.725, 6.698, 4.352, 8.731, 6.282, 10.512, all P < 0.05]. Serum levels of HDL-C and VD 3 in the study group were (1.51± 0.32) mmol/L and (16.16 ± 2.37) ng/mL, respectively, which were significantly lower than those in the control group [(1.88 ± 0.57) mmol/L, (17.86 ± 2.39) ng/mL, t = - 6.959, - 4.520, both P < 0.05]. BMI and serum levels of TC, TG, LDL-C, VA and VE in the early onset group were (23.13 ± 4.13) kg/m 2, (5.05 ± 0.34) mmol/L, (1.62 ± 0.27) mmol/L, (2.95 ± 0.32) mmol/L, (0.52 ± 0.06) ng/mL, (12.16 ± 1.80) ng/mL, respectively, which were significantly higher than those in the control group ( t = 6.507, 17.462, 11.217, 16.593, 9.075 and 4.142, all P < 0.05). Serum levels of HDL-C and VD 3 in the early onset group were (1.43 ± 0.28) mmol/L and (15.76 ± 2.42) ng/mL, respectively, which were significantly lower than those in the control group ( t = 14.635, 5.871, both P < 0.05). BMI and serum levels of TC, TG and VE in the late onset group were (22.70 ± 4.32) kg/m 2, (4.67±0.32) mmol/L, (1.49 ± 0.25) mmol/L and (11.45 ± 1.61) ng/mL, respectively, which were significantly higher than those in the control group ( t = 5.821, 12.857, 8.059, 3.482, all P < 0.05). Serum level of VD3 in the late onset group was (16.72 ± 2.31) ng/mL, which was significantly lower than that in the control group ( t = 4.319, P = 0.01). There were no significant differences in serum levels of LDL-C, HDL-C and VA between late onset group and control group (all P > 0.05). There were no significant differences in BMI, and serum levels of TC, TG, HDL-C, LDL-C, VA, VD 3 and VE between early onset and late onset groups (all P > 0.05). Logistic regression analysis results revealed that BMI and serum levels of TG, TC, HDL-C, LDL-C, VA, VD 3 and VE are independent influential actors of early onset severe preeclampsia ( P = 0.000, 0.008, 0.032, 0.043, 0.032, 0.002, 0.041, 0.009). BMI and serum levels of TG, TC, VD 3 and VE are independent influential actors of late onset severe preeclampsia ( P = 0.002, 0.016, 0.013, 0.031, 0.042). BMI, blood lipid and fat soluble vitamin in combination are of high value for the prediction of early onset severe preeclampsia (sensitivity 87.81% and specificity 76.67%), but they are not of high value for the prediction of late onset severe preeclampsia (sensitivity 52.51% and specificity 55.10%). Conclusion:BMI, serum lipid and fat soluble vitamin in combination are of high value in the prediction of early-onset severe preeclampsia.
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System-wide molecular characteristics of COVID-19, especially in those patients without comorbidities, have not been fully investigated. We compared extensive molecular profiles of blood samples from 231 COVID-19 patients, ranging from asymptomatic to critically ill, importantly excluding those with any comorbidities. Amongst the major findings, asymptomatic patients were characterized by highly activated anti-virus interferon, T/natural killer (NK) cell activation, and transcriptional upregulation of inflammatory cytokine mRNAs. However, given very abundant RNA binding proteins (RBPs), these cytokine mRNAs could be effectively destabilized hence preserving normal cytokine levels. In contrast, in critically ill patients, cytokine storm due to RBPs inhibition and tryptophan metabolites accumulation contributed to T/NK cell dysfunction. A machine-learning model was constructed which accurately stratified the COVID-19 severities based on their multi-omics features. Overall, our analysis provides insights into COVID-19 pathogenesis and identifies targets for intervening in treatment.
