Objective:To construct preeclampsia (PE) prediction models using information from the hospital electronic medical information and clinical laboratory data through logistic regression (LR) and machine learning algorithms, and to compare their predictive performance.Methods:The study was conducted based on the information from Rouji Pregnancy Test Database and the perinatal data of women who visited the Third Affiliated Hospital of Guangzhou Medical University from January 1, 2012, to December 31, 2019. Drawing upon clinical treatment guidelines and related literature, 28 clinical indicators from 2 736 pregnant women at 24 to 28 weeks of gestation were selected after a thorough integration and used for the construction of the PE prediction model dataset. Patients diagnosed with PE comprised the PE group ( n=245), while another 255 cases from the rest who did not have PE were selected, with undersampling method, as the control group. The Random Forest algorithm (RF), eXtreme Gradient Boosting (XGB) algorithm, and LR model were each employed to develop predictive models for PE. Following the construction of the models, external validation of PE prediction accuracy was carried out using data acquired from an independent prospective cohort study on PE that was conducted from June 2019 to December 2022, in which 38 PE cases and 80 controls were chosen. The performance of predictive models were evaluated using metrics such as accuracy, sensitivity, specificity, and the area under the curve (AUC) of receiver operating characteristic. Results:Indicators included in the construction of the three predictive models suggested that uric acid, creatinine, maternal age, early pregnancy body mass index, urea, triglycerides, red blood cell count, eosinophil count, total cholesterol, neutrophil count, urine protein, alanine aminotransferase, and urine occult blood were influential in PE prediction models. The AUCs for RF, XGB, and LR models in the training and test sets were 0.851 (95% CI:0.730-0.891), 0.955 (95% CI:0.865-0.987), 0.884 (95% CI:0.767-0.923) vs. 0.845 (95% CI:0.723-0.868), 0.907 (95% CI:0.791-0.919), 0.851 (95% CI:0.755-0.893), respectively. In the test set, the accuracy, sensitivity, and specificity for RF, XGB, and LR models were 0.803, 0.607, 0.958, 0.864, 0.790, 0.927, and 0.832, 0.661, 0.971, respectively. In the external validation of the RF, XGB and LR predictive models, the accuracy were 0.822, 0.814, and 0.763; the sensitivity were 0.737, 0.789, and 0.605, and the specificity were 0.863, 0.825, and 0.838, respectively. Among them, XGB model showed the highest Youden's index (0.614). Conclusion:Compared to traditional methods of model construction, machine learning algorithms can establish more effective PE prediction models using real clinical data.

Objective:To explore the relationship between carotid atherosclerosis (CAS) and bone metabolism marker osteocalcin (OC) in patients with type 2 diabetes (T2DM).Methods:A total of 100 patients with T2DM admitted to Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University) from January 2018 to August 2018 were selected as study subjects, and the carotid intima-media thickness (IMT) was detected.The patients were divided into CAS group and normal carotid IMT group (NC group), with 50 cases in each group.The levels of OC, fasting plasma glucose(FPG), fasting insulin(FINS), glycosylated hemoglobin(HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein(HDL-C), low density lipoprotein (LDL-C), insulin resistance index (HOMA-IR) were compared between the two groups.Results:The OC level of the CAS group[(11.86±4.46)ng/mL] was significantly lower than that of the NC group[(23.94±4.52)ng/mL] ( t=-9.640, P=0.001). The LDL-C level of the CAS group[(2.89±0.82)mmol/L] was significantly higher than that of the NC group[(2.55±1.16)mmol/L]( t=2.03, P=0.049). Pearson correlation analysis showed that IMT was positively correlated with age, LDL-C, HbA1c ( r=0.285, 0.190, 0.173; P=0.000, 0.020, 0.035), and negatively correlated with OC ( r=-0.603, P=0.000). Conclusion:CAS in patients with T2DM is closely related to OC, and the reduction of OC levels may be a risk factor for CAS in T2DM patients.

Objective To investigate the relationship between serum phospholipid polyunsaturated fatty acids (PUFA) and interleukin-6 (IL-6) in patients with metabolic syndrome.Methods Serum phospholipid PUFA profiles of 61 patients with metabolic syndrome and 55 healthy controls was analyzed with high performance gas chromatography.Enzyme-linked immunosorbent assay was used to measure serum IL-6 levels.Results The IL-6 concentration was significantly higher in the MS group than in the control group [(16.0 ± 4.7) pg/ml vs.(9.2 ± 2.6) pg/ml,P =0.000].The total PUFA percentage was lower in the MS group than in the control group [(47.2±2.4)％ vs.(50.8 ±2.5)％,P=0.001].The serum IL-6 concentration was negatively correlated with n-3 PUFA,n-6 PUFA,and total PUFA (r =-0.51,P ＜0.01;r=-0.27,P＜0.01;r=-0.38,P＜0.01).Conclusions Serum PUFA in patients with metabolic syndrome is lower than in healthy people.Serum IL-6 concentration may be negatively correlated with total PUFA concentration.

Objective To investigate the correlation between the expression of mononuclear cells Inter-leukin-18(IL-18)and early renal damage in diabetic patients.Methods 480 cases with type 2 diabetes mellitus (T2DM)in our hospital from Jan.2010 to Dec.2012 were selected.According to urine albumin excretion rate, They were randomly divided into diabetic group, micro proteinuria group, and proteinuria group.160 cases of normal people were selected as the control group.Glycosylated hemoglobin, serum cholesterol, serum triglycer-ides, serum creatinine, blood urea nitrogen.2 h postprandial blood glucose and urine protein were detected.Af-ter mononuclear cells being isolated and cultured for 12 h and 24 h, IL-18 was detected.-137G/C and-607C/A gene polymorphism were detected.Results Normal group were significantly lower than diabetes group, micro proteinuria group, and proteinuria group(P<0.01)in BMI, 2 h postprandial blood sugar, cholesterol, glycosy-lated protein, urea nitrogen and serum creatinine index.Micro proteinuria group and proteinuria group were high-er than diabetic group in 2 h blood sugar, cholesterol, glycosylated protein, urea nitrogen and serum creatinine index(P<0.05).Diabetes group, micro proteinuria group, and proteinuria group were significantly higher than normal group in urine protein, 12 h IL 18 and 24 h IL-18(P<0.01).Micro albuminuria and proteinuria group was significantly higher than diabetic group in urine protein, 12 h IL 18 and 24 h IL-18(P<0.01).There were positive correlation between urine protein and 12 h, 24 h IL-18(r=0.454, P<0.01; r=0.479, P<0.01). There was statistical difference between albuminuria group and diabetes group in -137G/C genotype frequency (χ2 =5.45, P<0.05) and there was statistical differencebetween the allele frequency distribution(χ2 =5.76, P<0.05) .Conclusions IL-18 can be used as an indicator for detecting early renal damage.Gene -137G/C polymorphism may increase the risk of diabetic nephropathy by upregulating the expression of IL-18.

Objective To investigate characteristics of free fatty acid (FFA) and high-sensitivity Creactive protein (hs-CRP) in patients with type 2 diabetes mellitus and metabolic syndrome (MS) compared to those with type 2 diabetes mellitus without MS.Methods Totally 120 patients with type 2 diabetes mellitus who received blood glucose control in Shaoxing People's Hospital from January to June 2013 were recruited and divided into MS group (n =56) and non-MS group (n =64).The serum FFA profile of the patients was measured by enzymatic assay, and the serum hs-CRP level measured by particle-enhanced immuno-precipitation assay.Results The level of FFA was higher in the MS group than that in the non-MS group [(0.60 ±0.25) mmoL/L vs.(0.45 ±0.21) mmol/L, P =0.033].The level of hs-CRP was higher in the MS group than that in the non-MS group [5.29 (4.69-5.82) mg/L vs.0.73 (0.42-1.26) mg/L, P =0.000].The level of hs-CRP was higher in the patients with central obesity than that in those without central obesity [4.34 (0.91-5.46) mg/L vs.1.80 (0.82-3.27) mg/L, P=0.014], also higher in hypertensive patients than in non-hypertensive patients [5.21 (3.18-5.96) mg/L vs.2.93 (0.89-4.98) mg/L, P =0.012].Conclusions Serum FFA and hs-CRP concentrations may be significantly higher in type 2 diabetes mellitus patients with MS.The increased levels of FFA and hs-CRP may play an important role in the pathogenesis of type 2 diabetes mellitus and MS.

Objective To investigate the relationship between triglyceride and serum polyunsaturated fatty acid (PUFA) in patients with metabolic syndrome (MS).Methods Totally 74 MS patients (MS group) and 62 healthy subjects (normal control group,NC group) were recruited from June 2011 to June 2012 in Shaoxing People's Hospital.Serum phospholipid fatty acid profiles were analyzed with capillary gas chromatography.Serum lipids were measured by enzymatic assay.Results The triglyceride concentration was significantly higher in MS group than that in NC group [(2.0 ±0.8) mmol/L vs.(1.3 ±0.5) mmol/L,P=0.000].The levels of n-3 PUFA,n-6 PUFA,and PUFA were significantly lower in MS group than those in NC group (9.8％ ±2.2％ vs.11.1％ ±2.4％,P=0.002; 35.4％ ±6.7％ vs.39.5％ ±7.8％,P=0.009; 45.2％ ±8.9％ vs.50.6％ ±10.1％,P =0.000).Triglyceride concentration was inversely correlated with n-3 PUFA and PUFA levels (r =-0.42,P =0.008 ; r =-0.23,P =0.013).Conclusions n-3 PUFA,n-6 PUFA,and PUFA decrease in MS patients.Triglyceride concentration is inversely correlated with PUFA.

Angiopoietin-2 levels were 5. 80 ( 3. 83-8. 00 ) , 4. 42 ( 2. 56-5. 55 ) , and 2. 75 ( l. 40-4. 64 )ng/ml in type 2 diabetic patients with proliferative retinopathy, patients with non-proliferative retinopathy, and patients without retinopathy, respectively. Statistical significances existed between any two groups (all P ＜0. 01 ). Angiopoietin-1 level in patients with non-proliferative retinopathy was higher than that in patients without retinopathy [10. 57 ( 8. 99-12. 05 ) vs 9. 21 (7. 71-11.2 ) ng/ml, P＜0. 05]. No difference in receptor Tie-2 was found among the 3 groups (P＞0. 05 ). The results suggested that serum angiopoietin-2 level might be associated with the severity of retinopathy in type 2 diabetic patients.

Objective To investigate the relationship between serum omega-3 polyunsaturated fatty acid (ω-3PUFA) and insulin resistance(IR) in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease (NAFLD). Methods This trial involved 51 patients of type 2 diabetes mellitus with NAFLD (G4 group), 50 patients of type 2 diabetes alone(G3 group), 45 patients of NAFLD alone (G2 group) and 42 healthy control subjects (G1 group). Serum ω-3PUFA profile was analyzed with capillary gas chromatography. Insulin resistance was assessed by homeostasis model assessment (HOMA-IR). ALT, AST, γ-glutamyltransferase(GGT) and serum lipids were measured. Results The levels of HOMA-IR were higher in G4 group than those in G3, G2 and G1 group(4. 90 ± 2. 54 vs 2. 38 ± 1.23, 2. 20 ± 1.15, 1.13± 0.42;P<0.05). The level of ALT, AST, GGT, TC, TG, LDL-C were higher in G4 group than those in G3, G2 and G1 group(P < 0. 05). The level of ω-3PUFA was signifieantly lower in G4 group than those in G3, G2 and G1 group(5.68 ±2.02 vs 7. 17 ±2. 38, 6.97±2.32, 10.08±2.76;P <0.05). ω-3PUFA cocentration was negatively correlated with HOMA-IR, TC, TG and LDL-C (r = -0.491, -0. 376, - 0. 462, - 0. 408, P < 0. 05). Conclusions Serum ω-3 PUFA is significantly decreased in patients with type 2 diabetes mellitus and NAFLD. Serum ω-3PUFA is negatively correlated with insulin resistance. ω-3PUEA plays a very important role in the development of diabetes mellitus and NAFLD.

The association of the serum phospholipid fatty acid components with high-sensitivity C reactive protein in patients with metabolic syndrome and type 2 diabetes mellitus was investigated.Saturated fatty acid in patients with metabolic syndrome and type 2 diabetes mellitus was increased (45.98±1.55 vs 42.05±2.04,P＜0.01),while polyunsaturated fatty acid was decreased(42.38±1.93 vs 46.60±2.06,P＜0.01),and high sensitivity C reactive protein was significantly increased[(6.36± 1.28 vs 0.79±0.45) mg/L,P＜0.01)].

Objective To study the relationship between NF kappa-B (NF-κB) and the development of diabetic macroangiopathy in patients with type 2 diabetes, the expression level of Nuclear Faetor-κB in peripheral mononuclear cell of type 2 diabetes patients with and without macroangiopathy were compared, Methods Enzyme-linked immunosorbent assay was used to measure soluble intercellular adhesion molecule-1 (slCAM-1) in plasma and immunohistochemical method was used to measure the activity of NF-κB in peripheral blood mononu-clear cell in 50 type 2 diabetes patients with macroangiopathy(G3) , 41 type 2 diabetes patients without maeroangiopathy(G2) and 30 nor-real control subjects(G1). Linear correlation model was used to analyze the correlation between the level of sICAM-1 and NF-κB. Results The expression level of Nuclear Factor-κB in peripheral mononuclear cell of G3 was significantly higher than that in G2 and G1(P <0.01). The concentration of plasma sICAM-1 in G3 was significantly higher than that in G2 and G1. The expression level of Nuclear Factor-κB in peripheral mononuclear cell of G2 was significantly higher than that in GI (P < 0.01). The concentration of plasma sICAM-1 in G2 was significantly higher than that in G1. The levels of plasma sICAM-1 in three groups were positive correlated with activity of NF-κB in peripher-al blood mononuclear cells(r = 0.376, 0.283, 0.302, P < 0.05). Conclusion Increased level of NF kappa-B in peripheral blood mono-nuclear might be risk factor for peripheral macroangiopathy in patients with diabetes. It may induce macroangiopathy via up-regulating sI- CAM-1 expression.