PDF(Pubmed)
Abstract：
The present study aimed to investigate the correlation between weight status and mortality in mechanically ventilated patients and explore the potential mediators.
Three medical centers encompassing 3301 critically ill patients receiving mechanical ventilation were assembled for retrospective analysis to compare mortality across various weight categories of patients using machine learning algorithms. Bioinformatics analysis identified genes exhibiting differential expression among distinct weight categories. A prospective study was then conducted on a distinct cohort of 50 healthy individuals and 193 other mechanically ventilated patients. The expression levels of the genes identified through bioinformatics analysis were quantified through enzyme-linked immunosorbent assay (ELISA).
The retrospective analysis revealed that overweight individuals had a lower mortality rate than underweight individuals, and body mass index (BMI) was an independent protective factor. Bioinformatics analysis identified matrix metalloproteinase 8 (MMP-8) as a differentially expressed gene between overweight and underweight populations. The results of further prospective studies showed that overweight patients had significantly lower MMP-8 levels than underweight patients ((3.717 (2.628, 4.191) vs. 2.763 (1.923, 3.753), ng/ml, P = 0.002). High MMP-8 levels were associated with increased mortality risk (OR = 4.249, P = 0.005), indicating that elevated level of MMP-8 predicts the mortality risk of underweight patients receiving mechanical ventilation.
This study provides evidence for a protective effect of obesity in mechanically ventilated patients and highlights the potential role of MMP-8 level as a biomarker for predicting mortality risk in this population.
Three medical centers encompassing 3301 critically ill patients receiving mechanical ventilation were assembled for retrospective analysis to compare mortality across various weight categories of patients using machine learning algorithms. Bioinformatics analysis identified genes exhibiting differential expression among distinct weight categories. A prospective study was then conducted on a distinct cohort of 50 healthy individuals and 193 other mechanically ventilated patients. The expression levels of the genes identified through bioinformatics analysis were quantified through enzyme-linked immunosorbent assay (ELISA).
The retrospective analysis revealed that overweight individuals had a lower mortality rate than underweight individuals, and body mass index (BMI) was an independent protective factor. Bioinformatics analysis identified matrix metalloproteinase 8 (MMP-8) as a differentially expressed gene between overweight and underweight populations. The results of further prospective studies showed that overweight patients had significantly lower MMP-8 levels than underweight patients ((3.717 (2.628, 4.191) vs. 2.763 (1.923, 3.753), ng/ml, P = 0.002). High MMP-8 levels were associated with increased mortality risk (OR = 4.249, P = 0.005), indicating that elevated level of MMP-8 predicts the mortality risk of underweight patients receiving mechanical ventilation.
This study provides evidence for a protective effect of obesity in mechanically ventilated patients and highlights the potential role of MMP-8 level as a biomarker for predicting mortality risk in this population.
摘要：
背景：本研究旨在探讨机械通气患者体重状况与死亡率之间的相关性，并探讨潜在的调节因素。
方法：三个医疗中心，包括3301名接受机械通气的危重患者，进行回顾性分析，使用机器学习算法比较不同体重类别患者的死亡率。生物信息学分析鉴定了在不同重量类别中表现出差异表达的基因。然后对50名健康个体和193名其他机械通气患者的不同队列进行了前瞻性研究。通过酶联免疫吸附测定(ELISA)定量通过生物信息学分析鉴定的基因的表达水平。
结果：回顾性分析显示，超重个体的死亡率低于体重不足个体，体重指数(BMI)是独立的保护因素。生物信息学分析确定基质金属蛋白酶8（MMP-8）是超重和体重不足人群之间的差异表达基因。进一步的前瞻性研究结果表明，超重患者的MMP-8水平明显低于体重不足患者（（3.717（2.628，4.191）与2.763(1.923,3.753),ng/ml,P=0.002)。高MMP-8水平与死亡风险增加相关(OR=4.249,P=0.005)。提示MMP-8水平升高可预测接受机械通气的体重不足患者的死亡风险。
结论：这项研究为肥胖在机械通气患者中的保护作用提供了证据，并强调了MMP-8水平作为预测该人群死亡风险的生物标志物的潜在作用。
方法：三个医疗中心，包括3301名接受机械通气的危重患者，进行回顾性分析，使用机器学习算法比较不同体重类别患者的死亡率。生物信息学分析鉴定了在不同重量类别中表现出差异表达的基因。然后对50名健康个体和193名其他机械通气患者的不同队列进行了前瞻性研究。通过酶联免疫吸附测定(ELISA)定量通过生物信息学分析鉴定的基因的表达水平。
结果：回顾性分析显示，超重个体的死亡率低于体重不足个体，体重指数(BMI)是独立的保护因素。生物信息学分析确定基质金属蛋白酶8（MMP-8）是超重和体重不足人群之间的差异表达基因。进一步的前瞻性研究结果表明，超重患者的MMP-8水平明显低于体重不足患者（（3.717（2.628，4.191）与2.763(1.923,3.753),ng/ml,P=0.002)。高MMP-8水平与死亡风险增加相关(OR=4.249,P=0.005)。提示MMP-8水平升高可预测接受机械通气的体重不足患者的死亡风险。
结论：这项研究为肥胖在机械通气患者中的保护作用提供了证据，并强调了MMP-8水平作为预测该人群死亡风险的生物标志物的潜在作用。
