Evidence map›Paper›PMID 34824115›Full record

ArticleBMJ open2021

Early-pregnancy prediction of risk for pre-eclampsia using maternal blood leptin/ceramide ratio: discovery and confirmation.

Qianyang Huang, Shiying Hao, Jin You, Xiaoming Yao, Zhen Li, James Schilling, Sheeno Thyparambil, Wei-Li Liao, Xin Zhou, Lihong Mo and 12 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Emerging Role of Leptin in Vascular and Placental Dysfunction in Preeclampsia.Arteriosclerosis, thrombosis, and vascular biology · 2025
    Review
  4. Article
  5. Review
  6. Review
  7. Article
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 7 institutions in 2 countries.

Qianyang HuangmProbe, Inc, Mountain View, California, USA.
Shiying HaoDepartment of Cardiothoracic Surgery, Stanford University, Stanford, California, USA.
Jin YouDepartment of Bioengineering, University of California Riverside, Riverside, California, USA.
Xiaoming YaomProbe, Inc, Mountain View, California, USA.
Zhen LiDepartment of Surgery, Stanford University, Stanford, California, USA.
James SchillingmProbe, Inc, Mountain View, California, USA.
Sheeno ThyparambilmProbe, Inc, Mountain View, California, USA.
Wei-Li LiaomProbe, Inc, Mountain View, California, USA.
Xin ZhouTianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin, China.
Lihong MoDepartment of Obstetrics and Gynecology, University of California San Francisco, Fresno, California, USA.
Subhashini LadellaDepartment of Obstetrics and Gynecology, University of California San Francisco, Fresno, California, USA.
Shantay R Davies-BalchBLACK Wellness & Prosperity Center, Fresno, California, USA.
Hangyi ZhaoDepartment of Mathematics, Stanford University, Stanford, California, USA.
David FanDepartment of Statistics and Applied Probability, University of California Santa Barbara, Santa Barbara, California, USA.
John C WhitinDepartment of Pediatrics, Stanford University, Stanford, California, USA.
Harvey J CohenDepartment of Pediatrics, Stanford University, Stanford, California, USA.
Doff B McElhinneyDepartment of Cardiothoracic Surgery, Stanford University, Stanford, California, USA.
Ronald J WongDepartment of Pediatrics, Stanford University, Stanford, California, USA.
Gary M ShawDepartment of Pediatrics, Stanford University, Stanford, California, USA.
David K StevensonDepartment of Pediatrics, Stanford University, Stanford, California, USA.
Karl G SylvesterDepartment of Surgery, Stanford University, Stanford, California, USA.
Xuefeng B LingDepartment of Surgery, Stanford University, Stanford, California, USA bxling@stanford.edu.ORCID 0000-0002-5386-3884
Stanford University · USLucile Packard Children's Hospital · USUniversity of California, San Francisco · USPingjin Hospital · CNSoutheast University · CNUniversity of California, Riverside · USUniversity of California, Santa Barbara · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to develop a blood test for the prediction of pre-eclampsia (PE) early in gestation. We hypothesised that the longitudinal measurements of circulating adipokines and sphingolipids in maternal serum over the course of pregnancy could identify novel prognostic biomarkers that are predictive of impending event of PE early in gestation. STUDY

designRetrospective discovery and longitudinal confirmation.

settingMaternity units from two US hospitals.

participantsSix previously published studies of placental tissue (78 PE and 95 non-PE) were compiled for genomic discovery, maternal sera from 15 women (7 non-PE and 8 PE) enrolled at ProMedDx were used for sphingolipidomic discovery, and maternal sera from 40 women (20 non-PE and 20 PE) enrolled at Stanford University were used for longitudinal observation. OUTCOME MEASURES: Biomarker candidates from discovery were longitudinally confirmed and compared in parallel to the ratio of placental growth factor (PlGF) and soluble fms-like tyrosine kinase (sFlt-1) using the same cohort. The datasets were generated by enzyme-linked immunosorbent and liquid chromatography-tandem mass spectrometric assays.

resultsOur discovery integrating genomic and sphingolipidomic analysis identified leptin (Lep) and ceramide (Cer) (d18:1/25:0) as novel biomarkers for early gestational assessment of PE. Our longitudinal observation revealed a marked elevation of Lep/Cer (d18:1/25:0) ratio in maternal serum at a median of 23 weeks' gestation among women with impending PE as compared with women with uncomplicated pregnancy. The Lep/Cer (d18:1/25:0) ratio significantly outperformed the established sFlt-1/PlGF ratio in predicting impending event of PE with superior sensitivity (85% vs 20%) and area under curve (0.92 vs 0.52) from 5 to 25 weeks of gestation.

conclusionsOur study demonstrated the longitudinal measurement of maternal Lep/Cer (d18:1/25:0) ratio allows the non-invasive assessment of PE to identify pregnancy at high risk in early gestation, outperforming the established sFlt-1/PlGF ratio test.

Indexed as

Pre-EclampsiaBiomarkersCeramidesFemaleHumansLeptinPlacentaPlacenta Growth FactorPredictive Value of TestsPregnancyRetrospective StudiesBiomarkersCeramidesLeptinPlacenta Growth Factorgynaecologyobstetricspublic health

Identifiers

PMID34824115
PMCPMC8627403
OpenAlexW3217172192

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.