Circular RNA in blood corpuscles combined with plasma protein factor for early prediction of pre-eclampsia

ObjectiveTo determine the expression of circular RNA (circRNA) in blood corpuscles of pregnant women before 20weeks of pregnancy and to create a new model to identify the performance of circRNA combined with protein factors for the early diagnosis of pre-eclampsia (PE). DesignNested case-control study. SettingUniversity medical centre, Guangzhou, China. PopulationA total of 1400 pregnant women recruited between 8 and 20weeks of gestation. In all, 41 women with PE were included in the study, and were matched with 41 normally pregnant women based on maternal age and gestational age at same-size ratio. MethodsThe samples were analysed using a human circRNA microarray in the discovery phase, then the circRNA and the plasma protein factor endoglin (ENG) were validated. Finally we combined ENG with circRNA to create a new early prediction model for PE. Main outcome measuresEarly changes of circRNA and ENG in PE. ResultsThe circ_101222 levels in blood corpuscles of patients with PE were significantly higher than those in corresponding healthy women (P<0.001). Using ENG in combination with circ_101222 resulted in a sensitivity of 0.7073, a specificity of 0.8049, and overall area under the curve of 0.876 (95% confidence interval 0.816-0.922) for the prediction of PE. ConclusionCircRNA and plasma proteins may have some predictive value for PE (such as circ_101222 and ENG). The performance of each of these factors may be strengthened when plasma proteins are used in combination with circRNA. The results are preliminary and need to be validated in larger studies and other populations. Tweetable abstractPlasma protein endoglin in combination with circ_101222 strengthened the predictive power for pre-eclampsia. Tweetable abstract Plasma protein endoglin in combination with circ_101222 strengthened the predictive power for pre-eclampsia.