Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico; Clinical Laboratory "Los Ángeles, Endocrinology area, rio Nexapa 6153, col. San Manuel, Puebla, C.P. 72560, Mexico.
Clinical Laboratory "Los Ángeles, Endocrinology area, rio Nexapa 6153, col. San Manuel, Puebla, C.P. 72560, Mexico.
Cytokine. 2022 May;153:155868. doi: 10.1016/j.cyto.2022.155868. Epub 2022 Mar 28.
The COVID-19 disease has forced us to consider the physiologic role of obesity and metabolically healthy and unhealthy status in response to SARS-CoV-2 infection. Hematological, coagulation, biochemical, and immunoinflammatory changes have been informed with a disparity in morbidity and mortality. Therefore, we aimed to investigate the influence of metabolic health on clinical features in a cross-sectional study in Mexican subjects with and without SARS-CoV-2 infection in non-severe stages after a rigorous classification of obese and non-obese subjects who were metabolically healthy and unhealthy. Four groups were formed: 1) metabolically healthy with normal BMI (MHN); 2) metabolically unhealthy with normal BMI (MUN); 3) metabolically healthy obese (MHO); 4) metabolically unhealthy obese (MUO). Serum proinflammatory (TNF-α, MCP-1, IL-1β, and IL-6) and anti-inflammatory (TGF-β, IL-1Ra, IL-4, and IL-10) cytokines, hematological parameters, coagulation, and acute phase components were evaluated. Our results showed that MHO people live with inflammaging. Meanwhile, MUN and MUO subjects develop metaflammation. Both inflammaging and metaflammation cause imperceptible modifications on hematological parameters, mainly in leukocyte populations and platelets, as well as acute phase and coagulation components. The statistical analysis revealed that many clinical features are dependent on metabolic health. In conclusion, MHO subjects seem to be transitioning from metabolically healthy to unhealthy, which is accelerated in acute processes, such as SARS-CoV-2 infection. Meanwhile, metabolically unhealthy subjects independently of BMI have a deteriorating immunometabolic status associated with a hyperinflammatory state leading to multi-organ dysfunction, treatment complications, and severe COVID-19 disease.
COVID-19 疾病迫使我们考虑肥胖和代谢健康与不健康状态在应对 SARS-CoV-2 感染中的生理作用。血液学、凝血、生化和免疫炎症变化与发病率和死亡率的差异有关。因此，我们旨在通过一项横断面研究，在非重症阶段感染 SARS-CoV-2 的墨西哥受试者和未感染 SARS-CoV-2 的受试者中，调查代谢健康对临床特征的影响，对肥胖和非肥胖受试者进行了严格的代谢健康与不健康分类。形成了四个组：1）代谢健康正常 BMI（MHN）；2）代谢不健康正常 BMI（MUN）；3）代谢健康肥胖（MHO）；4）代谢不健康肥胖（MUO）。评估了血清促炎（TNF-α、MCP-1、IL-1β 和 IL-6）和抗炎（TGF-β、IL-1Ra、IL-4 和 IL-10）细胞因子、血液学参数、凝血和急性期成分。我们的结果表明，MHO 人群患有炎症老化。同时，MUN 和 MUO 受试者发生代谢炎症。炎症老化和代谢炎症都会对血液学参数产生难以察觉的改变，主要是白细胞和血小板以及急性期和凝血成分。统计分析表明，许多临床特征取决于代谢健康。总之，MHO 受试者似乎正在从代谢健康向不健康状态转变，这种转变在 SARS-CoV-2 感染等急性过程中加速。同时，无论 BMI 如何，代谢不健康的受试者都存在免疫代谢状态恶化的情况，与过度炎症状态相关，导致多器官功能障碍、治疗并发症和严重 COVID-19 疾病。
