Glycemic Variability Is Independently Associated With Poor Prognosis in Five Pediatric ICU Centers in Southwest China

作者：Milan Dong, Wenjun Liu, Yetao Luo, Jing Li, Bo Huang, Yingbo Zou, Fuyan Liu, Guoying Zhang, Chen Ju, Jianyu Jiang, Ling Duan, Daoxue Xiong, Hongmin Fu, Kai Yu · 发表于：Frontiers in Nutrition · 年份：2022 · DOI：10.3389/fnut.2022.757982 · 被引用次数：15 · 研究领域：Hyperglycemia and glycemic control in critically ill and hospitalized patients、Diabetes Management and Research、Sepsis Diagnosis and Treatment

Background Glucose variability (GV) is a common complication of dysglycemia in critically ill patients. However, there are few studies on the role of GV in the prognosis of pediatric patients, and there is no consensus on the appropriate method for GV measurement. The objective of this study was to determine the “optimal” index of GV in non-diabetic critically ill children in a prospective multicenter cohort observational study. Also, we aimed to confirm the potential association between GV and unfavorable outcomes and whether this association persists after controlling for hypoglycemia or hyperglycemia. Materials and Methods Blood glucose values were recorded for the first 72 h and were used to calculate the GV for each participant. Four different metrics [SD, glycemic lability index (GLI), mean absolute glucose (MAG), and absolute change of percentage (ACACP)] were considered and compared to identify the “best” GV index associated with poor prognosis in non-diabetic critically ill children. Among the four metrics, the SD was most commonly used in previous studies, while GLI- and MAG-integrated temporal information, that is the rate and magnitude of change and the time interval between glucose measurements. The fourth metric, the average consecutive ACACP, was introduced in our study, which can be used in real-time clinical decisions. The primary outcome of this study was the 28-day mortality. The receiver operating characteristic (ROC) curve analysis was conducted to compar...