The association between stress hyperglycemia and poor outcome in critically ill children is modulated by hyperlactatemia
BackgroundThe available evidence on tight glycemic control is conflicting, while the interaction between glucose and lactate in critically ill children remains unclear.ObjectiveTo explore the potential role of hyperlactatemia (HL) in modulating the relationship between stress hyperglycemia (SHG) and...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-06-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1518746/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849688794466353152 |
|---|---|
| author | Wenjun Liu Milan Dong Jing Li Guoying Zhang Ju Chen Jianyu Jiang Ling Duan Daoxue Xiong Bo Huang Yingbo Zou Fuyan Liu Hongmin Fu Kai Yu |
| author_facet | Wenjun Liu Milan Dong Jing Li Guoying Zhang Ju Chen Jianyu Jiang Ling Duan Daoxue Xiong Bo Huang Yingbo Zou Fuyan Liu Hongmin Fu Kai Yu |
| author_sort | Wenjun Liu |
| collection | DOAJ |
| description | BackgroundThe available evidence on tight glycemic control is conflicting, while the interaction between glucose and lactate in critically ill children remains unclear.ObjectiveTo explore the potential role of hyperlactatemia (HL) in modulating the relationship between stress hyperglycemia (SHG) and poor outcomes, aiming to establish tailored glucose targets in critically ill children.MethodsThis was a secondary analysis of a prospective observational cohort study conducted in five Pediatric Intensive Care Units (PICU) in southwestern China (ChiCTR2000030846). The interaction effect between glucose and lactate metrics concerning outcomes and subsequent subgroup regression analysis was conducted. SHG was defined as glucose > 150 mg/dL(8.3mmol/L) and HL as lactate > 2 mmol/L.ResultsA cohort of 433 pediatric patients with 4885 arterial blood gas measurements were finally enrolled. 90 (20.8%) cases died within 28 days of PICU admission. Significant interaction effects between SHG and HL on outcomes were observed (p < 0.05). In the non-HL group, SHG was not an independent predictor of 28-day mortality (p = 0.656) and was not correlated with either 28-day ventilator-free days (p = 0.916) or 28-day ICU-free days (p = 0.914). In contrast, in the HL group, SHG was independently associated with 28-day mortality (OR 3.55, 95% CI 1.62~7.80, p = 0.002) and correlated with a reduction of 5.04 28-day ventilator-free days (p = 0.003) and 4.10 28-day ICU-free days (p = 0.004).ConclusionsHL potentially modulates the correlation between SHG and poor outcomes in pediatric critically ill patients. Combined SHG and HL are associated with poor outcomes, whereas SHG without HL is not. |
| format | Article |
| id | doaj-art-4bb8171448e34f6c99dd88d5d0dea438 |
| institution | DOAJ |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-4bb8171448e34f6c99dd88d5d0dea4382025-08-20T03:21:51ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-06-011610.3389/fendo.2025.15187461518746The association between stress hyperglycemia and poor outcome in critically ill children is modulated by hyperlactatemiaWenjun Liu0Milan Dong1Jing Li2Guoying Zhang3Ju Chen4Jianyu Jiang5Ling Duan6Daoxue Xiong7Bo Huang8Yingbo Zou9Fuyan Liu10Hongmin Fu11Kai Yu12Department of Critical Care Medicine, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, ChinaDepartment of Pediatrics, Women and Children’s Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, Chongqing, ChinaDepartment of Critical Care Medicine, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, ChinaDepartment of Pediatric Critical Care, Chengdu Women and Children’s Central Hospital, Chengdu, Sichuan, ChinaDepartment of Pediatric Critical Care, Chengdu Women and Children’s Central Hospital, Chengdu, Sichuan, ChinaDepartment of Pediatric Intensive Medicine, Chongqing University Three Gorges Hospital, Wanzhou, Chongqing, ChinaDepartment of Pediatric Intensive Medicine, Chongqing University Three Gorges Hospital, Wanzhou, Chongqing, ChinaDepartment of Pediatric Intensive Medicine, Chongqing University Three Gorges Hospital, Wanzhou, Chongqing, ChinaDepartment of Pediatric Critical Care, The First People’s Hospital of Zunyi, Zunyi, Guizhou, ChinaDepartment of Pediatric Critical Care, The First People’s Hospital of Zunyi, Zunyi, Guizhou, ChinaDepartment of Pediatric Critical Care, The First People’s Hospital of Zunyi, Zunyi, Guizhou, ChinaDepartment of Pediatric Critical Care, Kunming Children’s Hospital, Kunming, Yunnan, ChinaDepartment of Pediatric Critical Care, Kunming Children’s Hospital, Kunming, Yunnan, ChinaBackgroundThe available evidence on tight glycemic control is conflicting, while the interaction between glucose and lactate in critically ill children remains unclear.ObjectiveTo explore the potential role of hyperlactatemia (HL) in modulating the relationship between stress hyperglycemia (SHG) and poor outcomes, aiming to establish tailored glucose targets in critically ill children.MethodsThis was a secondary analysis of a prospective observational cohort study conducted in five Pediatric Intensive Care Units (PICU) in southwestern China (ChiCTR2000030846). The interaction effect between glucose and lactate metrics concerning outcomes and subsequent subgroup regression analysis was conducted. SHG was defined as glucose > 150 mg/dL(8.3mmol/L) and HL as lactate > 2 mmol/L.ResultsA cohort of 433 pediatric patients with 4885 arterial blood gas measurements were finally enrolled. 90 (20.8%) cases died within 28 days of PICU admission. Significant interaction effects between SHG and HL on outcomes were observed (p < 0.05). In the non-HL group, SHG was not an independent predictor of 28-day mortality (p = 0.656) and was not correlated with either 28-day ventilator-free days (p = 0.916) or 28-day ICU-free days (p = 0.914). In contrast, in the HL group, SHG was independently associated with 28-day mortality (OR 3.55, 95% CI 1.62~7.80, p = 0.002) and correlated with a reduction of 5.04 28-day ventilator-free days (p = 0.003) and 4.10 28-day ICU-free days (p = 0.004).ConclusionsHL potentially modulates the correlation between SHG and poor outcomes in pediatric critically ill patients. Combined SHG and HL are associated with poor outcomes, whereas SHG without HL is not.https://www.frontiersin.org/articles/10.3389/fendo.2025.1518746/fullcritically illchildrenhyperlactatemiastress hyperglycemiaoutcome |
| spellingShingle | Wenjun Liu Milan Dong Jing Li Guoying Zhang Ju Chen Jianyu Jiang Ling Duan Daoxue Xiong Bo Huang Yingbo Zou Fuyan Liu Hongmin Fu Kai Yu The association between stress hyperglycemia and poor outcome in critically ill children is modulated by hyperlactatemia Frontiers in Endocrinology critically ill children hyperlactatemia stress hyperglycemia outcome |
| title | The association between stress hyperglycemia and poor outcome in critically ill children is modulated by hyperlactatemia |
| title_full | The association between stress hyperglycemia and poor outcome in critically ill children is modulated by hyperlactatemia |
| title_fullStr | The association between stress hyperglycemia and poor outcome in critically ill children is modulated by hyperlactatemia |
| title_full_unstemmed | The association between stress hyperglycemia and poor outcome in critically ill children is modulated by hyperlactatemia |
| title_short | The association between stress hyperglycemia and poor outcome in critically ill children is modulated by hyperlactatemia |
| title_sort | association between stress hyperglycemia and poor outcome in critically ill children is modulated by hyperlactatemia |
| topic | critically ill children hyperlactatemia stress hyperglycemia outcome |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1518746/full |
| work_keys_str_mv | AT wenjunliu theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT milandong theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT jingli theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT guoyingzhang theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT juchen theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT jianyujiang theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT lingduan theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT daoxuexiong theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT bohuang theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT yingbozou theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT fuyanliu theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT hongminfu theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT kaiyu theassociationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT wenjunliu associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT milandong associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT jingli associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT guoyingzhang associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT juchen associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT jianyujiang associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT lingduan associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT daoxuexiong associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT bohuang associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT yingbozou associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT fuyanliu associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT hongminfu associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia AT kaiyu associationbetweenstresshyperglycemiaandpooroutcomeincriticallyillchildrenismodulatedbyhyperlactatemia |