The significance of glycemic variability in conjunction with lactate metabolism levels in the clinical assessment of neonatal hypoxic-ischemic encephalopathy

Abstract The disruption of cerebral cellular energy metabolism represents the initial phase in the pathogenesis of neonatal hypoxic-ischemic encephalopathy (HIE). This study aimed to investigate the significance of glycemic variability (GV) and lactate (LAC) metabolic levels for early assessment of...

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Main Authors: Lili Zhang, Chuanhua Wang, Qi Jia, Hui Li, Fudong Wang, Lijun Jiang
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-14871-7
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author Lili Zhang
Chuanhua Wang
Qi Jia
Hui Li
Fudong Wang
Lijun Jiang
author_facet Lili Zhang
Chuanhua Wang
Qi Jia
Hui Li
Fudong Wang
Lijun Jiang
author_sort Lili Zhang
collection DOAJ
description Abstract The disruption of cerebral cellular energy metabolism represents the initial phase in the pathogenesis of neonatal hypoxic-ischemic encephalopathy (HIE). This study aimed to investigate the significance of glycemic variability (GV) and lactate (LAC) metabolic levels for early assessment of HIE. A retrospective study was conducted on asphyxiated neonates admitted to our hospital from January 2018 to January 2024. Neonates ultimately diagnosed with HIE were categorized into the HIE group, while those excluded from the HIE diagnosis were allocated to the control group. GV was assessed using the difference between maximum and minimum (max-min), standard deviation (SD), and coefficient of variation (CV). Lactate clearance rate (LCR) was used as an indicator of lactate metabolism. We found that GLU CV and LCR were independent risk factors for brain injury following asphyxia. The combination of GLU CV and LCR demonstrated a sensitivity of 84.2% and specificity of 78.6% in predicting HIE, and achieved a sensitivity of 90.0% and specificity of 61.1% in predicting moderate-severe HIE. Early monitoring of GV and LAC levels can serve as valuable indicators for predicting neonatal HIE and assessing disease severity.
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spelling doaj-art-a976c6edb4244d308d90a7a544c0135a2025-08-20T03:04:39ZengNature PortfolioScientific Reports2045-23222025-08-011511910.1038/s41598-025-14871-7The significance of glycemic variability in conjunction with lactate metabolism levels in the clinical assessment of neonatal hypoxic-ischemic encephalopathyLili Zhang0Chuanhua Wang1Qi Jia2Hui Li3Fudong Wang4Lijun Jiang5Department of Neonatology, Affiliated Hospital of Yangzhou UniversityDepartment of Neonatology, Affiliated Hospital of Yangzhou UniversityDepartment of Neonatology, Affiliated Hospital of Yangzhou UniversityDepartment of Interventional Medicine, Yangzhou Hongquan HospitalDepartment of Neonatology, Affiliated Hospital of Yangzhou UniversityDepartment of Neonatology, Affiliated Hospital of Yangzhou UniversityAbstract The disruption of cerebral cellular energy metabolism represents the initial phase in the pathogenesis of neonatal hypoxic-ischemic encephalopathy (HIE). This study aimed to investigate the significance of glycemic variability (GV) and lactate (LAC) metabolic levels for early assessment of HIE. A retrospective study was conducted on asphyxiated neonates admitted to our hospital from January 2018 to January 2024. Neonates ultimately diagnosed with HIE were categorized into the HIE group, while those excluded from the HIE diagnosis were allocated to the control group. GV was assessed using the difference between maximum and minimum (max-min), standard deviation (SD), and coefficient of variation (CV). Lactate clearance rate (LCR) was used as an indicator of lactate metabolism. We found that GLU CV and LCR were independent risk factors for brain injury following asphyxia. The combination of GLU CV and LCR demonstrated a sensitivity of 84.2% and specificity of 78.6% in predicting HIE, and achieved a sensitivity of 90.0% and specificity of 61.1% in predicting moderate-severe HIE. Early monitoring of GV and LAC levels can serve as valuable indicators for predicting neonatal HIE and assessing disease severity.https://doi.org/10.1038/s41598-025-14871-7NewbornHypoxic-ischemic encephalopathyAsphyxiaGlycemic variabilityLactic acidLactate clearance rate
spellingShingle Lili Zhang
Chuanhua Wang
Qi Jia
Hui Li
Fudong Wang
Lijun Jiang
The significance of glycemic variability in conjunction with lactate metabolism levels in the clinical assessment of neonatal hypoxic-ischemic encephalopathy
Scientific Reports
Newborn
Hypoxic-ischemic encephalopathy
Asphyxia
Glycemic variability
Lactic acid
Lactate clearance rate
title The significance of glycemic variability in conjunction with lactate metabolism levels in the clinical assessment of neonatal hypoxic-ischemic encephalopathy
title_full The significance of glycemic variability in conjunction with lactate metabolism levels in the clinical assessment of neonatal hypoxic-ischemic encephalopathy
title_fullStr The significance of glycemic variability in conjunction with lactate metabolism levels in the clinical assessment of neonatal hypoxic-ischemic encephalopathy
title_full_unstemmed The significance of glycemic variability in conjunction with lactate metabolism levels in the clinical assessment of neonatal hypoxic-ischemic encephalopathy
title_short The significance of glycemic variability in conjunction with lactate metabolism levels in the clinical assessment of neonatal hypoxic-ischemic encephalopathy
title_sort significance of glycemic variability in conjunction with lactate metabolism levels in the clinical assessment of neonatal hypoxic ischemic encephalopathy
topic Newborn
Hypoxic-ischemic encephalopathy
Asphyxia
Glycemic variability
Lactic acid
Lactate clearance rate
url https://doi.org/10.1038/s41598-025-14871-7
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