Association between various blood glucose variability-related indicators during early ICU admission and 28-day mortality in non-diabetic patients with sepsis
Abstract Background Various blood glucose (BG) variability-related indexes have been widely used to assess glycemic control and predict glycemic risks, but the association between BG variations and prognosis in non-diabetic patients with sepsis remains unclear. Methods The single-center retrospectiv...
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BMC
2025-01-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01580-4 |
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| author | Jingyan Zhou Zhiheng Chen Hao-Neng Huang Chun-Quan Ou Xin Li |
| author_facet | Jingyan Zhou Zhiheng Chen Hao-Neng Huang Chun-Quan Ou Xin Li |
| author_sort | Jingyan Zhou |
| collection | DOAJ |
| description | Abstract Background Various blood glucose (BG) variability-related indexes have been widely used to assess glycemic control and predict glycemic risks, but the association between BG variations and prognosis in non-diabetic patients with sepsis remains unclear. Methods The single-center retrospective cohort study included 7,049 non-diabetic adults with sepsis who had at least 3 records of bedside capillary point of care BG testing during the first day after ICU admission from MIMIC-IV database (2008 to 2019). Coefficient of variation and standard deviation of glucose (i.e., GluCV and GluSD), M-value, J-index, high blood glucose index (HBGI), and low blood glucose index (LBGI) were used to describe glucose variability, quality of glycemic control, and glycemic risk of patients with sepsis. The dose-response relationship between BG variability-related indexes and mortality was explored using multivariate logistic regression with restricted cubic spline (RCS) function. If the dose-response curve presented a J-shape with a specific threshold value, a linear threshold function instead of RCS would be employed. Results There is a J-shaped relationship between hospital mortality risk and glucose variability-related indexes in ICU patients with sepsis. The mortality risk remained relatively stable below the threshold of these indexes. However, over the threshold, the 28-day mortality risk increased by 2.82% (95% CI: 1.80–3.85%), 1.13% (95% CI: 0.66–1.60%), 1.96% (95% CI: 0.98–2.95%), 1.37% (95% CI: 0.57–2.16%), 11.19% (95% CI: 6.56–15.98%) and 39.04% (95% CI: 29.86–48.81%) for each unit increases in GluCV, GluSD, M-value, J-index, LBGI and HBGI, respectively. The effects of LBGI and HBGI on 7-day and 14-day mortality were more pronounced. Conclusions High levels of GluCV, GluSD, M-value, J-index, HBGI, and LBGI on the first day of ICU admission were important risk markers of hospital mortality among non-diabetic patients with sepsis. |
| format | Article |
| id | doaj-art-c4d0ec86b6804e5baff6e59841cc9904 |
| institution | Kabale University |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-c4d0ec86b6804e5baff6e59841cc99042025-01-26T12:45:26ZengBMCDiabetology & Metabolic Syndrome1758-59962025-01-0117111010.1186/s13098-025-01580-4Association between various blood glucose variability-related indicators during early ICU admission and 28-day mortality in non-diabetic patients with sepsisJingyan Zhou0Zhiheng Chen1Hao-Neng Huang2Chun-Quan Ou3Xin Li4Department of Emergency Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityState Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical UniversityState Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical UniversityDepartment of Emergency Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Emergency Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityAbstract Background Various blood glucose (BG) variability-related indexes have been widely used to assess glycemic control and predict glycemic risks, but the association between BG variations and prognosis in non-diabetic patients with sepsis remains unclear. Methods The single-center retrospective cohort study included 7,049 non-diabetic adults with sepsis who had at least 3 records of bedside capillary point of care BG testing during the first day after ICU admission from MIMIC-IV database (2008 to 2019). Coefficient of variation and standard deviation of glucose (i.e., GluCV and GluSD), M-value, J-index, high blood glucose index (HBGI), and low blood glucose index (LBGI) were used to describe glucose variability, quality of glycemic control, and glycemic risk of patients with sepsis. The dose-response relationship between BG variability-related indexes and mortality was explored using multivariate logistic regression with restricted cubic spline (RCS) function. If the dose-response curve presented a J-shape with a specific threshold value, a linear threshold function instead of RCS would be employed. Results There is a J-shaped relationship between hospital mortality risk and glucose variability-related indexes in ICU patients with sepsis. The mortality risk remained relatively stable below the threshold of these indexes. However, over the threshold, the 28-day mortality risk increased by 2.82% (95% CI: 1.80–3.85%), 1.13% (95% CI: 0.66–1.60%), 1.96% (95% CI: 0.98–2.95%), 1.37% (95% CI: 0.57–2.16%), 11.19% (95% CI: 6.56–15.98%) and 39.04% (95% CI: 29.86–48.81%) for each unit increases in GluCV, GluSD, M-value, J-index, LBGI and HBGI, respectively. The effects of LBGI and HBGI on 7-day and 14-day mortality were more pronounced. Conclusions High levels of GluCV, GluSD, M-value, J-index, HBGI, and LBGI on the first day of ICU admission were important risk markers of hospital mortality among non-diabetic patients with sepsis.https://doi.org/10.1186/s13098-025-01580-4MIMIC-IVSepsisMortalityGlucose variabilityQuality of glycemic controlGlycemic risk |
| spellingShingle | Jingyan Zhou Zhiheng Chen Hao-Neng Huang Chun-Quan Ou Xin Li Association between various blood glucose variability-related indicators during early ICU admission and 28-day mortality in non-diabetic patients with sepsis Diabetology & Metabolic Syndrome MIMIC-IV Sepsis Mortality Glucose variability Quality of glycemic control Glycemic risk |
| title | Association between various blood glucose variability-related indicators during early ICU admission and 28-day mortality in non-diabetic patients with sepsis |
| title_full | Association between various blood glucose variability-related indicators during early ICU admission and 28-day mortality in non-diabetic patients with sepsis |
| title_fullStr | Association between various blood glucose variability-related indicators during early ICU admission and 28-day mortality in non-diabetic patients with sepsis |
| title_full_unstemmed | Association between various blood glucose variability-related indicators during early ICU admission and 28-day mortality in non-diabetic patients with sepsis |
| title_short | Association between various blood glucose variability-related indicators during early ICU admission and 28-day mortality in non-diabetic patients with sepsis |
| title_sort | association between various blood glucose variability related indicators during early icu admission and 28 day mortality in non diabetic patients with sepsis |
| topic | MIMIC-IV Sepsis Mortality Glucose variability Quality of glycemic control Glycemic risk |
| url | https://doi.org/10.1186/s13098-025-01580-4 |
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