Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications

<i>Background and Objectives</i>: Diabetic ketoacidosis (DKA) represents the most prevalent hyperglycemic emergency and poses a significant life-threatening metabolic risk for individuals with diabetes. The present study examines the predictive role of the leukocyte glucose index (LGI) v...

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Main Authors: Mircea Cătălin Coșarcă, Raluca Maria Tilinca, Nicolae Alexandru Lazăr, Suzana Vasilica Șincaru, Bogdan Corneliu Bandici, Cosmin Carașca, Ráduly Gergő, Adrian Vasile Mureșan, Mariana Cornelia Tilinca
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Language:English
Published: MDPI AG 2025-05-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/5/898
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author Mircea Cătălin Coșarcă
Raluca Maria Tilinca
Nicolae Alexandru Lazăr
Suzana Vasilica Șincaru
Bogdan Corneliu Bandici
Cosmin Carașca
Ráduly Gergő
Adrian Vasile Mureșan
Mariana Cornelia Tilinca
author_facet Mircea Cătălin Coșarcă
Raluca Maria Tilinca
Nicolae Alexandru Lazăr
Suzana Vasilica Șincaru
Bogdan Corneliu Bandici
Cosmin Carașca
Ráduly Gergő
Adrian Vasile Mureșan
Mariana Cornelia Tilinca
author_sort Mircea Cătălin Coșarcă
collection DOAJ
description <i>Background and Objectives</i>: Diabetic ketoacidosis (DKA) represents the most prevalent hyperglycemic emergency and poses a significant life-threatening metabolic risk for individuals with diabetes. The present study examines the predictive role of the leukocyte glucose index (LGI) values at baseline in diagnosing the severity of DKA and their correlation with the presence of diabetes-related microvascular complications. <i>Materials and Methods</i>: A retrospective observational study was conducted involving a total of 94 patients who had previously confirmed diagnoses of either Type I or Type II diabetes mellitus and presented with ketoacidosis upon emergency admission to the Department of Diabetology, Nutrition, and Metabolic Disease. Demographic information, values of arterial systolic and diastolic pressure, known duration and type of diabetes, severity of ketoacidosis, routine laboratory results, and blood gas analyses were retrieved from the hospital’s electronic database. <i>Results</i>: Higher diastolic blood pressure (DBP) values were observed in both mild (<i>p</i> = 0.021) and severe DKA (<i>p</i> = 0.035) compared to moderate DKA. When examining laboratory data, elevated white blood cell (WBC) counts were observed in severe DKA when compared to mild DKA (<i>p</i> = 0.009), as well as increased neutrophil counts in both moderate (<i>p</i> = 0.038) and severe (<i>p</i> = 0.011) DKA relative to mild DKA. Furthermore, patients with severe DKA exhibited lower values of venous blood pH, partial pressure of carbon dioxide (pvCO<sub>2</sub>), base excess (BE), and bicarbonate than the other groups (all <i>p</i> < 0.05), alongside higher levels of lactate, anion gap, and LGI (all <i>p</i> < 0.05). Regarding the parameters of arterial blood gas, we identified a negative correlation between LGI values and venous blood pH (r = −0.383, <i>p</i> < 0.001), serum bicarbonate (r = −0.352, <i>p</i> < 0.001), pCO<sub>2</sub> (r = −0.271, <i>p</i> = 0.009), and BE (r = −0.330, <i>p</i> < 0.001). At univariate analysis, elevated LGI values are associated with the severity of DKA (OR: 1.87, <i>p</i> = 0.016) and diabetes-related microvascular complications (OR: 2.16, <i>p</i> = 0.010). <i>Conclusions</i>: The positive correlation between LGI and DKA severity and between LGI and diabetes microvascular complications highlights the potential utility of LGI as a predictive marker, facilitating early risk stratification and clinical decision-making.
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spelling doaj-art-ee22676c2b3945078f4819081105c69b2025-08-20T03:14:41ZengMDPI AGMedicina1010-660X1648-91442025-05-0161589810.3390/medicina61050898Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular ComplicationsMircea Cătălin Coșarcă0Raluca Maria Tilinca1Nicolae Alexandru Lazăr2Suzana Vasilica Șincaru3Bogdan Corneliu Bandici4Cosmin Carașca5Ráduly Gergő6Adrian Vasile Mureșan7Mariana Cornelia Tilinca8Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaClinic of Epidemiology, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaClinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaClinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaClinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaDepartment of Forensic Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaClinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaDiscipline of Internal Medicine, Department ME2, Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania<i>Background and Objectives</i>: Diabetic ketoacidosis (DKA) represents the most prevalent hyperglycemic emergency and poses a significant life-threatening metabolic risk for individuals with diabetes. The present study examines the predictive role of the leukocyte glucose index (LGI) values at baseline in diagnosing the severity of DKA and their correlation with the presence of diabetes-related microvascular complications. <i>Materials and Methods</i>: A retrospective observational study was conducted involving a total of 94 patients who had previously confirmed diagnoses of either Type I or Type II diabetes mellitus and presented with ketoacidosis upon emergency admission to the Department of Diabetology, Nutrition, and Metabolic Disease. Demographic information, values of arterial systolic and diastolic pressure, known duration and type of diabetes, severity of ketoacidosis, routine laboratory results, and blood gas analyses were retrieved from the hospital’s electronic database. <i>Results</i>: Higher diastolic blood pressure (DBP) values were observed in both mild (<i>p</i> = 0.021) and severe DKA (<i>p</i> = 0.035) compared to moderate DKA. When examining laboratory data, elevated white blood cell (WBC) counts were observed in severe DKA when compared to mild DKA (<i>p</i> = 0.009), as well as increased neutrophil counts in both moderate (<i>p</i> = 0.038) and severe (<i>p</i> = 0.011) DKA relative to mild DKA. Furthermore, patients with severe DKA exhibited lower values of venous blood pH, partial pressure of carbon dioxide (pvCO<sub>2</sub>), base excess (BE), and bicarbonate than the other groups (all <i>p</i> < 0.05), alongside higher levels of lactate, anion gap, and LGI (all <i>p</i> < 0.05). Regarding the parameters of arterial blood gas, we identified a negative correlation between LGI values and venous blood pH (r = −0.383, <i>p</i> < 0.001), serum bicarbonate (r = −0.352, <i>p</i> < 0.001), pCO<sub>2</sub> (r = −0.271, <i>p</i> = 0.009), and BE (r = −0.330, <i>p</i> < 0.001). At univariate analysis, elevated LGI values are associated with the severity of DKA (OR: 1.87, <i>p</i> = 0.016) and diabetes-related microvascular complications (OR: 2.16, <i>p</i> = 0.010). <i>Conclusions</i>: The positive correlation between LGI and DKA severity and between LGI and diabetes microvascular complications highlights the potential utility of LGI as a predictive marker, facilitating early risk stratification and clinical decision-making.https://www.mdpi.com/1648-9144/61/5/898diabetic ketoacidosisDKAleukocyte glucose indexLGIbiomarkers
spellingShingle Mircea Cătălin Coșarcă
Raluca Maria Tilinca
Nicolae Alexandru Lazăr
Suzana Vasilica Șincaru
Bogdan Corneliu Bandici
Cosmin Carașca
Ráduly Gergő
Adrian Vasile Mureșan
Mariana Cornelia Tilinca
Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications
Medicina
diabetic ketoacidosis
DKA
leukocyte glucose index
LGI
biomarkers
title Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications
title_full Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications
title_fullStr Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications
title_full_unstemmed Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications
title_short Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications
title_sort elevated leukocyte glucose index lgi is associated with diabetic ketoacidosis dka severity and presence of microvascular complications
topic diabetic ketoacidosis
DKA
leukocyte glucose index
LGI
biomarkers
url https://www.mdpi.com/1648-9144/61/5/898
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