Correlative analysis of blood glucose fluctuations within 24 hours of admission on short-term prognosis in patients with acute pancreatitis
10.3760/cma.j.cn115667-20241101-00182
- VernacularTitle:入院24 h血糖波动对急性胰腺炎患者短期预后的相关性分析
- Author:
Yun ZHANG
1
;
Ying XIA
1
;
Jiuhong MA
1
;
Yue GONG
1
Author Information
1. 南昌大学第一附属医院消化内科，南昌 330006
- Publication Type:Journal Article
- Keywords:
Acute pancreatitis;
Blood glucose;
Prognosis
- From:
Chinese Journal of Pancreatology
2025;25(3):206-210
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To Investigate the impact of blood glucose fluctuations within 24 hours of admission on the short-term (3-month) prognosis of patients with acute pancreatitis.Methods:A total of 416 patients with acute pancreatitis admitted to the Department of Gastroenterology of the First Affiliated Hospital of Nanchang University from November 2022 to October 2023 were enrolled as the research subjects. According to whether re-admission occurred within 3 months after discharge, they were divided into good prognosis group ( n=352) and poor prognosis group ( n=64). General data, laboratory indicators, and blood glucose values within 24 hours of admission [including initial blood glucose, 24-hour average blood glucose, maximum blood glucose, minimum blood glucose, standard deviation of blood glucose (SDBG), and largest amplitude of glycemic excursion (LAGE)] were compared between the two groups. Logistic regression analysis was used to identify risk factors affecting the prognosis of patients with acute pancreatitis. Receiver operating characteristic curves (ROC) were plotted and the area under the curve (AUC), sensitivity, and specificity were calculated, so as to evaluate the predictive efficacy of each indicator for the prognosis of patients with acute pancreatitis. Results:Compared with the good prognosis group, the poor prognosis group showed significantly higher levels of initial blood glucose [12.80(7.13, 17.75) mmol/L vs 8.90(6.80, 11.60) mmol/L], maximum blood glucose [16.15(13.45, 21.10) mmol/L vs 11.2(9.10, 14.40) mmol/L], SDBG [4.19(2.47, 5.03) mmol/L vs 1.79(1.15, 2.81) mmol/L], and LAGE [5.15(3.58,7.65) mmol/L vs 4.05(2.40, 5.70) mmol/L], as well as a significantly longer length of hospital stay [10.5(6, 26.75) days vs 9(6, 15) days], with all differences being statistically significant (all P value <0.05). Multivariate logistic regression analysis showed that initial blood glucose ( OR=1.201, 95% CI 1.099-1.313), SDBG ( OR=1.681, 95% CI 1.306-2.164), LAGE ( OR=1.848, 95% CI 1.524-2.240), and length of hospital stay ( OR=1.136, 95% CI 1.082-1.193) were influencing factors for the prognosis of patients with acute pancreatitis. ROC analysis showed that the AUC values for initial blood glucose, SDBG, LAGE, and length of hospital stay were 0.741(0.676-0.806), 0.794 (0.728-0.860), 0.836(95% CI 0.793-0.879), and 0.847(95% CI 0.807-0.887), respectively, with sensitivities of 80.1%, 91.8%, 60.8%, and 64.8%, and specificities of 56.3%, 56.3%, 93.8%, and 93.8%. Conclusions:Blood glucose fluctuations within 24 hours of admission are risk factors for poor prognosis in patients with acute pancreatitis.
