Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Anaesthesia and Critical Care, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China.
Diabetes Res Clin Pract. 2020 Oct;168:108381. doi: 10.1016/j.diabres.2020.108381. Epub 2020 Aug 25.
Coronavirus disease 2019 (COVID-19) has become a recognized worldwide pandemic. Researchers now know that mortality from COVID-19 can be reduced through early prevention measures. This retrospective, multi-centered study of 293 COVID-19 patients without diabetes explores the association between fasting blood glucose (FBG) levels and the risk of COVID-19 disease progression, with the goal of providing clinical evidence for glycemic targets in patients.
The multivariate stepwise binary logistic regression analysis was used to test the dose-response effects of FBG levels on the risk of severe and critical condition in COVID-19 patients.
FBG levels were plotted in quintiles with set at <4.74, 4.74-5.21, 5.21-5.78, 5.78-7.05, and ≧7.05 mmol/L. The constituent ratio of severe or critical cases in each FBG quintile was 20.7%, 1.7%, 13.8%, 27.1%, and 67.2%, respectively (P < 0.0001). When the second quintile was used as the reference, the adjusted odds ratios (AORs) (95%CI) for the risk of severe/critical condition in COVID-19 was 25.33 (2.77, 231.64), 1.00 (Reference), 3.13 (0.33, 29.67), 10.59 (1.23, 91.24), 38.93 (4.36, 347.48) per FBG quintile respectively (P < 0.001).
We provide evidence of J-shaped associations between FBG and risk of severe and critical condition in non-diabetes patients with COVID-19, with nadir at 4.74-5.78 mmol/L.
2019 年冠状病毒病（COVID-19）已成为全球公认的大流行疾病。研究人员现在知道，通过早期预防措施可以降低 COVID-19 的死亡率。本项针对 293 例无糖尿病 COVID-19 患者的回顾性多中心研究探讨了空腹血糖（FBG）水平与 COVID-19 疾病进展风险之间的关系，旨在为 COVID-19 患者的血糖目标提供临床证据。
采用多变量逐步二项逻辑回归分析测试 FBG 水平对 COVID-19 患者严重和危急病情风险的剂量反应效应。
将 FBG 水平绘制在五分位数中，设定值分别为<4.74、4.74-5.21、5.21-5.78、5.78-7.05 和≧7.05mmol/L。每个 FBG 五分位数中严重或危急病例的构成比分别为 20.7%、1.7%、13.8%、27.1%和 67.2%（P<0.0001）。当第二五分位数作为参考时，COVID-19 严重/危急情况的调整比值比（AOR）（95%CI）分别为 25.33（2.77，231.64）、1.00（参考）、3.13（0.33，29.67）、10.59（1.23，91.24）和 38.93（4.36，347.48）（P<0.001）。
我们提供了非糖尿病 COVID-19 患者 FBG 与严重和危急病情风险之间呈 J 形关联的证据，谷值在 4.74-5.78mmol/L。
