Calcaterra Valeria, Bosoni Pietro, Dilillo Dario, Mannarino Savina, Fiori Laura, Fabiano Valentina, Carlucci Patrizia, Di Profio Elisabetta, Verduci Elvira, Mameli Chiara, Pelizzo Gloria, Zoia Elena, Sacchi Lucia, Larizza Cristiana, Zuccotti Gianvincenzo
Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy.
Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy.
Children (Basel). 2021 May 13;8(5):384. doi: 10.3390/children8050384.
An interaction between metabolic glucose impairment and coronavirus disease 2019 is reported. The development of a severe multisystem inflammatory syndrome in children (MIS-C) related to SARS-CoV-2 infection has been described. We evaluated the impact of MIS-C on glycemic patterns in pediatric patients. A group of 30 children and adolescents affected by MIS-C were considered; all patients were normal weight. Clinical and biochemical assessments, including surrogate markers of insulin resistance (IR) such as homeostasis model analysis-IR (HOMA-IR) and triglyceride-glucose (TyG) indexes, were recorded. Patients were also invited to undergo an intermittently scanned continuous glucose monitoring (isCGM). HOMA-IR index was calculated in 18 patients (60%), of which 17 (94%) revealed a pathological value. TyG index was computed for all patients and pathological values were detected in all cases. In 15 patients, isCGM data were recorded on average for 9 days (±3 days). Overall, average glucose was 105 mg/dL (±16 mg/dL) and average time spent in the 70-180 mg/dL range (TIR) was 93.76%, with nearly 10% of glucose readings in the 141-180 mg/dL range; glycemic fluctuations over the hyperglycemic threshold were detected in four patients. Regular glucose monitoring may be useful to prevent metabolic imbalance and obtain a better outcome.
据报道，代谢性葡萄糖损伤与2019冠状病毒病之间存在相互作用。已描述了与严重急性呼吸综合征冠状病毒2感染相关的儿童严重多系统炎症综合征（MIS-C）的发展情况。我们评估了MIS-C对儿科患者血糖模式的影响。研究纳入了一组30名受MIS-C影响的儿童和青少年；所有患者体重均正常。记录了临床和生化评估结果，包括胰岛素抵抗（IR）的替代标志物，如稳态模型评估-IR（HOMA-IR）和甘油三酯-葡萄糖（TyG）指数。还邀请患者接受间歇性扫描式动态血糖监测（isCGM）。18名患者（60%）计算了HOMA-IR指数，其中17名（94%）显示病理值。计算了所有患者的TyG指数，所有病例均检测到病理值。15名患者平均记录isCGM数据9天（±3天）。总体而言，平均血糖为105mg/dL（±16mg/dL），在70-180mg/dL范围内的平均时间（TIR）为93.76%，141-180mg/dL范围内的血糖读数近10%；4名患者检测到血糖超过高血糖阈值的波动。定期血糖监测可能有助于预防代谢失衡并获得更好的结果。
