Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn) & Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), 28034 Madrid, Spain.
Nutrients. 2021 Aug 28;13(9):3010. doi: 10.3390/nu13093010.
We aimed to study the possible association of stress hyperglycemia in COVID-19 critically ill patients with prognosis, artificial nutrition, circulating osteocalcin, and other serum markers of inflammation and compare them with non-COVID-19 patients. Fifty-two critical patients at the intensive care unit (ICU), 26 with COVID-19 and 26 non-COVID-19, were included. Glycemic control, delivery of artificial nutrition, serum osteocalcin, total and ICU stays, and mortality were recorded. Patients with COVID-19 had higher ICU stays, were on artificial nutrition for longer ( = 0.004), and needed more frequently insulin infusion therapy ( = 0.022) to control stress hyperglycemia. The need for insulin infusion therapy was associated with higher energy ( = 0.001) and glucose delivered through artificial nutrition ( = 0.040). Those patients with stress hyperglycemia showed higher ICU stays (23 ± 17 vs. 11 ± 13 days, = 0.007). Serum osteocalcin was a good marker for hyperglycemia, as it inversely correlated with glycemia at admission in the ICU ( = -0.476, = 0.001) and at days 2 ( = -0.409, = 0.007) and 3 ( = -0.351, = 0.049). In conclusion, hyperglycemia in critically ill COVID-19 patients was associated with longer ICU stays. Low circulating osteocalcin was a good marker for stress hyperglycemia.
我们旨在研究 COVID-19 危重症患者应激性高血糖与预后、人工营养、循环骨钙素及其他炎症血清标志物的可能相关性,并将其与非 COVID-19 患者进行比较。共纳入 52 例 ICU 危重症患者,其中 COVID-19 患者 26 例,非 COVID-19 患者 26 例。记录血糖控制、人工营养、血清骨钙素、总住院时间、ICU 住院时间和死亡率。COVID-19 患者的 ICU 住院时间更长,接受人工营养的时间更长(=0.004),且更频繁地需要胰岛素输注治疗(=0.022)来控制应激性高血糖。胰岛素输注治疗的需求与更高的能量(=0.001)和通过人工营养输送的葡萄糖(=0.040)相关。应激性高血糖患者的 ICU 住院时间更长(23±17 天 vs. 11±13 天,=0.007)。血清骨钙素是高血糖的一个良好标志物,因为它与 ICU 入院时的血糖(=−0.476,=0.001)以及第 2 天(=−0.409,=0.007)和第 3 天(=−0.351,=0.049)的血糖呈负相关。总之,COVID-19 危重症患者的高血糖与 ICU 住院时间延长相关。低循环骨钙素是应激性高血糖的一个良好标志物。