Qi Ling-Yao, Liu Han-Xiong, Cheng Lian-Chao, Luo Yan, Yang Si-Qi, Chen Xu, Cai Lin
Department of Cardiology, The Third People's Hospital of Chengdu Affiliated Hospital of Southwest Jiaotong University, Chengdu, People's Republic of China.
Diabetes Metab Syndr Obes. 2022 Jun 9;15:1725-1736. doi: 10.2147/DMSO.S356461. eCollection 2022.
The leuko-glycaemic index (LGI) is an index that combines white blood cell count and blood glucose and could be a marker of systemic inflammatory response syndrome. The prognostic value of the LGI in acute myocardial infarction (AMI) is still unclear. We aimed to investigate the prognostic value of the LGI for short- and long-term prognosis in AMI patients with different diabetic status.
This was an observational, multicenter study involving 1256 AMI patients admitted in 11 hospitals between March 2014 and June 2019 in Chengdu. White blood cell count and blood glucose were measured on admission. The LGI was calculated by multiplying both values and dividing them by a thousand. Logistic regression was used to explore the predictive value of LGI in in-hospital mortality. Receiver operating characteristic curve was used to determine the optimal cut-off values of the LGI to predict in-hospital mortality. The patients were classified into diabetic and non-diabetic groups and further divided into higher and lower LGI subgroups according to the optimal cut-off values. The endpoints were all-cause mortality during the hospitalization and major adverse cardiovascular and cerebrovascular events (MACCE) during follow-up, including all-cause mortality, non-fatal myocardial infarction, vessel revascularization and non-fatal stroke.
LGI was an independent predictor of all-cause mortality during the hospitalization in non-diabetics, but not in diabetics. The optimal cut-off values of diabetics and non-diabetics were 3593 mg/dl. mm and 1402 mg/dl. mm, respectively. Whether diabetics or not, in-hospital mortality was higher in the higher LGI subgroup (p-value < 0.001). And in the follow-up of 15 months (9 months, 22 months), we observed 99 (8.6%), 6 (0.5%), 54 (4.7%) and 29 (2.5%) cases of death, non-fatal MI, revascularization and non-fatal stroke, respectively. The cumulative incidence of MACCE during follow-up was higher in the higher LGI subgroup, both in the diabetics and non-diabetics (p-value < 0.05). In non-diabetics, higher LGI was an independent predictor of MACCE.
LGI was an independent predictor for short- and long-term prognosis in AMI patients without diabetes, but had no prognostic value for short- and long-term prognosis of AMI patients with diabetes.
白细胞血糖指数（LGI）是一种综合白细胞计数和血糖的指数，可能是全身炎症反应综合征的一个标志物。LGI在急性心肌梗死（AMI）中的预后价值仍不明确。我们旨在研究LGI对不同糖尿病状态的AMI患者短期和长期预后的预后价值。
这是一项观察性多中心研究，纳入了2014年3月至2019年6月期间在成都11家医院收治的1256例AMI患者。入院时测量白细胞计数和血糖。LGI通过将两个值相乘并除以1000来计算。采用逻辑回归分析探讨LGI对院内死亡率的预测价值。采用受试者工作特征曲线确定LGI预测院内死亡率的最佳截断值。将患者分为糖尿病组和非糖尿病组，并根据最佳截断值进一步分为LGI较高和较低的亚组。终点指标为住院期间的全因死亡率和随访期间的主要不良心血管和脑血管事件（MACCE），包括全因死亡率、非致命性心肌梗死、血管重建和非致命性卒中。
LGI是无糖尿病患者住院期间全因死亡率的独立预测因子，但在糖尿病患者中不是。糖尿病患者和非糖尿病患者的最佳截断值分别为3593mg/dl·mm和1402mg/dl·mm。无论是否为糖尿病患者，LGI较高亚组的院内死亡率均较高（p值<0.001）。在15个月（9个月，22个月）的随访中，我们分别观察到99例（8.6%）、6例（0.5%）、54例（4.7%）和29例（2.5%）死亡、非致命性心肌梗死、血管重建和非致命性卒中病例。随访期间，LGI较高亚组的糖尿病患者和非糖尿病患者的MACCE累积发生率均较高（p值<0.05）。在非糖尿病患者中，较高的LGI是MACCE的独立预测因子。
LGI是无糖尿病的AMI患者短期和长期预后的独立预测因子，但对糖尿病AMI患者的短期和长期预后无预后价值。
