Jiao Xu, Wang Huifang, Li Mingfei, Lu Yun
Emergency Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Horm Metab Res. 2023 Mar;55(3):176-183. doi: 10.1055/a-2010-2345. Epub 2023 Feb 27.
Glycemic disorder may affect the outcomes of patients with intracerebral hemorrhage (ICH). However, the association between glycemic variability (GV) and prognosis in these patients remains to be determined. We performed a meta-analysis to compressive the influence of GV on functional outcome and mortality in patients with ICH. Observational studies comparing the risks of poor functional outcome (defined as modified Rankin Scale>2) and all-cause mortality between ICH patients with higher versus lower acute GV were retrieved by systematic search of Medline, Web of Science, Embase, CNKI, and Wanfang databases. A random-effect model was used to pool the data after incorporating the between-study heterogeneity. Sensitivity analyses were performed to evaluate the stability of the findings. Eight cohort studies involving 3400 patients with ICH were included in the meta-analysis. The follow-up duration was within 3 months after admission. All of the included studies used standard deviation of blood glucose (SDBG) as the indicator of acute GV. Pooled results showed that ICH patients with higher SDBG were associated with a higher risk of poor functional outcome as compared to those with lower SDBG [risk ratio (RR): 1.84, 95% confidence interval (CI): 1.41 to 2.42, p<0.001, I2=0%]. In addition, patients with higher category of SDBG were also associated with a higher mortality risk (RR: 2.39, 95% CI: 1.79 to 3.19, p<0.001, I2=0%). In conclusion, high acute GV may be a predictor of poor functional outcome and mortality of patients with ICH.
血糖紊乱可能会影响脑出血(ICH)患者的预后。然而,这些患者的血糖变异性(GV)与预后之间的关联仍有待确定。我们进行了一项荟萃分析,以比较GV对ICH患者功能结局和死亡率的影响。通过系统检索Medline、Web of Science、Embase、CNKI和万方数据库,检索了比较急性GV较高与较低的ICH患者之间功能结局不良(定义为改良Rankin量表>2)风险和全因死亡率的观察性研究。在纳入研究间异质性后,使用随机效应模型汇总数据。进行敏感性分析以评估研究结果的稳定性。荟萃分析纳入了八项涉及3400例ICH患者的队列研究。随访时间在入院后3个月内。所有纳入研究均使用血糖标准差(SDBG)作为急性GV的指标。汇总结果显示,与SDBG较低的ICH患者相比,SDBG较高的ICH患者功能结局不良的风险更高[风险比(RR):1.84,95%置信区间(CI):1.41至2.42,p<0.001,I2=0%]。此外,SDBG较高类别的患者死亡风险也更高(RR:2.39,95%CI:1.79至3.19,p<0.001,I2=0%)。总之,高急性GV可能是ICH患者功能结局不良和死亡的预测因素。