Razali Mohamad Hafis Bin, Hussain Suhaimi, Kamaruzaman Mohd Hazman Bin, Ambak Nurul Jannah Binti
Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
J ASEAN Fed Endocr Soc. 2025 May;40(1):20-25. doi: 10.15605/jafes.040.01.13. Epub 2025 Apr 19.
We aimed to study the prevalence of hypophosphatemia and its associated risk factors in Diabetic Ketoacidosis (DKA) patients in the pediatric population.
We included 65 subjects aged 7 months to 18 years old who were admitted to Hospital Universiti Sains Malaysia (HUSM) for DKA. Patients' socio-demographic and clinical characteristics, and biochemical examinations from their first admission for DKA were analyzed. The diagnosis of DKA was based on the International Society for Pediatric and Adolescent Diabetes (ISPAD) criteria. Multiple logistic regression models examined associations between different variables and hypophosphatemia.
The prevalence of hypophosphatemia in DKA was highest on day 1, at 70.8%, with a mean age of 11 on presentation. Multiple logistic regression analysis showed plasma bicarbonate at day 3 [adjusted odds ratio (OR) 1.2, with a p-value of 0.027] and baseline hemoglobin [adjusted OR 0.62, with p-value 0.009] were significantly associated with hypophosphatemia during DKA.
The prevalence of hypophosphatemia in DKA pediatric patients admitted to our center was highest on day 1 of admission. There were many factors associated with hypophosphatemia from simple logistic regression analysis. However, our final model revealed that plasma bicarbonate on day 3 and baseline Hb were the only significant risk factors for hypophosphatemia in DKA patients in the pediatric population.
我们旨在研究小儿糖尿病酮症酸中毒（DKA）患者中低磷血症的患病率及其相关危险因素。
我们纳入了65名年龄在7个月至18岁之间因DKA入住马来西亚理科大学医院（HUSM）的受试者。分析了患者的社会人口统计学和临床特征，以及他们首次因DKA入院时的生化检查结果。DKA的诊断基于国际儿童和青少年糖尿病协会（ISPAD）的标准。多元逻辑回归模型检验了不同变量与低磷血症之间的关联。
DKA患者中低磷血症的患病率在第1天最高，为70.8%，就诊时的平均年龄为11岁。多元逻辑回归分析显示，第3天的血浆碳酸氢盐[调整后的优势比（OR）为1.2，p值为0.027]和基线血红蛋白[调整后的OR为0.62，p值为0.009]与DKA期间的低磷血症显著相关。
入住我们中心的DKA小儿患者中，低磷血症的患病率在入院第1天最高。单因素逻辑回归分析显示有许多因素与低磷血症有关。然而，我们的最终模型显示，第3天的血浆碳酸氢盐和基线血红蛋白是小儿DKA患者低磷血症的唯一显著危险因素。
