Coșarcă Mircea Cătălin, Tilinca Raluca Maria, Lazăr Nicolae Alexandru, Șincaru Suzana Vasilica, Bandici Bogdan Corneliu, Carașca Cosmin, Gergő Ráduly, Mureșan Adrian Vasile, Tilinca Mariana Cornelia
Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania.
Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania.
Medicina (Kaunas). 2025 May 15;61(5):898. doi: 10.3390/medicina61050898.
: Diabetic ketoacidosis (DKA) represents the most prevalent hyperglycemic emergency and poses a significant life-threatening metabolic risk for individuals with diabetes. The present study examines the predictive role of the leukocyte glucose index (LGI) values at baseline in diagnosing the severity of DKA and their correlation with the presence of diabetes-related microvascular complications. : A retrospective observational study was conducted involving a total of 94 patients who had previously confirmed diagnoses of either Type I or Type II diabetes mellitus and presented with ketoacidosis upon emergency admission to the Department of Diabetology, Nutrition, and Metabolic Disease. Demographic information, values of arterial systolic and diastolic pressure, known duration and type of diabetes, severity of ketoacidosis, routine laboratory results, and blood gas analyses were retrieved from the hospital's electronic database. : Higher diastolic blood pressure (DBP) values were observed in both mild ( = 0.021) and severe DKA ( = 0.035) compared to moderate DKA. When examining laboratory data, elevated white blood cell (WBC) counts were observed in severe DKA when compared to mild DKA ( = 0.009), as well as increased neutrophil counts in both moderate ( = 0.038) and severe ( = 0.011) DKA relative to mild DKA. Furthermore, patients with severe DKA exhibited lower values of venous blood pH, partial pressure of carbon dioxide (pvCO), base excess (BE), and bicarbonate than the other groups (all < 0.05), alongside higher levels of lactate, anion gap, and LGI (all < 0.05). Regarding the parameters of arterial blood gas, we identified a negative correlation between LGI values and venous blood pH (r = -0.383, < 0.001), serum bicarbonate (r = -0.352, < 0.001), pCO (r = -0.271, = 0.009), and BE (r = -0.330, < 0.001). At univariate analysis, elevated LGI values are associated with the severity of DKA (OR: 1.87, = 0.016) and diabetes-related microvascular complications (OR: 2.16, = 0.010). : The positive correlation between LGI and DKA severity and between LGI and diabetes microvascular complications highlights the potential utility of LGI as a predictive marker, facilitating early risk stratification and clinical decision-making.
糖尿病酮症酸中毒（DKA）是最常见的高血糖急症，对糖尿病患者构成重大的危及生命的代谢风险。本研究探讨基线时白细胞葡萄糖指数（LGI）值在诊断DKA严重程度中的预测作用及其与糖尿病相关微血管并发症的相关性。：进行了一项回顾性观察研究，共纳入94例先前确诊为I型或II型糖尿病且因酮症酸中毒紧急入住糖尿病、营养与代谢疾病科的患者。从医院电子数据库中获取人口统计学信息、动脉收缩压和舒张压值、已知糖尿病病程和类型、酮症酸中毒严重程度、常规实验室检查结果及血气分析结果。：与中度DKA相比，轻度DKA（P = 0.021）和重度DKA（P = 0.035）患者的舒张压（DBP）值更高。在检查实验室数据时，与轻度DKA相比，重度DKA患者的白细胞（WBC）计数升高（P = 0.009），与轻度DKA相比，中度（P = 0.038）和重度（P = 0.011）DKA患者的中性粒细胞计数均增加。此外，重度DKA患者的静脉血pH值、二氧化碳分压（pvCO₂）、碱剩余（BE）和碳酸氢盐水平均低于其他组（均P < 0.05），同时乳酸、阴离子间隙和LGI水平更高（均P < 0.05）。关于动脉血气参数，我们发现LGI值与静脉血pH值（r = -0.383，P < 0.001）、血清碳酸氢盐（r = -0.352，P < 0.001）、pCO₂（r = -0.271，P = 0.009）和BE（r = -0.330，P < 0.001）呈负相关。在单因素分析中，LGI值升高与DKA严重程度（OR：1.87，P = 0.016）和糖尿病相关微血管并发症（OR：2.16，P = 0.010）相关。：LGI与DKA严重程度以及LGI与糖尿病微血管并发症之间的正相关突出了LGI作为预测标志物的潜在效用，有助于早期风险分层和临床决策。
