Tang Shanshan, Zhang Zhiqiang, Cheng Yu, Zhang Lizhuang, Wang Qiyao, Wang Cuihua
Department of Cardiology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China.
Cardiac Rehabilitation Group, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
PLoS One. 2025 Jun 25;20(6):e0325006. doi: 10.1371/journal.pone.0325006. eCollection 2025.
The influence of glycemic variability (GV), defined as blood glucose fluctuations, on short-term mortality in patients with aortic diseases, such as aneurysms and dissections, remains understudied. This study evaluates the association between GV and mortality, explores non-linear patterns, and determines a GV threshold predictive of mortality risk.
A retrospective analysis of 2,441 patients with aortic aneurysm or dissection from the MIMIC IV and eICU-CRD databases was performed. Key variables, including demographics, clinical characteristics, comorbidities, laboratory findings, and treatments, were assessed. Logistic and Cox regression models, smooth curve fitting, and subgroup analyses examined associations between GV and ICU and 30-day mortality.
ICU mortality occurred in 165 patients (6.8%), and 30-day mortality in 235 patients (9.6%). Increased GV was linearly associated with ICU mortality risk (P for non-linearity = 0.666). For 30-day mortality, a U-shaped relationship was observed, with minimal risk at a GV index of 0.2047 (P for non-linearity = 0.041). Adjusted models confirmed these findings (ICU mortality: OR = 1.15, 95% CI = 1.03-1.30, 30-day mortality: HR = 1.10, 95% CI = 1.03-1.18).
GV is significantly associated with short-term mortality in aortic disease patients, with a U-shaped pattern for 30-day mortality and an optimal threshold of 0.2047. These findings underscore the importance of tailored glucose management strategies and call for further research into underlying mechanisms.
血糖变异性（GV）定义为血糖波动，其对主动脉疾病（如动脉瘤和夹层）患者短期死亡率的影响仍未得到充分研究。本研究评估了GV与死亡率之间的关联，探索了非线性模式，并确定了预测死亡风险的GV阈值。
对来自MIMIC IV和eICU-CRD数据库的2441例主动脉瘤或夹层患者进行回顾性分析。评估了关键变量，包括人口统计学、临床特征、合并症、实验室检查结果和治疗情况。采用逻辑回归和Cox回归模型、平滑曲线拟合以及亚组分析来研究GV与ICU死亡率和30天死亡率之间的关联。
165例患者（6.8%）发生ICU死亡，235例患者（9.6%）发生30天死亡。GV增加与ICU死亡风险呈线性相关（非线性P值 = 0.666）。对于30天死亡率，观察到呈U形关系，GV指数为0.2047时风险最低（非线性P值 = 0.041）。校正模型证实了这些发现（ICU死亡率：OR = 1.15，95% CI = 1.03 - 1.30；30天死亡率：HR = 1.10，95% CI = 1.03 - 1.18）。
GV与主动脉疾病患者的短期死亡率显著相关，30天死亡率呈U形模式，最佳阈值为0.2047。这些发现强调了定制血糖管理策略的重要性，并呼吁进一步研究潜在机制。
