Association of the systemic host immune response with acute hyperglycemia in mechanically ventilated septic patients.
Association of the systemic host immune response with acute hyperglycemia in mechanically ventilated septic patients.
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DOI：
10.1371/journal.pone.0248853
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Shah FA
中科院分区：
文献类型：
--
作者：
Farooq N;Chuan B;Mahmud H;El Khoudary SR;Nouraie SM;Evankovich J;Yang L;Dunlap D;Bain W;Kitsios G;Zhang Y;O'Donnell CP;McVerry BJ;Shah FA
脓毒症期间的高血压与器官功能障碍增加和死亡率升高相关。在脓毒症期间宿主免疫应答在高血糖症发展中的作用仍不清楚。我们对需要机械通气的重症脓毒症成人患者（n = 153）进行了回顾性分析，以研究高血糖与ICU入院第一天（基线）测量的宿主损伤和免疫反应的10个标志物之间的关系。我们确定了每种生物标志物与以下各项之间的关联：（1）通过Pearson相关性收集生物标志物时的葡萄糖、胰岛素和c肽水平;（2）通过线性回归确定ICU入院前两天的平均葡萄糖和血糖变异性;以及（3）通过逻辑回归确定高血糖症（血糖> 180 mg/dL）的发生。结果根据年龄、既往糖尿病、疾病严重程度、胰岛素和糖皮质激素总剂量进行调整。在未校正和校正分析中，基线血浆ST 2和降钙素原水平与ICU入院前两天的平均血糖和血糖变异性呈正相关。此外，较高的基线ST 2、IL-1 ra、降钙素原和正五聚蛋白-3水平与高血糖风险增加相关。我们的研究结果表明，重症脓毒症患者的宿主免疫反应和高血糖之间的关联，特别是涉及白细胞介素-1轴（IL-1 ra），白细胞介素-33轴（ST 2），和宿主对细菌感染的反应（降钙素原，正五聚蛋白-3）。
Hyperglycemia during sepsis is associated with increased organ dysfunction and higher mortality. The role of the host immune response in development of hyperglycemia during sepsis remains unclear. We performed a retrospective analysis of critically ill adult septic patients requiring mechanical ventilation (n = 153) to study the relationship between hyperglycemia and ten markers of the host injury and immune response measured on the first day of ICU admission (baseline). We determined associations between each biomarker and: (1) glucose, insulin, and c-peptide levels at the time of biomarker collection by Pearson correlation; (2) average glucose and glycemic variability in the first two days of ICU admission by linear regression; and (3) occurrence of hyperglycemia (blood glucose>180mg/dL) by logistic regression. Results were adjusted for age, pre-existing diabetes mellitus, severity of illness, and total insulin and glucocorticoid dose. Baseline plasma levels of ST2 and procalcitonin were positively correlated with average blood glucose and glycemic variability in the first two days of ICU admission in unadjusted and adjusted analyses. Additionally, higher baseline ST2, IL-1ra, procalcitonin, and pentraxin-3 levels were associated with increased risk of hyperglycemia. Our results suggest associations between the host immune response and hyperglycemia in critically ill septic patients particularly implicating the interleukin-1 axis (IL-1ra), the interleukin-33 axis (ST2), and the host response to bacterial infections (procalcitonin, pentraxin-3).
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影响因子：
28.2
作者：
Leonidou, Leonidia;Mouzaki, Athanassia;Gogos, Charalambos A.
通讯作者：
Gogos, Charalambos A.
影响因子：
7.7
作者：
Duncan, BB;Schmidt, MI;Heiss, G
通讯作者：
Heiss, G
影响因子：
3.1
作者：
Leonidou, Leonidia;Michalaki, Marina;Gogos, Charalambos A.
通讯作者：
Gogos, Charalambos A.
影响因子：
8.8
作者：
Krinsley, James S.
通讯作者：
Krinsley, James S.
影响因子：
8.8
作者：
Kitsios, Georgios D.;Yang, Libing;McVerry, Bryan J.
通讯作者：
McVerry, Bryan J.