Fasting Blood Glucose and COVID-19 Severity: Nonlinearity Matters

被引：39

作者：

Alahmad, Barrak ^{[1
]}

Al-Shammari, Abdullah A. ^{[2
,3
]}

Bennakhi, Abdullah ^{[2
]}

Al-Mulla, Fahd ^{[2
]}

Ali, Hamad ^{[2
,4
]}

机构：

[1] Harvard Univ, Harvard TH Chan Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA

[2] Dasman Diabet Inst DDI, Dasman, Kuwait

[3] Kuwait Univ, Fac Sci, Dept Math, Kuwait, Kuwait

[4] Kuwait Univ, Fac Allied Hlth Sci, Dept Med Lab Sci, Hlth Sci Ctr, Kuwait, Kuwait

来源：

DIABETES CARE | 2020年 / 43卷 / 12期

关键词：

DIABETES-MELLITUS; RISK; DISEASE;

D O I：

10.2337/dc20-1941

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

OBJECTIVE Fasting blood glucose (FBG) could be an independent predictor for coronavirus disease 2019 (COVID-19) morbidity and mortality. However, when included as a predictor in a model, it is conventionally modeled linearly, dichotomously, or categorically. We comprehensively examined different ways of modeling FBG to assess the risk of being admitted to the intensive care unit (ICU). RESEARCH DESIGN AND METHODS Utilizing COVID-19 data from Kuwait, we fitted conventional approaches to modeling FBG as well as a nonlinear estimation using penalized splines. RESULTS For 417 patients, the conventional linear, dichotomous, and categorical approaches to modeling FBG missed key trends in the exposure-response relationship. A nonlinear estimation showed a steep slope until about 10 mmol/L before flattening. CONCLUSIONS Our results argue for strict glucose management on admission. Even a small incremental increase within the normal range of FBG was associated with a substantial increase in risk of ICU admission for COVID-19 patients.

引用

页码：3113 / 3116

页数：4

共 13 条

[1]

Alshukry A, 2020, CLIN CHARACTERISTICS

[2]

Influence of diabetes and hyperglycaemia on infectious disease hospitalisation and outcome [J].

Benfield, T. ;

Jensen, J. S. ;

Nordestgaard, B. G. .

DIABETOLOGIA, 2007, 50 (03) :549-554

[3]

PROBLEMS IN THE AVERAGE-RISK INTERPRETATION OF CATEGORICAL DOSE-RESPONSE ANALYSES [J].

GREENLAND, S .

EPIDEMIOLOGY, 1995, 6 (05) :563-565

[4]

Leibovici L, 1996, DIABETIC MED, V13, P457, DOI 10.1002/(SICI)1096-9136(199605)13:5<457::AID-DIA83>3.0.CO

[5]

2-T

[6]

National Research Council, 2007, ASS HUM HLTH RISKS T, P315

[7]

Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies [J].

Sarwar, N. ;

Gao, P. ;

Seshasai, S. R. Kondapally ;

Gobin, R. ;

Kaptoge, S. ;

Di Angelantonio, E. ;

Ingelsson, E. ;

Lawlor, D. A. ;

Selvin, E. ;

Stampfer, M. ;

Stehouwer, C. D. A. ;

Lewington, S. ;

Pennells, L. ;

Thompson, A. ;

Sattar, N. ;

White, I. R. ;

Ray, K. K. ;

Danesh, J. ;

Tipping, R. W. ;

Ford, C. E. ;

Pressel, S. L. ;

Folsom, A. R. ;

Chambless, L. E. ;

Wagenknecht, L. E. ;

Panagiotakos, D. B. ;

Pitsavos, C. ;

Chrysohoou, C. ;

Stefanadis, C. ;

Knuiman, M. ;

Whincup, P. H. ;

Wannamethee, S. G. ;

Morris, R. W. ;

Kiechl, S. ;

Willeit, J. ;

Oberhollenzer, F. ;

Mayr, A. ;

Wald, N. ;

Ebrahim, S. ;

Yarnell, J. W. ;

Gallacher, J. ;

Casiglia, E. ;

Tikhonoff, V. ;

Nietert, P. J. ;

Sutherland, S. E. ;

Bachman, D. L. ;

Keil, J. E. ;

de Boer, I. H. ;

Kizer, J. R. ;

Mukamal, K. J. ;

Tybjaerg-Hansen, A. .

LANCET, 2010, 375 (9733) :2215-2222

[8]

Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific Death [J].

Seshasai, Sreenivasa Rao Kondapally ;

Kaptoge, Stephen ;

Thompson, Alexander ;

Di Angelantonio, Emanuele ;

Gao, Pei ;

Sarwar, Nadeem ;

Whincup, Peter H. ;

Mukamal, Kenneth J. ;

Gillum, Richard F. ;

Holme, Ingar ;

Njolstad, Inger ;

Fletcher, Astrid ;

Nilsson, Peter ;

Lewington, Sarah ;

Collins, Rory ;

Gudnason, Vilmundur ;

Thompson, Simon G. ;

Sattar, Naveed ;

Selvin, Elizabeth ;

Hu, Frank B. ;

Danesh, John .

NEW ENGLAND JOURNAL OF MEDICINE, 2011, 364 (09) :829-841

[9]

Skin and Soft Tissue Infections and Associated Complications among Commercially Insured Patients Aged 0-64 Years with and without Diabetes in the US [J].

Suaya, Jose A. ;

Eisenberg, Debra F. ;

Fang, Christy ;

Miller, Loren G. .

PLOS ONE, 2013, 8 (04)

[10]

Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study [J].

Wang, Sufei ;

Ma, Pei ;

Zhang, Shujing ;

Song, Siwei ;

Wang, Zhihui ;

Ma, Yanling ;

Xu, Juanjuan ;

Wu, Feng ;

Duan, Limin ;

Yin, Zhengrong ;

Luo, Huilin ;

Xiong, Nian ;

Xu, Man ;

Zeng, Tianshu ;

Jin, Yang .

DIABETOLOGIA, 2020, 63 (10) :2102-2111

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