Predictive Value of Glycemic Variability and HDL-C for Secondary Persistent Inflammatory Immunosuppressed Catabolic Syndrome in Patients with Sepsis

Figures & data

Table 1 Baseline Patient Demographics and Characteristics

Variables	Non-PICS (n=88)	PICS (n=77)	P
Age (years)	61.19±16.71	67.66±15.16	0.010*
Male [n (%)]	45 (51.14)	37 (48.05)	0.693
ICU stay(d)	28.72±10.92	35.97±16.83	0.017*
APACHE II	20.49±6.69	26.29±8.89	<0.001*
Infection site [n, (%)]
Respiratory system	39 (44.32)	41 (53.25)	0.252
Urinary system	10 (11.36)	7 (9.09)	0.632
Bloodstream	11 (12.5)	8 (10.39)	0.672
Abdomen	25 (28.41)	20 (25.97)	0.726
Others	3 (3.41)	1 (1.30)	0.379
Clinical measures
1d WBCs (×10^9/L)	14.58±6.79	15.41±8.63	0.490
1d Neutrophil (×10^9/L)	13.39±10.14	14.49±11.75	0.517
1d LYM (×10^9/L)	0.89±1.12	0.87±1.12	<0.001*
1d CRP (mg/L)	121.14±64.44	121.34±62.24	0.147
1d ALB (g/L)	28.60±6.45	27.28±4.25	0.130
Lac (mmol/L)	3.84±2.53	3.88±2.53	0.481
PCT (ng/mL)	26.35±29.24	119.68±806.59	0.279
HbA1c (%)	6.14±0.83	6.97±1.76	<0.001*
14d WBCs (×10^9/L)	10.10±5.28	9.97±5.28	0.870
14d Neutrophil (×10^9/L)	8.10±4.15	8.75±5.29	0.379
14d LYM (×10^9/L)	1.11±0.59	0.53±0.22	<0.001*
14d CRP (mg/L)	142.87±762.84	89.51±63.17	0.542
14d ALB (g/L)	31.08±3.78	25.22±2.63	<0.001*
GV (%)	19.89±6.58	27.46±8.33	<0.001*
GLUave	8.25±3.12	11.37±4.28	<0.001*
IL-6 (pg/mL)	605.30±135.74	785.78±160.20	<0.001*
IL-8 (pg/mL)	108.03±228.35	110.84±138.97	<0.001*
IL-10 (pg/mL)	33.75±37.81	55.79±23.98	0.036*
1d HDL (mmol/L)	0.71±0.19	0.51±0.17	<0.001*
1d LDL-C (mmol/L)	1.88±0.45	1.69±0.35	0.092
1d TC (mmol/L)	2.75±1.26	2.54±1.60	0.062

Notes: Except for 14-day WBCs, Neutrophil, LYM, CRP, and ALB, all were 1d data. GV, GLUave is a 7 day mean. *P<0.05.

Abbreviations: APACHE II, acute physiology and chronic health evaluation II; WBCs, white blood cells; LYM, lymphocyte; CRP, C-reactive protein; ALB, albumin; Lac, lactic acid; PCT, procalcitonin; HbA1c, glycated hemoglobin; GV, glycemic variability; GLUave, glucose average; IL-6, interleukin-6; IL-8, interleukin-8; IL-10, interleukin-10; HDL-C, high density lipid-cholesterol; LDL-C, low-density lipoprotein cholesterol; TC, cholesterol.

Figure 1 (A) Effects of different levels of age, ICU stay, APACHE II, HbA1c, GV and GLUave on mortality in patients with sepsis secondary PICS. (B) Effects of different levels of IL-6, IL-8, IL-10, 1d LYM, 14d LYM, 14dALB and 1d HDL-C on mortality in patients with sepsis secondary PICS. **P<0.01, *P<0.05.

Abbreviations: APACHE II, acute physiology and chronic health evaluation II; HbA1c, glycated hemoglobin; GV, glycemic variability; GLUave, glucose average; IL-6, interleukin-6; IL-8, interleukin-8; IL-10, interleukin-10; LYM, lymphocyte; ALB, albumin; HDL-C, high density lipid-cholesterol.

Table 2 Characteristic Analysis of Patients Receiving Insulin Therapy

Variables	Insulin Treatment (n=45)	Non-Insulin Treatment (n=120)	P
GV (%)	25.13±5.72	19.22±6.13	0.073
HDL-C (mmol/L)	0.58±0.21	0.69±0.16	0.216
PICS [n, (%)]	28 (62.2)	49 (40.83)	0.157

Table 3 Binary Logistic Regression Analysis of Secondary PICS Risk Factors in Patients with Sepsis

Variables	β	SE	χ^2	P	OR	95% CI
Constant	−0.637	1.287	0.245	<0.001	0.529	–
HDL-C (mmol/L)	−4.331	1.211	12.797	<0.001	0.013	0.001~0.141
GV (%)	0.085	0.028	8.944	0.003	1.089	1.030~1.151
APACHEII	0.036	0.014	6.209	0.013	1.036	1.008~1.066

Table 4 ROC Curve Parameter

Variables	AUC	SE	P	95% CI	Youden Index	Sensitivity (%)	Specificity (%)
GV (%)	0.760	0.039	<0.001	0.683~0.836	0.593	77.5	81.8
HDL-C (mmol/L)	0.780	0.035	<0.001	0.151~0.289	0.514	76.6	74.8

Figure 2 ROC curve of the predictive value of GV and HDL-C for secondary PICS in sepsis patients.

Abbreviations: GV, glycemic variability; HDL-C, high density lipid-cholesterol.