Correlation between blood glucose and disease severity in patients having hemorrhagic fever with renal syndrome
WU Chunxiang
XIE Liping
LIN Taofa
WANG Shaoyang
Abstract：Objective To investigate the correlation between blood glucose level and disease severity in patients having hemorrhagic fever with renal syndrome(HFRS).Methods A retrospective analysis was conducted on 139 confirmed HFRS patients admitted to the 900th Hospital of the PLA Joint Logistics Support Force from 2012 to 2021.Patients were divided into four groups based on the highest fasting venous plasma glucose levels during hospitalization for comparative clinical data analysis.Patients were also categorized into two groups based on hormone treatment(Class Ⅰ/Class Ⅱ).Restricted cubic spline were applied to determine the glucose threshold in the non-hormone treatment group.The relationship between blood glucose and disease severity indicators such as white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),platelet count(PLT),prothrombin time(PT),partial thromboplastin time(APTT),length of stay,and disease course was assessed using univariate and multivariate linear regression,as well as univariate and multivariate logistic regression analysis.The relationship between blood glucose and disease progression was further analyzed after adjusting for hormone treatment.Results Statistically significant differences were found among the four groups in terms of age,blood glucose,CRP,PCT,PT,length of stay,disease course,and hormone treatment(P<0.05).The reference thresholds for blood glucose were 6.6 mmol/L and 10.0 mmol/L.Univariate linear or logistic regression analysis showed that the lowest PLT,highest CRP,maximum PT,and maximum APTT in both patient groups were correlated with blood glucose levels.In the non-hormone treatment group,blood glucose was also correlated with the highest PCT,highest white blood cell count,length of stay,and disease course.Multivariate linear regression indicated that in the non-hormone treatment group,for every 1 mmol/L increase in blood glucose,the maximum PT increased by 0.19(95％CI:0.07-0.31),the maximum APTT increased by 1.79(95％CI:0.97-2.62),"the"length of stay increased by 0.58(95％CI:0.20-0.96),and the disease course increased by 0.58(95％CI:0.17-0.99).For every one-level increase in blood glucose,the maximum PT value increased by 0.63(95％CI:0.15-1.10);the length of stay was prolonged by 1.60(95％CI:0.05-3.15).After adjusting for hormone treatment,multivariate linear regression suggested that for every one-level increase in blood glucose,the length of stay was prolonged by 1.48(95％CI:0.17-2.80).No correlation was found between blood glucose and disease classification or outcome(P>0.05);hormone treatment was associated with prolonged length of stay(P=0.020,P=0.040)and blood purification(P=0.030).Conclusion The highest venous plasma blood glucose levels in HFRS patients may be correlated with the severity of the disease.Venous plasma blood glucose of 6.6 mmol/L and 10.0 mmol/L may serve as thresholds indicating disease progression,requiring further investigation with large-sample prospective trials.Hormone treatment is associated with prolonged length of stay,and its clinical use should be approached with caution.
Keywords：hemorrhagic fever with renal syndromeblood glucoseseverity typehormonecorrelation
Publication Date：2024-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 434-442 )