PDF(Pubmed)
Abstract：
UNASSIGNED: Diabetic ketoacidosis (DKA) is the most serious metabolic complication of type 1 diabetes mellitus (T1DM). Insulin deficiency and inflammation play a role in the pathogenesis of DKA. The authors aimed to assess the systemic immune-inflammation index (SII) as a marker of severity among T1DM patients with DKA and without infection.
UNASSIGNED: The authors included T1DM patients older than or equal to 12 years hospitalized because of DKA. The authors excluded patients with infection or any condition that can change SII parameters or cause metabolic acidosis. The authors compared SII, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) between severe and non-severe DKA groups. The authors also assessed the need for an ICU, length of stay, and 90-day readmission rate between the groups.
UNASSIGNED: The study included 241 patients with a median age of 17 (14, 24) years, and 44.8% were males. More patients with severe DKA (45%) required ICU admission (P<0.001). Median SII increased with DKA severity, and the difference was significant (P=0.033). No significant difference was observed as regards median NLR or PLR (P=0.380 and 0.852, respectively). SII, but not NLR or PLR, had a significant negative correlation with PH (r=-0.197, P=0.002) and HCO3 level (r=-0.144, P=0.026). Also, being in the highest SII quartile was an independent risk factor for DKA severity (OR, 2.522; 95% CI, 1.063-6.08; P=0.037). The authors estimated an SII cut-off value of 2524.24 to predict DKA severity with high specificity.
UNASSIGNED: Elevated SII is a risk factor for DKA severity in T1DM. It is better than NLR and PLR in prognosticating DKA patients. These findings highlight the role of inflammation in DKA. SII can help as a valuable and simple tool to assess DKA severity.
UNASSIGNED: The authors included T1DM patients older than or equal to 12 years hospitalized because of DKA. The authors excluded patients with infection or any condition that can change SII parameters or cause metabolic acidosis. The authors compared SII, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) between severe and non-severe DKA groups. The authors also assessed the need for an ICU, length of stay, and 90-day readmission rate between the groups.
UNASSIGNED: The study included 241 patients with a median age of 17 (14, 24) years, and 44.8% were males. More patients with severe DKA (45%) required ICU admission (P<0.001). Median SII increased with DKA severity, and the difference was significant (P=0.033). No significant difference was observed as regards median NLR or PLR (P=0.380 and 0.852, respectively). SII, but not NLR or PLR, had a significant negative correlation with PH (r=-0.197, P=0.002) and HCO3 level (r=-0.144, P=0.026). Also, being in the highest SII quartile was an independent risk factor for DKA severity (OR, 2.522; 95% CI, 1.063-6.08; P=0.037). The authors estimated an SII cut-off value of 2524.24 to predict DKA severity with high specificity.
UNASSIGNED: Elevated SII is a risk factor for DKA severity in T1DM. It is better than NLR and PLR in prognosticating DKA patients. These findings highlight the role of inflammation in DKA. SII can help as a valuable and simple tool to assess DKA severity.
摘要：
■糖尿病酮症酸中毒（DKA）是1型糖尿病（T1DM）最严重的代谢并发症。胰岛素缺乏和炎症在DKA的发病机制中起作用。作者旨在评估全身免疫炎症指数（SII）作为DKA和无感染的T1DM患者严重程度的标志。
■作者纳入了因DKA住院的年龄大于或等于12岁的T1DM患者。作者排除了感染或任何可以改变SII参数或引起代谢性酸中毒的患者。作者比较了SII，中性粒细胞-淋巴细胞比率（NLR），重度和非重度DKA组之间的血小板-淋巴细胞比率（PLR）。作者还评估了ICU的需求，逗留时间,以及组间90天的再入院率。
■该研究包括241名患者，中位年龄为17（14，24）岁，男性占44.8%。更多严重DKA患者（45％）需要入住ICU（P<0.001）。SII中位数随DKA严重程度而增加，差异有统计学意义(P=0.033)。在中值NLR或PLR方面没有观察到显著差异(分别为P=0.380和0.852)。SII,但不是NLR或PLR，与PH(r=-0.197,P=0.002)和HCO3(r=-0.144,P=0.026)呈显著负相关。此外，处于最高SII四分位数是DKA严重程度的独立危险因素(OR，2.522；95%CI，1.063-6.08；P=0.037）。作者估计SII截断值为2524.24，以预测DKA严重程度具有高特异性。
■SII升高是T1DM患者DKA严重程度的危险因素。在预测DKA患者方面优于NLR和PLR。这些发现强调了炎症在DKA中的作用。SII可以作为评估DKA严重程度的有价值和简单的工具。
■作者纳入了因DKA住院的年龄大于或等于12岁的T1DM患者。作者排除了感染或任何可以改变SII参数或引起代谢性酸中毒的患者。作者比较了SII，中性粒细胞-淋巴细胞比率（NLR），重度和非重度DKA组之间的血小板-淋巴细胞比率（PLR）。作者还评估了ICU的需求，逗留时间,以及组间90天的再入院率。
■该研究包括241名患者，中位年龄为17（14，24）岁，男性占44.8%。更多严重DKA患者（45％）需要入住ICU（P<0.001）。SII中位数随DKA严重程度而增加，差异有统计学意义(P=0.033)。在中值NLR或PLR方面没有观察到显著差异(分别为P=0.380和0.852)。SII,但不是NLR或PLR，与PH(r=-0.197,P=0.002)和HCO3(r=-0.144,P=0.026)呈显著负相关。此外，处于最高SII四分位数是DKA严重程度的独立危险因素(OR，2.522；95%CI，1.063-6.08；P=0.037）。作者估计SII截断值为2524.24，以预测DKA严重程度具有高特异性。
■SII升高是T1DM患者DKA严重程度的危险因素。在预测DKA患者方面优于NLR和PLR。这些发现强调了炎症在DKA中的作用。SII可以作为评估DKA严重程度的有价值和简单的工具。
