Acute glycemic variability and risk of mortality in patients with sepsis: a meta-analysis

Xiaofei Li; Daofu Zhang; Yongxin Chen; Weiwei Ye; Shuang Wu; Lianqing Lou; Yanshuang Zhu

doi:10.1186/s13098-022-00819-8

Acute glycemic variability and risk of mortality in patients with sepsis: a meta-analysis

Diabetol Metab Syndr. 2022 Apr 23;14(1):59. doi: 10.1186/s13098-022-00819-8.

Authors

Xiaofei Li¹, Daofu Zhang², Yongxin Chen³, Weiwei Ye³, Shuang Wu³, Lianqing Lou³, Yanshuang Zhu³

Affiliations

¹ Department of Infectious Diseases, Yiwu Central Hospital, No. 519 Nanmen Street, Yiwu, 322000, Zhejiang, China. metshep@sina.com.
² Department of Intensive Care Unit, Liaocheng Daochangfu People's Hospital, Liaocheng, 252000, China.
³ Department of Infectious Diseases, Yiwu Central Hospital, No. 519 Nanmen Street, Yiwu, 322000, Zhejiang, China.

Abstract

Background: Acute glycemic variability (GV) has been correlated with the severity of sepsis. The aim of the study was to evaluate the potential association between acute GV and mortality risk in patients with sepsis.

Methods: Cohort studies comparing the risk of death within 3 months between septic patients with higher versus lower acute GV were retrieved by systematic search of Medline, Embase, Web of Science, Wanfang and CNKI databases. We used a random-effect model to pool the data by incorporating the between-study heterogeneity. Sensitivity analyses were performed to evaluate the stability of the findings.

Results: Ten studies including 4296 patients were available for the meta-analysis. Pooled results showed that septic patients with higher acute GV had significantly increased mortality risk compared to those with lower acute GV, as evidenced by results using different parameters including standard deviation of blood glucose (SDBG, risk ratio [RR]: 1.74, 95% confidence interval [CI] 1.36-2.24, p < 0.001; I² = 0%), coefficient of variation of blood glucose (RR: 1.91, 95% CI 1.57-2.31, p < 0.001; I² = 0%), mean amplitude of glycemic excursion (RR: 1.81. 95% CI 1.36-2.40, p < 0.001; I² = 0%), and glycemic lability index (RR: 2.52, 95% CI 1.72-3.68, p < 0.001; I² = 0%). Sensitivity analyses by excluding one study at a time did not significantly affect the results (p all < 0.05).

Conclusions: Higher acute GV may be a predictor of mortality risk in patients with sepsis.

Keywords: Glycemic variability; Meta-analysis; Mortality; Predictor; Sepsis.