U-shaped association between serum triglyceride levels and mortality among septic patients: An analysis based on the MIMIC-IV database

Min Xiao; Hongbin Deng; Wenjian Mao; Yang Liu; Qi Yang; Yuxiu Liu; Jiemei Fan; Weiqin Li; Dadong Liu

doi:10.1371/journal.pone.0294779

U-shaped association between serum triglyceride levels and mortality among septic patients: An analysis based on the MIMIC-IV database

PLoS One. 2023 Nov 27;18(11):e0294779. doi: 10.1371/journal.pone.0294779. eCollection 2023.

Authors

Min Xiao¹, Hongbin Deng², Wenjian Mao¹, Yang Liu², Qi Yang³, Yuxiu Liu⁴, Jiemei Fan¹, Weiqin Li¹, Dadong Liu^{1

5}

Affiliations

¹ Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing Medical University, Nanjing, China.
² Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
³ Department of Critical Care Medicine, Jinling Hospital, Nanjing, China.
⁴ Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
⁵ Department of Digestive Disease Institute of Jiangsu University, Affiliated Hospital of Jiangsu University, Zhenjiang, People's Republic of China.

Abstract

Background: Sepsis is characterized by upregulated lipolysis in adipose tissue and a high blood triglyceride (TG) level. It is still debated whether serum TG level is related to mortality in septic patients. The aim of this study is to investigate the association between serum TG level and mortality in septic patients admitted to the intensive care unit (ICU).

Methods: Data from adult septic patients (≥18 years) admitted to the ICU for the first time were obtained from the Multiparameter Intelligent Monitoring in Intensive Care IV (MIMIC-IV) database. The patients' serum TG levels that were measured within the first week after ICU admission were extracted for statistical analysis. The endpoints were 28-day, ICU and in-hospital mortality.

Results: A total of 2,782 septic patients were included. Univariate analysis indicated that the relationship between serum TG levels and the risk of mortality was significantly nonlinear. Both the Lowess smoothing technique and restricted cubic spline analyses revealed a U-shaped association between serum TG levels and mortality among septic patients. The lowest mortality rate was associated with a serum TG level of 300-500 mg/dL. Using 300∼500 mg/dL as the reference range, we found that both hypo-TG (<300 mg/dL) and hyper-TG (≥500 mg/dL) were associated with increased mortality. The result was further adjusted by Cox regression with and without the inclusion of some differential covariates.

Conclusions: There was a U-shaped association between serum TG and mortality in septic ICU patients. The optimal concentration of serum TG levels in septic ICU patients is 300-500 mg/dL.

Copyright: © 2023 Xiao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Adult
Critical Care
Hospital Mortality
Humans
Intensive Care Units
Retrospective Studies
Sepsis*
Shock, Septic*

Grants and funding

This study was supported by the National Natural Science Foundation of China (No. 82202389, No. 81870441, and No. 82070669). The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript.