在两个队列研究中,血红蛋白A1c升高和发展ARDS的风险
Avery M Bogart1,2, Christine R Lopez3, Sarah N Obeidalla4
1Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN.
CHEST critical care
|October 18, 2024
概括
血糖控制不足,由血红蛋白A1c (HbA1c) 升高表明,即使没有糖尿病诊断,也可能增加患急性呼吸困扰综合征 (ARDS) 的风险. 需要进一步的研究来证实这一关联.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 内分泌学 在内分泌学.
背景情况:
- 糖尿病等先前存在的疾病对急性呼吸窘迫综合征 (ARDS) 风险的贡献尚不清楚.
- 以前对糖尿病和ARDS的研究产生了相互矛盾的结果.
研究的目的:
- 为了调查血红蛋白A1c (HbA1c) 水平是否作为长期血糖控制的标志物,澄清了糖尿病和ARDS风险之间的关联.
- 为了确定HbA1c是否比正式的糖尿病诊断更好地预测ARDS.
主要方法:
- 分析了来自两个前性观察队伍 (VALID和EARLI) 的数据.
- 研究了HbA1c类别与风险患者ARDS发展之间的关联.
- 包括在注册前180天内或注册后14天内测量HbA1c的患者.
主要成果:
- 在任何一个队列中,正式的糖尿病诊断与ARDS风险增加没有显著的相关性.
- 血糖控制不充分的患者 (HbA1c升高) 在VALID队列中显示ARDS的风险明显更高 (P = .0073).
- 这种关联在多变量分析和结合两个队列时得到证实,表明血糖控制不足作为潜在的ARDS风险因素.
结论:
- 升高的HbA1c可能是ARDS的独立风险因素,无论糖尿病诊断如何.
- 不充分的血糖控制可能是ARDS未知的风险因素.
- 需要进行前性验证研究来证实这些发现.
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