作者：王岗，付洪芳，冯皓月，朱琦

单位：

1.643000四川省自贡市第一人民医院中西结合肺病科 2.610075四川省成都市，成都中医药大学附属医院感染科 通信作者：王岗，E-mail：342358533@qq.com

Units：

1.Department of Integrated Traditional Chinese and Western Pulmonary Disease, Zigong First People's Hospital, Zigong643000, China 2.Department of Infectious Disease, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China Corresponding auther: WANG Gang, E-mail: 342358533@qq.com

关键词：

新型冠状病毒肺炎; 空腹血糖; 病死率; Meta分析;

Keywords：

COVID-19; Fasting plasma glucose; Mortality; Meta-analysis

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.078

Funds：

四川省中医药管理局科技项目（2020LC0250）；自贡市医学科学院医药卫生自有基金2021年指导项目（2021ZCYKY02）

摘要：

目的 入院时空腹血糖水平升高与新型冠状病毒肺炎(COVID-19)患者病死率是否有关,目前研究结论存在矛盾,本研究采用Meta分析的方法探讨入院时空腹血糖水平升高与COVID-19患者病死率之间的关系。方法计算机检索Pub Med、Embase、Web of Science、Cochrane Library、中国生物医学文献服务系统、中国知网、万方数据知识服务平台、维普网等数据库,收集有关入院时空腹血糖水平升高与COVID-19患者病死率关系的相关文献(根据入院时空腹血糖水平是否升高将患者分为研究组和对照组)。检索时限为各数据库建库至2021-12-30。采用纽卡斯尔-渥太华量表(NOS)进行文献质量评价,采用Rev Man 5.2进行Meta分析。结果 共包括10篇文献中的5 940例患者纳入研究。Meta分析结果显示,研究组COVID-19患者病死率高于对照组〔OR=5.31,95%CI(3.42,8.24),P<0.000 01〕。根据空腹血糖水平升高诊断切点(分为≥7.0 mmol/L和≥7.7 mmol/L)及地域(分为来自中国和不是来自中国)进行亚组分析,不同空腹血糖水平升高诊断切点研究组COVID-19患者病死率高于对照组(P<0.05);来自中国的文献研究组COVID-19患者病死率高于对照组(P<0.05);不是来自中国的文献研究组与对照组COVID-19患者病死率比较,差异无统计学意义(P>0.05)。结论 入院时空腹血糖水平升高与COVID-19患者病死率有关,但由于纳入文献均为回顾性研究,研究结果需谨慎对待,今后需要更大的样本量和高质量的前瞻性队列研究来验证这一结果。

Abstract：

【Abstract】　ObjectiveThere are conflicting conclusions on whether fasting hyperglycemia at admission is related tothe mortality of coronavirus disease 2019 (COVID-19) . This meta-analysis was conducted to explore the relationship betweenfasting hyperglycemia at admission and mortality in COVID-19.MethodsPubMed, Embase, Web of Science, CochraneLibrary, SinoMed, CNKI, Wanfang Data, and VIP were searched to collect the literature that identified the relationship betweenfasting hyperglycemia at admission and mortality in COVID-19 patients, the retrieval time limit was from the establishmentof each database to December 30, 2021. The patients were divided into study group and control group according to the level offasting plasma glucose at admission whether increased. The Newcastle–Ottawa Scale was used for literature quality evaluation,and RevMan 5.2 was used for meta-analysis.ResultsA total of 5 940 patients from 10 literature were included in this metaanalysis. Meta-analysis results showed that the mortality of COVID-19 patients in the study group was significantly higher thanthat in the control group [OR=5.31, 95%CI(3.42, 8.24) ,P< 0.000 01] . Subgroup analysis was conducted according to differentfasting hyperglycemia cut-off values (≥7.0 mmol/L and≥7.7 mmol/L) and different regions (in Chinese and in non-Chinese) .The mortality of COVID-19 patients in the study group was higher than that in the control group in different fasting hyperglycemiacut-off value subgroups (P< 0.05) . In Chinese regions, the mortality of COVID-19 patients in the study group was higher thanthat in the control group (P< 0.05) . In non-Chinese regions, there was no significant difference in the mortality of COVID-19patients between the study group and the control group (P> 0.05) .ConclusionFasting hyperglycemia at admission is associatedwith mortality in COVID-19 patients. However, the included literatures are retrospective studies, the research results need to betreated with caution. In the future, high-quality prospective cohort studies with larger sample sizes should be conducted to verifythese research results.

ReferenceList：