Elevated alanine transaminase is nonlinearly associated with in-hospital death in ICU-admitted diabetic ketoacidosis patients

医学 危险系数 糖尿病酮症酸中毒 内科学 置信区间 丙氨酸转氨酶 糖尿病 天冬氨酸转氨酶 队列 比例危险模型 重症监护室 队列研究 胰岛素 内分泌学 生物化学 化学 碱性磷酸酶
作者
Qiaoling Liu,Gong Chen,Yunjie Geng,Jiuhong You
出处
期刊:Diabetes Research and Clinical Practice [Elsevier BV]
卷期号:197: 110555-110555 被引量:2
标识
DOI:10.1016/j.diabres.2023.110555
摘要

AimsTo investigate the association between alanine transaminase (ALT) and in-hospital death in patients admitted to the intensive care unit for diabetic ketoacidosis (DKA).MethodsA cohort of 2,684 patients was constructed from the eICU Collaborative Research Database. Baseline demographic and clinical characteristics were summarized. Cox regressions with restricted cubic spline functions were modelled to explore the association between alanine transaminase and in-hospital death. Subgroup analyses were conducted between sexes, age groups, and people with/without obesity.ResultsAfter adjusting multiple confounders, a nonlinear, S-shaped association between ALT and in-hospital death was found. Compared to patients at median ALT, patients at the 90th percentile of ALT have a 1.88 (95 % confidence interval [CI]: 1.34–2.62) times higher hazard of in-hospital death in the unstratified cohort. Similar results were found in males (hazard ratio [HR] = 1.69, 95 % CI: 1.24–2.30); patients aged under 65 years (HR = 1.65, 95 % CI: 1.09–2.49); patients aged 65 years or above (HR = 3.45, 95 % CI: 1.67–7.14); non-obese patients (HR = 1.52, 95 % CI: 1.00–2.32); and obese patients (HR = 2.76, 95 % CI: 1.38–5.54).ConclusionsElevated ALT is robustly associated with in-hospital death in ICU-admitted DKA patients across several subgroups. Close monitoring of ALT in these patients is recommended.
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