The relationship between blood glucose variability, disease severity and prognosis of the patients with acute pancreatitis

doi:10.16139/j.1007-9610.2025.03.07

Abstract

Abstract:

Objective To explore the relationship between blood glucose variability, disease severity and prognosis of the patients with acute pancreatitis. Methods Total of 242 patients with acute pancreatitis admitted to the department of emergency from January 2019 to December 2019 were enrolled. The organ failure was evaluated according to Marshall's score, the severity of the disease was evaluated according to Atlanta's score, and the blood glucose indexes of three groups of patients with mild acute pancreatitis, moderate severe acute pancreatitis and severe acute pancreatitis were compared within seven days after admission. The relationship between blood glucose index and disease severity in different patients with acute pancreatitis was analyzed. Taking whether a puncture was performed at admission, whether the patient was admitted to the intensive care unit (ICU), and whether the patient died as endpoint events as classification factors, the relationship between blood glucose indicators and disease prognosis of patients with acute pancreatitis was analyzed using the One-Way ANOVA, Kruskal-Wallis test, Mann-Whitney U test, receiver operating characteristic curve (ROC curve), etc. Results Of the 242 patients, 70 cases (28.9%) were mild acute pancreatitis, 71 cases (29.3%) with moderate severe acute pancreatitis, 101 cases (41.7%) with severe acute pancreatitis. There was no statistically significant difference in the coefficient of variation of blood glucose among the three groups within 7 days of admission. The mean, standard deviation, maximum, minimum value and difference between maximum and minimum value of venous blood glucose in severe acute pancreatitis group were higher than those in moderate severe acute pancreatitis group, while those in moderate severe acute pancreatitis group were higher than those in mild acute pancreatitis group. The mean value of blood glucose of invasive operation group (IOP) (n=55) was higher than that of non-invasive operation (NOP) group(n=187). Conclusions The blood glucose level and fluctuation range of patients with acute pancreatitis within seven days after admission, are of great significance for the judgment of the severity and prognosis of the disease.

Key words: Mean value of venous blood glucose, Variability of venous blood glucose, Acute pancreatitis, Severity, Puncture

CLC Number:

R576

ZHU Shiyi, LU Tingting, XIE Rongli, TAN Dan, FEI Jian, CHEN Erzhen, CHEN Ying, XIA Yi. The relationship between blood glucose variability, disease severity and prognosis of the patients with acute pancreatitis[J]. Journal of Surgery Concepts & Practice, 2025, 30(03): 223-227.

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Item	MAP(n=70)	MSAP(n=71)	SAP(n=101)	Statistical value	P^a) value	P^b) value	P^c)value
Age (year)	44.97±2.02	49.01±2.03	47.16±1.53	F=1.1	0.34	0.24	0.68
Gender	43/27（61.4）	44/27（62.0）	67/34（66.3）	χ²=0.6	0.76	0.95	0.56
Weight (kg)	77.37±2.28	76.65±2.25	74.61±1.61	F=0.5	0.58	0.96	0.68
Diabetes (%)	15/70（21.4）	17/71（23.9）	25/101（24.8）	χ²=0.3	0.88	0.72	0.90
Biliary (%)	30/70(42.9)	30/71(42.3)	49/101(48.5)	χ²=0.9	0.65	0.94	0.42
Mean blood glucose (mmol/L)	8.26±0.35	9.14±0.37	10.95±0.34	H=213.9	<0.000 1	<0.000 1	<0.000 1
GLUSD ( mmol/L)	1.53±0.12	1.70±0.13	2.69±0.38	H=190.9	<0.000 1	<0.000 1	<0.000 1
GLUCV (%)	0.19±0.01	0.18±0.01	0.22±0.02	H=5.0	0.11	0.19	0.07
GLUmax (mmol/L)	10.30±0.44	11.74±0.50	15.78±1.17	H=222.4	<0.000 1	<0.000 1	<0.000 1
GLUmin (mmol/L)	6.55±0.28	7.12±0.30	7.79±0.25	H=182.0	<0.000 1	<0.000 1	<0.000 1
GLUmax-min (mmol/L)	3.75±0.28	4.63±0.36	7.99±1.13	H=182.9	<0.000 1	<0.000 1	<0.000 1
Marshall socre	0.07±0.04	0.86±0.14	5.73±0.28	H=182.3	<0.000 1	<0.000 1	<0.000 1

Item	IOP(n=59)	NOP(n=183)	Z value	P value
Mean blood glucose (mmol/L)	10.27±0.39	9.43±0.26	-2.3	0.023
GLUSD (mmol/L)	2.04±0.19	2.07±0.22	-0.3	0.728
GLUCV (%)	0.19±0.01	0.20±0.01	-0.8	0.423
GLUmax (mmol/L)	13.52±0.71	12.85±0.69	-1.8	0.08
GLUmin (mmol/L)	7.56±0.31	7.13±0.19	-1.5	0.123
GLUmax-min (mmol/L)	5.96±0.58	5.72±0.64	-1.0	0.294
Marshall socre	5.05±0.48	1.90±0.20	-6.3	<0.0001