Association between thiamine deficiency and hyperlactatemia among critically ill patients with diabetes infected by SARS-CoV-2
重症糖尿病患者感染SARS-CoV-2后硫胺素缺乏与高乳酸血症的关系
Abstract
enBackground
The present study aims to verify the association between diabetes and thiamine deficiency in critically ill patients infected by severe acute respiratory syndrome coronavirus 2.
Methods
This is a descriptive cross-sectional study, whose demographic, anthropometric, and laboratory data (arterial lactate, bicarbonate, and plasma thiamine) were obtained in the first hours of admission to the intensive care unit. Patients with diabetes were compared with individuals without diabetes, and the correlation was performed between thiamine and lactate levels. Thiamine levels <28 μg/L were considered as thiamine deficiency.
Results
Overall, 270 patients met the inclusion criteria; 51.1% were men, and the median age was 74 years (66.8-81). The median value of thiamine was 54.0 μg/L (38-72.3), and 15.6% had thiamine deficiency. Among patients with diabetes, 26.3% had thiamine deficiency, and 69.3% had hyperlactatemia. There was an association between thiamine deficiency and diabetes (odds ratio 4.28; 95% CI, 2.08-8.81; P < .001). There was a strong negative correlation between thiamine and arterial lactate in patients with diabetes (r = −0.711, P < .001) and a moderate negative correlation in critically ill patients without diabetes (r = −0.489, P < .001).
Conclusions
The prevalence of thiamine deficiency in critically ill patients due to coronavirus disease 2019 is higher in patients with diabetes. There is a negative correlation between thiamine and arterial lactate levels, which is higher in people with diabetes.
摘要
zh背景
本研究旨在验证严重急性呼吸综合征冠状病毒2型感染的危重患者中, 糖尿病与硫胺素缺乏之间的关系。
方法
这是一项描述性横断面研究, 其人口学、测量学和实验室数据(动脉乳酸、碳酸氢盐和血浆硫胺素)在入住重症监护病房的第一个小时内获得。将糖尿病患者与非糖尿病患者进行比较, 并对硫胺素和乳酸水平进行相关性分析。硫胺素水平<28μg/L被定义为硫胺素缺乏症。
结果
总体上, 270名患者符合纳入标准, 51.1%为男性, 中位年龄为74岁(66.8-81岁)。硫胺素中位数为54.0μg/L(38~72.3), 其中15.6%为硫胺素缺乏症。糖尿病患者中, 26.3%有硫胺素缺乏, 69.3%有高乳酸血症。硫胺素缺乏与糖尿病相关(优势比4.28, 95%可信区间2.08-8.81, P<0.001)。糖尿病患者硫胺素与动脉血乳酸呈强负相关(r=−0.711, P<0.001), 无糖尿病危重患者硫胺素与动脉乳酸呈中度负相关(r=−0.489, P<0.001)。
结论
2019年冠状病毒病所致危重患者中, 糖尿病患者硫胺素缺乏症的患病率更高。硫胺素与动脉乳酸水平呈负相关, 糖尿病患者的血乳酸水平更高。
