Frontiers in nutrition · 2026
Short-term glycemic variability and the risk of adverse ICU outcomes in critically ill patients: a systematic review and meta-analysis.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wu Zhongyi, Cai Jianzheng, Fang Mingjing, Yu Weixia, Bi Cen, Shi Fang, Lu Xiaoyan
Аннотация
OBJECTIVE: To quantify associations between short-term glycemic variability (GV) metrics and multidimensional adverse outcomes in critically ill patients.
METHODS: We searched PubMed, EMBASE, and Web of Science from inception to August 16, 2025. We included observational studies of adult ICU patients reporting associations between short-term GV and adverse outcomes. Random-effects models were used for all meta-analyses. Where feasible, effect estimates were standardized to a relative risk (RR) comparing the highest versus lowest quartiles of GV.
RESULTS: We included 36 studies (123,911 patients), and 25 were meta-analyzed. ICU mortality was associated with standard deviation (SD; RR = 2.29, 95% CI 1.71-3.07) and mean absolute glucose change (MAG; RR = 2.24, 95% CI 1.19-4.23). Hospital mortality was associated with coefficient of variation (CV, RR = 1.39, 95% CI 1.05-1.85) and SD (RR = 2.26, 95% CI 1.19-4.30). 28/30-day mortality was associated with CV (RR = 1.34, 95% CI 1.10-1.63) and mean amplitude of glycemic excursions (MAGE; RR = 2.05, 95% CI 1.52-2.77), and MAGE also predicted 90-day mortality (RR = 2.90, 95% CI 1.96-4.30). Furthermore, each unit increase in SD predicted higher infection risk (OR = 1.02, 95% CI 1.01-1.04) but not neurological adverse events (OR = 1.23, 95% CI 0.91-1.66).
CONCLUSION: Short-term GV is a robust predictor of mortality across different follow-up windows and clinical settings, as well as infection-related outcomes. The current findings support using short-term GV as a key prognostic marker to complement mean glucose in intensive care.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251114266, identifier PROSPERO (CRD420251114266).
METHODS: We searched PubMed, EMBASE, and Web of Science from inception to August 16, 2025. We included observational studies of adult ICU patients reporting associations between short-term GV and adverse outcomes. Random-effects models were used for all meta-analyses. Where feasible, effect estimates were standardized to a relative risk (RR) comparing the highest versus lowest quartiles of GV.
RESULTS: We included 36 studies (123,911 patients), and 25 were meta-analyzed. ICU mortality was associated with standard deviation (SD; RR = 2.29, 95% CI 1.71-3.07) and mean absolute glucose change (MAG; RR = 2.24, 95% CI 1.19-4.23). Hospital mortality was associated with coefficient of variation (CV, RR = 1.39, 95% CI 1.05-1.85) and SD (RR = 2.26, 95% CI 1.19-4.30). 28/30-day mortality was associated with CV (RR = 1.34, 95% CI 1.10-1.63) and mean amplitude of glycemic excursions (MAGE; RR = 2.05, 95% CI 1.52-2.77), and MAGE also predicted 90-day mortality (RR = 2.90, 95% CI 1.96-4.30). Furthermore, each unit increase in SD predicted higher infection risk (OR = 1.02, 95% CI 1.01-1.04) but not neurological adverse events (OR = 1.23, 95% CI 0.91-1.66).
CONCLUSION: Short-term GV is a robust predictor of mortality across different follow-up windows and clinical settings, as well as infection-related outcomes. The current findings support using short-term GV as a key prognostic marker to complement mean glucose in intensive care.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251114266, identifier PROSPERO (CRD420251114266).