A retrospective analysis of the prognostic implications of glycemic variability on all-cause mortality in critically ill patients with mitral valve disease
BackgroundMitral valve disease is associated with higher cardiovascular morbidity and mortality. Glycemic variability (GV), reflecting blood glucose fluctuations, acts as an independent indicator for results in critically ill patients. However, it’s effect on patients in the ICU with mitral valve di...
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Frontiers Media S.A.
2025-07-01
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| author | Jie Peng Xingzhan Zhang Yunjing Mai Hongzhi Chen Dakai Liang Shaobo Li Huanhuan Wu Chao Li YuanShuo Ge Guangdong Wang Ling Zhao |
| author_facet | Jie Peng Xingzhan Zhang Yunjing Mai Hongzhi Chen Dakai Liang Shaobo Li Huanhuan Wu Chao Li YuanShuo Ge Guangdong Wang Ling Zhao |
| author_sort | Jie Peng |
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| description | BackgroundMitral valve disease is associated with higher cardiovascular morbidity and mortality. Glycemic variability (GV), reflecting blood glucose fluctuations, acts as an independent indicator for results in critically ill patients. However, it’s effect on patients in the ICU with mitral valve disease is unclear.MethodsAll blood glucose measurements of patients with mitral valve disease were extracted from MIMIC-IV database. GV was assessed using the coefficient of variation of glucose levels. Cox hazard regression models and restrictive cubic spline (RCS) were applied to examine the link between GV and outcomes. A threshold effect analysis was also conducted to explore potential inflection points. Subgroup analyses were performed to assess consistency across demographics and clinical subgroups.ResultsThe study of 3,378 adults with mitral valve disease found that higher GV was significantly associated with increased 28-day and 90-day mortality, as shown by Cox regression analysis. Subgroup analyses confirmed these findings.ConclusionsFor ICU patients with mitral valve disease, elevated GV was an independent predictor of short-term mortality. GV was recommended for consideration in risk stratification and glucose management strategies, particularly in non-diabetic critically ill populations. Monitoring and targeting GV were proposed to new avenues for improving clinical outcomes in this high-risk group. |
| format | Article |
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| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-a99257b0f9b048b4aad9d26ff913e06f2025-07-14T04:10:11ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.16207621620762A retrospective analysis of the prognostic implications of glycemic variability on all-cause mortality in critically ill patients with mitral valve diseaseJie Peng0Xingzhan Zhang1Yunjing Mai2Hongzhi Chen3Dakai Liang4Shaobo Li5Huanhuan Wu6Chao Li7YuanShuo Ge8Guangdong Wang9Ling Zhao10Department of Intensive Care Unit, The People’s Hospital Medical Group of Xiangzhou, Zhuhai, Guangdong, ChinaDepartment of Intensive Care Unit, The People’s Hospital Medical Group of Xiangzhou, Zhuhai, Guangdong, ChinaDepartment of Intensive Care Unit, The People’s Hospital Medical Group of Xiangzhou, Zhuhai, Guangdong, ChinaDepartment of Intensive Care Unit, The People’s Hospital Medical Group of Xiangzhou, Zhuhai, Guangdong, ChinaDepartment of Cardiology, People’s Hospital of Yangjiang, Yangjiang, Guangdong, ChinaDepartment of Cardiovascular and Metabolism Medicine, The People’s Hospital Medical Group of Xiangzhou, Zhuhai, Guangdong, ChinaDepartment of Intensive Care Unit, The People’s Hospital Medical Group of Xiangzhou, Zhuhai, Guangdong, ChinaDepartment of Intensive Care Unit, The People’s Hospital Medical Group of Xiangzhou, Zhuhai, Guangdong, ChinaJinzhou Medical University, Jinzhou, Liaoning, ChinaDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shanxi, ChinaDepartment of Intensive Care Unit, The People’s Hospital Medical Group of Xiangzhou, Zhuhai, Guangdong, ChinaBackgroundMitral valve disease is associated with higher cardiovascular morbidity and mortality. Glycemic variability (GV), reflecting blood glucose fluctuations, acts as an independent indicator for results in critically ill patients. However, it’s effect on patients in the ICU with mitral valve disease is unclear.MethodsAll blood glucose measurements of patients with mitral valve disease were extracted from MIMIC-IV database. GV was assessed using the coefficient of variation of glucose levels. Cox hazard regression models and restrictive cubic spline (RCS) were applied to examine the link between GV and outcomes. A threshold effect analysis was also conducted to explore potential inflection points. Subgroup analyses were performed to assess consistency across demographics and clinical subgroups.ResultsThe study of 3,378 adults with mitral valve disease found that higher GV was significantly associated with increased 28-day and 90-day mortality, as shown by Cox regression analysis. Subgroup analyses confirmed these findings.ConclusionsFor ICU patients with mitral valve disease, elevated GV was an independent predictor of short-term mortality. GV was recommended for consideration in risk stratification and glucose management strategies, particularly in non-diabetic critically ill populations. Monitoring and targeting GV were proposed to new avenues for improving clinical outcomes in this high-risk group.https://www.frontiersin.org/articles/10.3389/fendo.2025.1620762/fullglycemic variabilitymitral valve diseaseMIMIC-IV databaseall-cause mortalitycritical ill patient |
| spellingShingle | Jie Peng Xingzhan Zhang Yunjing Mai Hongzhi Chen Dakai Liang Shaobo Li Huanhuan Wu Chao Li YuanShuo Ge Guangdong Wang Ling Zhao A retrospective analysis of the prognostic implications of glycemic variability on all-cause mortality in critically ill patients with mitral valve disease Frontiers in Endocrinology glycemic variability mitral valve disease MIMIC-IV database all-cause mortality critical ill patient |
| title | A retrospective analysis of the prognostic implications of glycemic variability on all-cause mortality in critically ill patients with mitral valve disease |
| title_full | A retrospective analysis of the prognostic implications of glycemic variability on all-cause mortality in critically ill patients with mitral valve disease |
| title_fullStr | A retrospective analysis of the prognostic implications of glycemic variability on all-cause mortality in critically ill patients with mitral valve disease |
| title_full_unstemmed | A retrospective analysis of the prognostic implications of glycemic variability on all-cause mortality in critically ill patients with mitral valve disease |
| title_short | A retrospective analysis of the prognostic implications of glycemic variability on all-cause mortality in critically ill patients with mitral valve disease |
| title_sort | retrospective analysis of the prognostic implications of glycemic variability on all cause mortality in critically ill patients with mitral valve disease |
| topic | glycemic variability mitral valve disease MIMIC-IV database all-cause mortality critical ill patient |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1620762/full |
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