scholarly journals Leptin, Ghrelin, and Leptin/Ghrelin Ratio in Critically Ill Patients

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 36 ◽  
Author(s):  
Yaseen M. Arabi ◽  
Dunia Jawdat ◽  
Hasan M. Al-Dorzi ◽  
Hani Tamim ◽  
Waleed Tamimi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Intensive Care Unit ◽  
Regression Analysis ◽  
Critically Ill ◽  
Body Mass ◽  
Critically Ill Patients ◽  
Ghrelin Level ◽  
Multivariable Logistic Regression Analysis ◽  
Blood Samples ◽  
Permissive Underfeeding

The objective of this study was to evaluate leptin, ghrelin, and leptin/ghrelin ratio in critically ill patients and association of leptin/ghrelin ratio with outcomes. This is a sub-study of the PermiT trial (ISRCTN68144998). A subset of 72 patients who were expected to stay >14 days in the Intensive care unit were enrolled. Blood samples were collected on days 1, 3, 5, 7, and 14. Samples were analyzed for leptin and active ghrelin in addition to other hormones. Baseline leptin/ghrelin ratio was calculated, and patients were stratified into low and high leptin/ghrelin ratio based on the median value of 236. There was a considerable variation in baseline leptin level: Median 5.22 ng/mL (Q1, Q3: 1.26, 17.60). Ghrelin level was generally low: 10.61 pg/mL (Q1, Q3: 8.62, 25.36). Patients with high leptin/ghrelin ratio compared to patients with low leptin/ghrelin ratio were older, had higher body mass index and more likely to be diabetic. There were no differences in leptin/ghrelin ratio between patients who received permissive underfeeding and standard feeding. Multivariable logistic regression analysis showed that age and body mass index were significant independent predictors of high leptin–ghrelin ratio. Leptin–ghrelin ratio was not associated with 90-day mortality or other outcomes. Age and body mass index are predictors of high leptin/ghrelin ratio. Leptin/ghrelin ratio is not affected by permissive underfeeding and is not associated with mortality.

Body Mass Index Is Associated With Hospital Mortality in Critically Ill Patients

2013 ◽  
Vol 41 (8) ◽  
pp. 1878-1883 ◽  
Author(s):  
Peter Pickkers ◽  
Nicolette de Keizer ◽  
Joost Dusseljee ◽  
Daan Weerheijm ◽  
Johannes G. van der Hoeven ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Body Mass ◽  
Critically Ill Patients

scholarly journals Middle East Respiratory Syndrome in Critically Ill Patients with Diabetes: A  Multicenter Observational Study of Clinical Presentation, Management and Outcomes

2020 ◽  
Author(s):  
Jesna Jose ◽  
Hasan Al-Dorzi ◽  
Awad Al-Omari ◽  
Yasser Mandourah ◽  
Fahad Al-Hameed ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Risk Factor ◽  
Middle East ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Independent Predictor ◽  
Middle East Respiratory Syndrome ◽  
Multivariable Logistic Regression Analysis ◽  
Presenting Symptoms ◽  
Patients With Diabetes

Abstract Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data and outcomes of critically ill patients with diabetes who developed Middle East Respiratory Syndrome (MERS).Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012-January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms and signs, management and clinical course and outcomes between critically ill MERS patients who had diabetes and those with no diabetes. Multivariable logistic regression analysis was performed to determine if diabetes was an independent predictor of 90-day mortality.Results: Of the 350 MERS patients, 171 (48.9%) had diabetes, were more likely to be older and have comorbid conditions. Patients with diabetes were more likely to present with respiratory failure requiring intubation, vasopressors and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes. Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p<0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality (odds ratio, 2.09; 95% confidence interval, 1.18-3.72).Conclusions: Critically ill patients with diabetes constitute half of critically ill patients with MERS, presenting with more severe disease requiring mechanical ventilation compared to those who do not have diabetes. Diabetes is an independent predictor of mortality.

scholarly journals The Influence of Maternal Obesity on Pregnancy Complications and Neonatal Outcomes in Diabetic and Nondiabetic Women

2018 ◽  
Vol 78 (04) ◽  
pp. 400-406 ◽  
Author(s):  
Burcu Timur ◽  
Hakan Timur ◽  
Aytekin Tokmak ◽  
Hatice Isik ◽  
Elif Eyi
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Regression Analysis ◽  
Body Mass ◽  
Pregnancy Complications ◽  
Diabetic Group ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Multivariable Logistic Regression Analysis ◽  
Gestational Weight

Abstract Introduction This study aimed to investigate the influence of obesity on pregnancy complications and neonatal outcomes in diabetic and nondiabetic women. Materials and Methods This retrospective case control study was conducted on 1193 pregnant women and their neonates at a tertiary level maternity hospital between March 2007 and 2011. The pregnant women were classified into 2 groups according to the presence of diabetes mellitus. Six hundred and seven patients with gestational diabetes or pregestational diabetes formed the diabetic group (study group) and 586 patients were in the nondiabetic group (control group). Demographic characteristics, body mass index, gestational weight gain, obstetric history, smoking status, type of delivery, gestational ages, pregnancy complications, neonatal outcomes were recorded for each patient. Multivariable logistic regression analysis was performed to evaluate the effect of obesity and diabetes on the pregnancy complications and neonatal outcomes. Results The mean age and pre-pregnancy body mass indices of women with diabetes mellitus were significantly higher than the control groupʼs (p < 0.001). Gestational weight gain and number of smokers were similar among the groups. Multiparity and obesity were more prevalent in the diabetic group compared to controls (both p < 0.001). Although gestational age at birth was earlier in the diabetic group, birth weights were higher in this group than in the control group (both p < 0.001). Cesarean delivery rates, the incidence of macrosomia, and neonatal intensive care unit admission rates were significantly higher in the diabetes group both with normal and increased body mass index (all p < 0.001). However, adverse pregnancy outcomes were comparable between the groups (p = 0.279). Multivariable logistic regression analysis showed that obesity is a significant risk factor for pregnancy complications (OR = 1.772 [95% CI, 1.283 – 2.449], p = 0.001) but not for adverse neonatal outcomes (OR = 1.068 [95% CI, 0.683 – 1.669], p = 0.773). Conclusion While obesity increases risk of developing a pregnancy complication, diabetes worsens neonatal outcomes.

scholarly journals Association between Body Mass Index and Short-Term Clinical Outcomes in Critically Ill Patients with Sepsis: A Real-World Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Shan Lin ◽  
Shanhui Ge ◽  
Wanmei He ◽  
Mian Zeng
Keyword(s):  
Body Mass Index ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Body Mass ◽  
Critically Ill Patients ◽  
Medical Information ◽  
Cox Regression ◽  
Normal Weight ◽  
Male Patients ◽  
Using Data

Background. Obesity is now recognized as one of the major public health threats, especially for patients with a critical illness. However, studies regarding whether and how body mass index (BMI) affects clinical outcomes in patients with sepsis are still scarce and controversial. The aim of our study was to determine the effect of BMI on critically ill patients with sepsis. Materials and Methods. We performed this study using data from the Medical Information Center for Intensive Care III database. A multivariate Cox regression model was used to assess the independent association of BMI with the primary outcome. Results. A total of 7,967 patients were enrolled in this study. Firstly, we found that the 28-day mortality was reduced by 22% ( HR = 0.78 , 95% CI 0.69–0.88) and 13% ( HR = 0.87 , 95% CI 0.78–0.98) for obese and overweight compared to normal weight, respectively. Subsequently, a U-shaped association of BMI with 28-day mortality was observed in sepsis patients, with the lowest 28-day mortality at the BMI range of 30–40 kg/m2. Finally, significant interactions were observed only for sex ( P = 0.0071 ). Male patients with a BMI of 25-30 kg/m2 ( HR = 0.74 , 95% CI 0.63–0.86) and 30-40 kg/m2 ( HR = 0.63 , 95% CI 0.53–0.76) had a significantly lower risk of 28-day mortality. Conclusions. A U-shaped association of BMI with 28-day mortality in critically ill sepsis patients was found, with the lowest 28-day mortality at a BMI range of 30–40 kg/m2. Notably, male patients were protected by a higher BMI more effectively than female patients as males had a significantly lower mortality risk.

Sign in / Sign up

Export Citation Format

Share Document