Abstract
BackgroundThis study aims to explore the correlation between procalcitonin (PCT), 25-hydroxyvitamin D3 (25(OH)D), pentraxin-3 (PTX-3), amylase (AMS) levels and severity of diabetic ketoacidosis complicated by pancreatitis.MethodsA retrospective analysis of 198 patients with diabetic ketoacidosis admitted to our hospital from January 2015 to February 2020 were included. According to whether the patients with pancreatitis, subjects were divided into diabetic ketoacidosis with pancreatitis (DKA-AP) group and diabetic ketoacidosis (DKA) group. Healthy controls admitted to the hospital for physical examinations were included as a control group. Clinical outcomes were collected.ResultsOn the first day after admission, the levels of PCT, PTX-3, and AMS in DKA-AP group were significantly higher than those in DKA group and control group, and 25(OH)D levels in DKA-AP group were lower than those in DKA group and control group. PCT, PTX-3, and AMS levels were significantly increased, and 25(OH)D levels were decreased in the DKA group compared with the control group. Furthermore, the levels of PCT, 25(OH)D, PTX-3, and AMS in the DKA-AP group were correlated with the disease severity of of diabetic ketoacidosis complicated by pancreatitis. The levels of PCT, PTX-3, and AMS in the DKA-AP group on day 1 were significantly higher and 25(OH)D levels were significantly lower than those on days 3–7 after admission. The levels of PCT, PTX-3, and AMS in the DKA group on day 1 were significantly higher and 25(OH)D levels were significantly lower than those on days 2–7 after admission. The levels of these indicators returned to normal levels on day 3 or day 7 in DKA or DKA-AP group, respectively. PCT, PTX-3, and AMS levels in the DKA-AP group were significantly increased, while 25(OH)D levels in the DKA-AP group were decreased compared with DKA group on days 1–6 after admission. The duration of hospital stay, patients of ICU care, duration of ICU stay, and cost in DKA-AP group were all higher than those in the DKA group.ConclusionBlood levels of PCT, 25(OH)D, PTX-3, and AMS were correlated with diabetic ketoacidosis complicated by pancreatitis, and have certain application value in assessment of the disease severity.
Highlights
This study aims to explore the correlation between procalcitonin (PCT), 25-hydroxyvitamin D3 (25(OH)D), pentraxin-3 (PTX-3), amylase (AMS) levels and severity of diabetic ketoacidosis complicated by pancreatitis
Effective indexes are urgently needed to accurately assess the condition of diabetic ketoacidosis complicated by pancreatitis, which could guide clinicians to conduct effective medical treatments
The levels of creatine, HbAlc, blood urea nitrogen (BUN), high-density lipoprotein (HDL), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Carbondioxide combining power (CO2CP), blood glucose, blood potassium, blood ketone, hs-TnT, brain natriuretic peptide (BNP), TG, total cholesterol (TC), lactate, pH, and frequency of diabetic ketoacidosis, type of diabetes, duration of diabetes, vascular complications and abdominal pain were significantly different among the 3 groups (P < 0.05) (Table 1)
Summary
This study aims to explore the correlation between procalcitonin (PCT), 25-hydroxyvitamin D3 (25(OH)D), pentraxin-3 (PTX-3), amylase (AMS) levels and severity of diabetic ketoacidosis complicated by pancreatitis. Studies have shown that about 11% of diabetic ketoacidosis is complicated by pancreatitis, leading to increased incidence of multi-organ failure and mortality and aggravating the disease severity [3]. The diabetic ketoacidosis with pancreatitis is diagnosed by a comprehensive analysis of clinical indicators (including acute physiology and chronic health evaluation II (APACHE II) and Ranson scores), laboratory tests and imaging examinations. Effective indexes are urgently needed to accurately assess the condition of diabetic ketoacidosis complicated by pancreatitis, which could guide clinicians to conduct effective medical treatments
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