Elevated alanine transaminase is nonlinearly associated with in-hospital death in ICU-admitted diabetic ketoacidosis patients

Liu, Q., Gong, C., You, J. and Geng, Y. (2023) Elevated alanine transaminase is nonlinearly associated with in-hospital death in ICU-admitted diabetic ketoacidosis patients. Diabetes Research and Clinical Practice, 197, 110555. (doi: 10.1016/j.diabres.2023.110555) (PMID:36738833)

Abstract

Aims: To investigate the association between alanine transaminase (ALT) and in-hospital death in patients admitted to the intensive care unit for diabetic ketoacidosis (DKA). Methods: A cohort of 2,684 patients was constructed from the eICU Collaborative Research Database. Baseline demographic and clinical characteristics were summarized. Cox regression with restricted cubic spline functions was modelled to explore the nonlinear association between alanine transaminase and in-hospital death. Subgroup analyses were conducted between sexes, age groups, and people with/without obesity. Results: After adjusting multiple confounders, a nonlinear, S-shaped association between ALT and in-hospital death was found. Compared to patients at median ALT, patients at the 90th percentile of ALT have a 1.88 (95% CI: 1.34–2.62) times higher hazard of in-hospital death in the unstratified cohort. Similar results were found in males (hazard ratio (HR)=1.69, 95% confidence interval (CI): 1.24–2.30); patients aged under 65 years (HR=1.65, 95% CI: 1.09–2.49); patients aged 65 years or above (HR=3.45, 95% CI: 1.67–7.14); non-obese patients (HR=1.52, 95% CI: 1.00–2.32); and obese patients (HR=2.76, 95% CI: 1.38–5.54). Conclusions: Elevated ALT is robustly associated with in-hospital death in ICU-admitted DKA patients across several subgroups. Close monitoring of ALT in these patients is recommended.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Liu, Qiaoling
• Authors: Liu, Q., Gong, C., You, J., and Geng, Y.
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: Diabetes Research and Clinical Practice
• Publisher: Elsevier
• ISSN: 0168-8227
• ISSN (Online): 1872-8227
• Published Online: 03 February 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Diabetes Research and Clinical Practice 197:110555
• Publisher Policy: Reproduced under a Creative Commons licence