Influence of the metabolic syndrome and its components on the condition and prognosis of patients with severe pneumonia_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHANG Jing ¹ , WANG Huihui ¹ , DENG Huaying ² ,  LAI Fang ^3,4,5 , ZHOU Gengbiao ³ , HAN Yun ³

1. The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China;
2. The First Clinical Medical College, Guangzhou University of Chinese Medicine,Guangzhou, Guangdong 510010, P.R. China;
3. The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese, Guangzhou, Guangdong 510120, P.R. China;
4. Chao Enxiang Famous Chinese Medicine Expert lnheritance Studio, Guangdong Provincial Hospital of Chinese, Guangzhou, Guangdong 510120, P.R. China;
5. Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, Guangdong 510120, P.R. China;

Corresponding?author：

LAI Fang, Email: laifang@gzucm.edu.cn

Keywords：

Metabolic syndrome; Severe pneumonia; Prognosis

DOI：

10.7507/1671-6205.202311010

Video：

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Objective To explore the effects of Metabolic Syndrome (MS) and its components on the condition and prognosis of patients with Severe Pneumonia. Methods 306 patients with severe pneumonia admitted to the intensive care unit of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2020 to July 2023 were included as study subjects.The patients were divided into MS and non-MS groups according to whether they were combined with MS,and into survival and death groups according to 28-day prognosis,and the general data, laboratory indexes, condition and prognostic indexes of the two groups were compared; multifactorial logistic regression was used to analyze the independent risk factors for the prognosis of patients with severe pneumonia. ResultsThe levels of test indicators such as body mass index (BMI), fasting blood glucose (FBG), triglyceride (TG), blood lactate,white blood cell count(WBC),urea phosphate (Urea), creatinine (SCr),as well as the incidence of acute respiratory distress syndrome (ARDS), shock,multiple organ dysfunction syndrome (MODS), rate of endotracheal intubation and mortality, ICU treatment cost,and total treatment cost of the MS group were significantly higher than those of the non-MS group; the levels of high-density lipoprotein cholesterol (HDL-C) and oxygenation index (OI) of the MS group were significantly lower than those of the non-MS group (P<0.05).Multifactorial logistic regression analysis showed that the risk of death from severe pneumonia was 1.276 times higher in combined MS than in no combined MS (95%CI: 1.013, 5.114, P=0.047). Subgroup analyses also showed that the risk of death from non-viral severe pneumonia was 2.147 times higher in those with MS than those without (95%CI: 1.175, 8.428, P=0.023). ConclusionSevere pneumonia with MS may be more severe and may have a worse prognosis.

Citation： ZHANG Jing, WANG Huihui, DENG Huaying, LAI Fang, ZHOU Gengbiao, HAN Yun. Influence of the metabolic syndrome and its components on the condition and prognosis of patients with severe pneumonia. Chinese Journal of Respiratory and Critical Care Medicine, 2024, 23(4): 249-255. doi: 10.7507/1671-6205.202311010 Copy

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21.	Aslan ?in NN, Yard?mc? H, Ko? N, et al. iglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: a cross-sectional study. J Pediatr Endocrinol Metab, 2020, 24,33(6): 777-784.

1. Nair GB, Niederman MS. Updates on community acquired pneumonia management in the ICU. Pharmacol Ther. 2021;217: 107663.
2. Saklayen MG. The Global Epidemic of the Metabolic Syndrome. Curr Hypertens Rep. 2018;20(2): 12.
3. Szilveszter M, Pál S, Simon-Szabó Z, et al. The Management of COVID-19-Related Coagulopathy: A Focus on the Challenges of Metabolic and Vascular Diseases. Int J Mol Sci. 2023;24(16): 12782.
4. Smith M, Honce R, Schultz-Cherry S. Metabolic Syndrome and Viral Pathogenesis: Lessons from Influenza and Coronaviruses. Journal of Virology. 2020;94(18).
5. 中華醫學會呼吸病學分會. 中國成人社區獲得性肺炎診斷和治療指南(2016年版). 中華結核和呼吸雜志, 2016, 39(4): 253-279.
6. 中華醫學會糖尿病學分會代謝綜合征研究協作組. 中華醫學會糖尿病學分會關于代謝綜合征的建議. 中華糖尿病雜志, 2004(3): 5-10.
7. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA, 2001, 285(19): 2486-2497.
8. Venet F, Monneret G. Advances in the understanding and treatment of sepsis-induced immunosuppression. Nat Rev Nephrol, 2018, 14(2): 121-137.
9. Shimabukuro-Vornhagen A, G?del P, Subklewe M, et al. Cytokine release syndrome. J Immunother Cancer, 2018, 6(1): 56.
10. Cavallazzi R, Furmanek S, Arnold FW, et al. The Burden of Community-Acquired Pneumonia Requiring Admission to ICU in the United States. Chest. 2020, 158(3): 1008-1016.
11. Grandl G, Wolfrum C. Hemostasis, endothelial stress, inflammation, and the metabolic syndrome. Semin Immunopathol. 2018, 40(2): 215-224.
12. Qiu L, Gao C, Wang H, et al. Effects of dietary polyphenol curcumin supplementation on metabolic, inflammatory, and oxidative stress indices in patients with metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne). 2023, 14: 1216708.
13. Yao F, Bo Y, Zhao L, et al. Prevalence and Influencing Factors of Metabolic Syndrome among Adults in China from 2015 to 2017. Nutrients. 2021, 13(12): 4475.
14. Wang J, Zhu L, Liu L, et al. Clinical features and prognosis of COVID-19 patients with metabolic syndrome: A multicenter, retrospective study. Med Clin (Barc), 2022, 158(10): 458-465.
15. Steenblock C, Schwarz PEH, Ludwig B, et al. COVID-19 and metabolic disease: mechanisms and clinical management. The Lancet Diabetes & Endocrinology. 2021, 9(11): 786-798.
16. Diabetes Canada Clinical Practice Guidelines Expert Committee, Punthakee Z, Goldenberg R, et al. Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Can J Diabetes. 2018, 42 Suppl 1: S10-S15.
17. Chen Y, Xu W, Zhang W, et al. Plasma metabolic fingerprints for large-scale screening and personalized risk stratification of metabolic syndrome. Cell Rep Med. 2023, 4(7): 101109.
18. Nisar M, Iqbal MUN. Influence of hs-CRP, IL-6 and TNF-α and it’s role in dyslipidemia and type 2 diabetes in population of Karachi, Pakistan. Pak J Pharm Sci. 2021, 34(3(Special)): 1217-1225.
19. Berbudi A, Rahmadika N, Tjahjadi AI, et al. Type 2 Diabetes and its Impact on the Immune System. Curr Diabetes Rev. 2020;16(5):442-449.
20. Sakr HF, Sirasanagandla SR, Das S, et al. Insulin Resistance and Hypertension: Mechanisms Involved and Modifying Factors for Effective Glucose Control. Biomedicines, 2023, 11(8): 2271.
21. Aslan ?in NN, Yard?mc? H, Ko? N, et al. iglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: a cross-sectional study. J Pediatr Endocrinol Metab, 2020, 24,33(6): 777-784.

Chinese Journal of Respiratory and Critical Care Medicine

Influence of the metabolic syndrome and its components on the condition and prognosis of patients with severe pneumonia

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