Deaths from Acute Respiratory Infections are Linked to High Fasting Blood Glucose and Decreased Levels of Low-Density Lipoprotein/Small Dense Low-Density Lipoprotein

Abstract

Li Li,1 Wei Du,1 Jing Song,1 Ye Lu,1 Jing Wan,1 Wenjie Wang,1 Yunhai Feng,2 Jun Yin1,3,4 1Department of Endocrinology and Metabolism, Shanghai Eighth People’s Hospital, Shanghai, People’s Republic of China; 2Department of Otolaryngology, Head and Neck Surgery, Shanghai Eighth People’s Hospital, Shanghai, People’s Republic of China; 3Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, People’s Republic of China; 4Department of Endocrinology and Metabolism, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, People’s Republic of ChinaCorrespondence: Jun Yin, Department of Endocrinology and Metabolism, Shanghai Eighth People’s Hospital, 8 Caobao Road, Shanghai, 200235, People’s Republic of China, Email [email protected] Yunhai Feng, Department of Otolaryngology, Head and Neck Surgery, Shanghai Eighth People’s Hospital, 8 Caobao Road, Shanghai, 200235, People’s Republic of China, Email [email protected]: Winter poses a significant threat to acute respiratory infections (ARIs), often leading to severe outcomes including mortality. This study investigated the effect of glucose and lipid metabolism on mortality rates among individuals with ARIs.Patients and Methods: We collected clinical data including indicators related to glucose and lipid metabolism, liver and kidney function, complete blood count, coagulation function, and other parameters from 1675 hospitalized patients with ARIs who were consecutively admitted during the winter season. The clinical characteristics and influencing factors associated with mortality in these patients were analyzed.Results: Risk factors contributing to mortality in patients with ARIs include fasting blood glucose (FBG), low-density lipoprotein (LDL), apolipoprotein E (ApoE), small dense LDL (sdLDL), D-dimer, lymphocyte count, blood urea nitrogen, and a history of diabetes. Notably, when FBG above 7.8 mmol/L, mortality followed a parabolic association with HbA1c-lowest at extremes (< 5.7% or ≥ 8.5%) but markedly higher in the mid-range (5.7– 8.4%). Among patients with diabetes, those who succumbed to the infection exhibited higher FBG levels but lower glycated hemoglobin (HbA1c) levels than those who recovered. Moreover, low levels of LDL/sdLDL and high levels of ApoE were inversely and positively linked, respectively, to mortality rates.Conclusion: In patients with ARIs, FBG level, rather than HbA1c level, is a risk factor for mortality. Moreover, low LDL/sdLDL levels and high ApoE levels are associated with increased mortality. The retrospective design and lack of long-term follow-up may limit the findings, highlighting the need for prospective validation.Keywords: mortality, acute respiratory infection, blood glucose level, blood lipoproteins

Keywords

• mortality
• acute respiratory infection
• blood glucose level
• blood lipoproteins