Evidence mapPaperPMID 41136911Full record

ArticleBMC gastroenterology2025

The association between serum HbA1c and infected pancreatic necrosis in acute necrotizing pancreatitis.

Xinyu Wang, Yiwei Luo, Gang Li, Dadong Liu, Jingzhu Zhang, Jing Zhou, Bo Ye, Wenjian Mao, Lu Ke, Yuxiu Liu and 2 more

Abstract read
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Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Xinyu Wang *Department of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210002, China.
Yiwei Luo *Department of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210002, China.
Gang LiDepartment of Critical Care Medicine, Affiliated Jinling Hospital of Nanjing University, Nanjing, Jiangsu, 210002, China.
Dadong LiuDepartment of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210002, China.
Jingzhu ZhangDepartment of Critical Care Medicine, Affiliated Jinling Hospital of Nanjing University, Nanjing, Jiangsu, 210002, China.
Jing ZhouDepartment of Critical Care Medicine, Affiliated Jinling Hospital of Nanjing University, Nanjing, Jiangsu, 210002, China.
Bo YeDepartment of Critical Care Medicine, Affiliated Jinling Hospital of Nanjing University, Nanjing, Jiangsu, 210002, China.
Wenjian MaoDepartment of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210002, China. wjm9485@163.com.
Lu KeDepartment of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210002, China.
Yuxiu LiuDepartment of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210002, China.
Weiqin LiDepartment of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210002, China. ctgchina@medbit.cn.
Zhihui TongDepartment of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210002, China. njzyantol@hotmail.com.

Funding

National Natural Science Foundation of China 81900592National Natural Science Foundation of China 82070665
6 · The paper itself

Abstract

backgroundGiven the evidence that poor glycemic control is associated with immunological dysfunction, serum glycosylated hemoglobin A1c (HbA1c), as a useful indicator reflecting blood glucose homeostasis, has potential to predict infectious complications. In this study, we aimed to explore the association between poor glycemic control (HbA1c ≥ 6.5 as an indicator) and infected pancreatic necrosis (IPN) in patients with acute necrotizing pancreatitis (ANP).

methodsThis is a secondary analysis of pooled data from the TRACE trial and a retrospective single-center cohort, involving ANP patients admitted within 72 h after onset of abdominal pain between March 2017 and October 2022. Patients had no HbA1c data at enrollment/admission were excluded. The Multivariable Cox proportional hazards regression (MCPHR) model was used to assess the association between poor glycemic control and 90-day IPN. Mediation analyses were used to define the relationships between the independent variables and 90-day IPN.

resultsA total of 153 patients were enrolled, of whom 20.3% (31/153) patients developed IPN within 90 days. Most patients with IPN had HbA1c ≥ 6.5% at admission (25/31, 80.6%), compared to 38.5% (47/122) in the non-IPN patients. In the MCPHR model, HbA1c ≥ 6.5% [HR (95%CI) = 4.10 (1.42-11.90); p = 0.009], SOFA score on admission [HR (95%CI) = 1.47 (1.26-1.70); p < 0.001] and pancreatic necrosis extent > 50% [HR (95%CI) = 3.15 (1.06-9.35); p = 0.039] were independent risk factors for 90-day IPN. In addition, patients with HbA1c ≥ 6.5% experienced a higher incidence of hyperglycemia during the first week of enrollment [RR (95%CI) = 9.19 (4.23-19.95); p < 0.001]. Mediation analyses showed that the presence of hyperglycemia completely mediated the association between HbA1c ≥ 6.5% and 90-day IPN.

conclusionAmong ANP patients, HbA1c ≥ 6.5% was associated with the development of IPN. The mediation effect of hyperglycemia may explain it.

Indexed as

Glycated HemoglobinPancreatitis, Acute NecrotizingAdultAgedBlood GlucoseFemaleGlycemic ControlHumansMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesRisk FactorsBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanAcute necrotizing pancreatitisHyperglycemiaInfected pancreatic necrosisSerum HbA1c

Identifiers

PMID41136911
PMCPMC12553147

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.