Low HDL and Elevated Triglyceride-Glucose Index and HOMA-IR Associated with Multisystem Inflammatory Syndrome in Children (MIS-C)
Makaleler > Tam Makale · 2023
Yazarlar: Zümrüt ŞAHBUDAK BAL, Sema Yildirim Arslan, Gizem Guner Ozenen, Melis Bilen Nimet, Burçe Emine DÖRTKARDEŞLER, Pinar Yazici Ozkaya, Irem Ersayoglu, Candan ÇİÇEK, Burcu BARUTÇUOĞLU, Reşit Ertürk LEVENT, Samim ÖZEN, Feriştah Ferda ÖZKINAY, Nuri Zafer KURUGÖL
Annals of Endocrinology and Metabolism, Uluslararası, 2023, cilt 5
DOI: 10.36959/433/574
Özet
Background: Multisystem inflammatory syndrome in children (MIS-C) is a post infectious hyper inflammatory syndrome that develops 2-4 weeks after COVID-19.Impaired glucose-insulin metabolism and hypertriglyceridemia have been shown as risk factors for MIS-C.Triglyceride-glucose index (TyG) is a simple, cheap, and easily accessible marker calculated using fasting serum glucose and triglyceride values.Therefore, we aimed to evaluate the association between metabolic disorders and MIS-C development and to compare it with COVID-19.Methods: A retrospective case-control study, which included 49 COVID-19 patients, and 68 MIS-C patients, was conducted at a tertiary-level university hospital.All demographic characteristics, laboratory findings, and hospital courses were retrospectively recruited from electronic medical records.Results: Gender, standard deviation scores (SDS) of weights, and height did not significantly differ among the groups (p > 0.05).Higher triglyceride (TG) levels and lower high-density lipoprotein (HDL-C) levels were associated significantly with MIS-C; p levels were < 0.001 and < 0.001, respectively.The mean level of the homeostatic model assessment of insulin resistance (HOMA-IR) was significantly higher (5.5 vs.2.5; p < 0.001), insulin resistance was more common (60.3% vs. 22.4%; p < 0.001), and the mean level of TyG was significantly higher (4.8 ± 0.28 vs. 4.4 ± 0.25; p < 0.001) in MIS-C patients than COVID-19 patients.Increased age, lymphopenia, thrombocytopenia, monocytopenia, hypoalbuminemia, and higher levels of NT-pro BNP were significantly associated with pediatric intensive care unit (PICU) admission, p levels were 0.02, < 0.001, 0.013, 0.007, 0.002, < 0.001, 0.006 respectively.The ROC curve analysis showed HDL-C (< 30 mg/dL) with the highest AUC value of 0.902 and a sensitivity of 83.3 and a specificity of 100%.The AUC values of TyG, TG, and HOMA-IR were 0.871, 0.866, and 0.686, respectively.Conclusions: Metabolic abnormalities, including lower HDL-C and higher levels of HOMA-IR and TyG index associated with MIS-C.