Value of serum sICAM‑1, Metrnl, and BAR in assessing disease severity of diabetic ketoacidosis

CAO Yuqing; ZHANG Luwei; PENG Chunxia; WANG Xifu; LIAN Xiang

doi:10.14188/j.1671-8852.2026.0124

您当前的位置：

首页 >

文章列表页 >

Value of serum sICAM‑1, Metrnl, and BAR in assessing disease severity of diabetic ketoacidosis

更新时间：2026-10-28

- Value of serum sICAM‑1, Metrnl, and BAR in assessing disease severity of diabetic ketoacidosis
- Medical Journal of Wuhan University Pages: 1-5(2026)
- 作者机构：
  
  1.民航总医院急诊内科北京 100020
  2.首都医科大学附属北京安贞医院急诊危重症中心北京 100029
- 作者简介：
- 基金信息：
- DOI：10.14188/j.1671-8852.2026.0124
  CLC： R587.2
- Received：22 January 2026，
  
  Online First：28 October 2026，
- 稿件说明：
移动端阅览
CAO Yuqing, ZHANG Luwei, PENG Chunxia, et al. Value of serum sICAM‑1, Metrnl, and BAR in assessing disease severity of diabetic ketoacidosis[J/OL]. Medical Journal of Wuhan University, 2026, 1-5.
DOI：

CAO Yuqing, ZHANG Luwei, PENG Chunxia, et al. Value of serum sICAM‑1, Metrnl, and BAR in assessing disease severity of diabetic ketoacidosis[J/OL]. Medical Journal of Wuhan University, 2026, 1-5. DOI： 10.14188/j.1671-8852.2026.0124.

摘要

目的

探究血清可溶性细胞间黏附分子‑1（sICAM‑1）、镍纹样蛋白（Metrnl）、血尿素氮与血清白蛋白比值（BAR）对糖尿病酮症酸中毒（DKA）患者病情程度的评估价值。

方法

选择2022年7月—2025年7月民航总医院收治的101例DKA患者为DKA组，101例单纯2型糖尿病（T2DM）和101例体检健康者分别为T2DM组和NC组。检测所有研究对象血清sICAM‑1、Metrnl、BAR水平；Spearman相关性分析血清指标与病情程度的相关性；有序多因素Logistic回归模型筛选病情程度的影响因素；ROC曲线分析血清指标对重度DKA的评估价值。

结果

NC组、T2DM组、DKA组相比，FBG、HbA1c、血清sICAM‑1和BAR水平依次升高；Metrnl水平依次降低（

0.05）；血清sICAM‑1和BAR随病情程度加重依次升高，血清Metrnl依次降低（

0.05）；DKA患者血清sICAM‑1、BAR与病情程度分别呈正相关（

0.05），血清Metrnl与病情程度呈负相关（

0.05）；血清sICAM‑1、BAR、Metrnl均是DKA患者病情程度的影响因素（

0.05）；血清sICAM‑1、Metrnl、BAR联合评估重度DKA的曲线下面积（

AUC

）显著优于单独评估（

=2.143、2.274、2.165，

0.05）。

结论

DKA患者血清sICAM‑1、BAR上调，Metrnl下调，对重度DKA有良好评估效能。

Abstract

Objective

To explore the evaluation value of serum soluble intercellular adhesion molecule‑1 (sICAM‑1)

Meteorin‑like protein (Metrnl)

and the ratio of blood urea nitrogen to serum albumin (BAR) for the severity of diabetic ketoacidosis (DKA).

Methods

A total of 101 DKA patients admitted to the General Hospital of Civil Aviation from July 2022 to July 2025 were selected as the DKA group

and 101 patients with simple type 2 diabetes mellitus (T2DM) and 101 healthy individuals undergoing physical check ups were respectively selected as the T2DM group and control (NC) group. The serum levels of sICAM‑1

Metrnl

and BAR in all study subjects were detected. Spearman correlation analysis was used to analyze the correlation between serum indicators and disease severity. Ordinal multivariate Logistic regression model was applied to screen the influencing factors of disease severity. ROC curve analysis was performed to evaluate the value of serum indicators in assessing severe DKA.

Results

Compared with the NC group

T2DM group

and DKA group

levels of FBG

HbA1c

serum sICAM‑1

and BAR were progressively higher

while Metrnl levels were progressively lower (

0.05). Serum sICAM‑1 and BAR were gradually elevated with the aggravation of disease severity

and serum Metrnl was gradually decreased (

0.05). Serum sICAM‑1 and BAR in DKA patients were positively correlated with the severity of the disease respectively (

0.05)

and serum Metrnl was negatively correlated with the severity of the disease (

0.05). Serum sICAM‑1

BAR and Metrnl were all independent influencing factors for disease severity in DKA patients (

0.05). The

UC value for the combined assessment of severe DKA u

sing sICAM⁃1

Metrnl

and BAR was significantly greater than those for the single⁃marker assessments (

=2.143

2.274

and 2.165

respectively;

0.05).

Conclusion

Serum sICAM‑1 and BAR were up‑regulated while Metrnl was down‑regulated in DKA patients

all of which exhibited good predictive efficacy for severe DKA.

关键词

Keywords

references

CALIMAG A P P , CHLEBEK S , LERMA E V , et al . Diabetic ketoacidosis [J ] . Dis Mon , 2023 , 69 ( 3 ): 101418 .

DHATARIYA K K , The Joint British Diabetes Societies for Inpatient Care . The management of diabetic ketoacidosis in adults: An updated guideline from the Joint British Diabetes Society for Inpatient Care [J ] . Diabet Med , 2022 , 39 ( 6 ): e14788 .

徐丽丹 , 刘瑜 , 赵洪影 . 2型糖尿病合并代谢综合征患者血清SFRP5、sICAM‑1、Fetuin‑B水平及临床意义 [J ] . 国际检验医学杂志 , 2025 , 46 ( 9 ): 1030 ‑ 1034 .

XU L D , LIU Y , ZHAO H Y . Levels of serum SFRP5, sICAM‑1 and Fetuin‑B in patients with type 2 diabetes mellitus complicated with metabolic syndrome and their clinical significance [J ] . Int J Lab Med , 2025 , 46 ( 9 ): 1030 ‑ 1034 .

DONGW S , HU C , HU M , et al . Metrnl: A promising biomarker and therapeutic target for cardiovascular and metabolic diseases [J ] . Cell Commun Signal , 2024 , 22 ( 1 ): 389 .

CHEN H , WANG Y F , JI R , et al . Association between blood urea nitrogen to serum albumin ratio and in‑hospital mortality in critical patients with diabetic ketoacidosis: A retrospective analysis of the eICU database [J ] . Front Endocrinol , 2024 , 15 : 1411891 .

中华医学会糖尿病学分会 . 中国高血糖危象诊断与治疗指南 [J ] . 中华糖尿病杂志 , 2013 , 5 ( 8 ): 449 ‑ 461 .

Diabetes Society of Chinese Medical Association . Guidelines for the Diagnosis and Treatment of Hyperglycemia Crises in China [J ] . Chin J Diabetes Mellit , 2013 , 5 ( 8 ): 449 ‑ 461 .

中华医学会糖尿病学分会 . 中国2型糖尿病防治指南(2020年版) [J ] . 国际内分泌代谢杂志 , 2021 , 41 ( 5 ): 482 ‑ 548 .

Diabetes Society of Chinese Medical Association . Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition) [J ] . Int J Endocrinol Metab , 2021 , 41 ( 5 ): 482 ‑ 548 .

刘彦群 , 孙立东 , 于吉芬 . 二氧化碳结合力联合血清β‑羟丁酸、乳酸在糖尿病酮症酸中毒诊断及病情评估中的价值 [J ] . 现代医药卫生 , 2025 , 41 ( 4 ): 887 ‑ 890 .

LIU Y Q , SUN L D , YU J F . Value of carbon dioxide binding capacity combined with serum β‑hydroxybutyrate and lactic acid in the diagnosis and assessment of diabetic ketoacidosis [J ] . J Mod Med Heal , 2025 , 41 ( 4 ): 887 ‑ 890 .

DAGDEVIREN M , AKKAN T , ERTUGRUL D T . Re‑emergence of a forgotten diabetes complication: Euglycemic diabetic ketoacidosis [J ] . Turk J Emerg Med , 2024 , 24 ( 1 ): 1 ‑ 7 .

SRIDHARAN K , SIVARAMAKRISHNAN G . Risk of diabetic ketoacidosis associated with sodium glucose cotransporter‑2 inhibitors: A network meta‑analysis and meta‑regression [J ] . J Clin Med , 2024 , 13 ( 6 ): 1748 .

潘艳丽 , 汪四虎 , 黄大祥 . CRP/Lac、β‑HBA、AMS在糖尿病酮症酸中毒诊断和病情评估中价值 [J ] . 分子诊断与治疗杂志 , 2021 , 13 ( 8 ): 1260 ‑ 1263 .

PAN Y L , WANG S H , HUANG D X . The value of CRP/Lac, β‑HBA and AMS in diagnosis and evaluation of diabetic ketoacidosis [J ] . J Mol Diagn Ther , 2021 , 13 ( 8 ): 1260 ‑ 1263 .

SERAG H , EL WAKEEL L , ADLY A . Coenzyme Q10 administration has no effect on sICAM‑1 and metabolic parameters of pediatrics with type 1 diabetes mellitus [J ] . Int J Vitam Nutr Res , 2021 , 91 ( 3/4 ): 315 ‑ 324 .

LI J L , YE P , SI J L , et al . Meteorin‑like/Metrnl: A pleiotropic cytokine implicated in metabolic, inflammatory and malignant disorders [J ] . Cytokine Growth Factor Rev , 2026 , 87 : 64 ‑ 72 .

LI Z Q , GAO Z Y , SUN T , et al . Meteorin‑like/Metrnl, a novel secreted protein implicated in inflammation, immunology, and metabolism: A comprehensive review of preclinical and clinical studies [J ] . Front Immunol , 2023 , 14 : 1098570 .

LI W , LI N , ZHAN Y J , et al . Blood urea nitrogen to albumin ratio as predictor of mortality among acute pancreatitis patients in ICU: A retrospective cohort study [J ] . PLoS One , 2025 , 20 ( 5 ): e0323321 .

LIU S Z , QIU C Y , LI W X , et al . Blood urea nitrogen to serum albumin ratio as a new prognostic indicator in type 2 diabetes mellitus patients with chronic kidney disease [J ] . Sci Rep , 2024 , 14 : 8002 .

HANG T T , HUANG J , HE G P , et al . Blood urea nitrogen to serum albumin ratio as a new prognostic indicator in critically ill patients with diabetic ketoacidosis: A retrospective cohort study [J ] . Exp Clin Endocrinol Diabetes , 2024 , 132 ( 5 ): 249 ‑ 259 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Emergency Treatment of 102 Cases of Diabetic Ketoacidosis by Traditional Chinese Medicine

Fumarate attenuates intestinal ischemia⁃reperfusion injury by suppressing cGAS⁃STING⁃mediated necroptosis

Preparation of methylene blue‐loaded nanoparticles and a preliminary study of photodynamic anti‐Trichophyton rubrum effect in vitro

Standardized recommendations for orthogonal experimental validation of genetic variants identified in clinical next⁃generation sequencing reports

Impact of preventive analgesia combined with stepwise intervention on pain control in school‑aged children with acute appendicitis

Related Author

杨斌

Related Institution

武警云南总队医院急诊科

AI问答

⁰