Fasting blood glucose as an independent mortality predictor in anti-MDA5-positive dermatomyositis-associated interstitial lung disease

Abstract

Abstract Background: Anti-MDA5-positive dermatomyositis-associated interstitial lung disease (ILD) is a life-threatening disease with poor prognosis. Hyperglycemia is associated with an increased risk of mortality in patients with auto-immune disease. This work aimed to assess the clinical significance of fasting blood glucose (FBG) level in patients with anti-MDA5-positive dermatomyositis (DM)-associated interstitial lung disease. Methods: This is a retrospective study in a single center at West China Hospital of Sichuan University, Chendu, China. The outcome was defined as death from any cause during the follow-up period. Multivariable Cox regression was performed to explore the risk factors associated with mortality in patients with anti-MDA5-positive DM-associated ILD. Results: A total of 200 consecutive patients were enrolled, among which 55 died during the follow-up period. Multivariable Cox regression analysis showed that the hazard ratio (HR) for long-term mortality in patients with FBG ≥ 7 mmol/L and 5.6-6.9 mmol/L vs. < 5.6 mmol/L was 2.16 (95% confidence interval [CI] 1.10 to 4.23) and 1.61 (95% CI 0.80 to 3.26), respectively. Patients with the history of diabetes showed no significantly increased overall mortality compared with those without a history of diabetes (crude HR 0.75, 95% CI 0.27 to 2.06). Conclusions: Hyperglycemia is highly prevalent in anti-MDA5-positive CADM-ILD patients. FBG ≥ 7 mmol/L on admission represents a clinical risk factor for long-term mortality in patients with anti-MDA5-positive DM-associated ILD. Thus, timely and strict glycemic control may substantially affect mortality.