1. 2024;27;51-58Predictive Value of Blood Glucose Coefficient of Variation for Prognoses in Patients with Diabetes Mellitus-Associated Herpes Zoster
   Observational Study
   Jiayi Tang, MD, Zhiqiang Zhang, MD, and Ming Yao, PhD.

BACKGROUND: Herpes zoster (HZ) and diabetes mellitus (DM) are common diseases in middle-aged and older adults aged 50 years or more, and the prevalence of DM-associated HZ is gradually increasing. Several studies have confirmed that DM is a significant risk factor for postherpetic neuralgia (PHN). However, few studies have investigated the correlation between blood glucose-related indices and prognoses in patients with DM-associated HZ. The purpose of this study was to investigate the effect of blood glucose-related indices on the prognoses of these patients.

OBJECTIVES: The purpose of this study was to observe the potential value of blood glucose-related indices in predicting prognoses in patients with DM-associated HZ.

STUDY DESIGN: A retrospective, observational study.

SETTING: The study was carried out in the Pain Department of the First Hospital Affiliated to Jiaxing College in Jiaxing, China.

METHODS: Patients with DM-associated HZ admitted to the First Hospital of Jiaxing between October 2019 and February 2022 were enrolled. The patients were divided into PHN and non-PHN groups. Demographic data, including gender, age, period of first clinical visit, site of involvement, history of DM, DM-related complications, comorbidities, and treatment were collected. Simultaneously, blood glucose-related data, including blood glucose level at admission (GLUadm), blood glucose level difference (GLUdif), and blood glucose coefficient of variation (GLUcv) were collected. Univariate and multivariate logistic regression analyses were performed to analyze factors affecting prognosis. A receiver operating characteristic (ROC) curve was constructed to assess the value of GLUcv in predicting prognosis.

RESULTS: Overall, 136 patients were included. Among them, 65 and 71 were in the PHN and non-PHN groups, respectively. Univariate analysis showed that gender (x^2 = 2.023, P = 0.044), history of DM (x^2 = 3.850, P < 0.001), DM-related complications (x^2 = 3.238, P = 0.016), comorbidities (x^2 = 2.439, P = 0.019), and GLUcv (x^2 = 3.576, P < 0.001) were associated with PHN. Multivariate logistic regression analysis showed that a history of DM >= 10 years (OR = 4.096, 95% CI: 1.759–10.082, P = 0.001), comorbidities (OR = 2.680, 95% CI: 1.143–6.567, P = 0.026), and GLUcv >= 30.56 (OR = 5.234, 95% CI: 2.325–12.603, P = 0.001) were independent factors. The ROC curve revealed that GLUcv had a high predictive value for PHN (AUC = 0.714, P < 0.001).

LIMITATIONS: The nonrandomized, single-center, retrospective design and small sample size are major limitations of this study.

CONCLUSIONS: GLUcv has a high predictive value for the prognoses of patients with DM-associated HZ. The higher the GLUcv value, the likelier the patient is to have a poor prognosis.

KEY WORDS: Blood glucose, coefficient of variation, herpes zoster, diabetes mellitus