Key result
Highest FBG/HDL-C ratio linked to ~230% greater 90-day mortality in critically ill PH patients.
Why the study?
The fasting blood glucose to high-density lipoprotein cholesterol ratio predicts adverse outcomes in critically ill patients, but its prognostic value in pulmonary hypertension remains unclear.
Does an elevated fasting blood glucose to high-density lipoprotein cholesterol (FBG/HDL-C) ratio predict 90-day mortality in critically ill patients with pulmonary hypertension?
Cohort (n=281)
No
Does an elevated fasting blood glucose to high-density lipoprotein cholesterol (FBG/HDL-C) ratio predict 90-day mortality in critically ill patients with pulmonary hypertension?
An elevated fasting blood glucose to HDL cholesterol ratio is independently associated with increased 90-day mortality in critically ill patients with pulmonary hypertension, particularly in WHO Group 2.
Answers are grounded in this paper and cite their sources.
Elevated FBG/HDL-C ratio was associated with higher mortality risk in critically ill pulmonary hypertension; hypothesis-generating and requires prospective validation.
Pulmonary hypertension (PH) is a heterogeneous condition with variable prognosis across World Health Organization (WHO) subtypes. The fasting blood glucose to high-density lipoprotein cholesterol (FBG/HDL-C) ratio has been suggested as a metabolic predictor of adverse outcomes in critically ill patients, but its prognostic value in PH remains unclear. This retrospective cohort included 281 ICU patients with pulmonary hypertension (PH) from MIMIC-IV (2008–2022). Patients were divided into tertiles based on ln(1 + FBG/HDL-C). The primary endpoint was 90-day all-cause mortality, which was assessed using Cox proportional hazards regression, with exploratory subgroup analyses by WHO PH groups. In fully adjusted models, patients in the highest tertile of ln(1 + FBG/HDL-C) had higher 90-day mortality than those in the lowest tertile (HR = 3.30, 95% CI: 1.82, 5.97; p < 0.001). Elevated risk was observed across WHO PH Groups 1, 2, and 5, with the most statistically robust and clinically interpretable association in Group 2 (HR = 2.66, 95% CI: 1.40, 5.05; p = 0.003). Elevated FBG/HDL-C ratio was independently associated with 90-day mortality, with the association in Group 2 being the most statistically stable and clinically interpretable.
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Xiang et al. (2026) conducted a cohort in Pulmonary hypertension in critically ill patients (n=281). Elevated FBG/HDL-C ratio (highest tertile) vs. Lowest tertile of FBG/HDL-C ratio was evaluated on 90-day all-cause mortality (HR 3.30, 95% CI 1.82-5.97, p=<0.001). In critically ill patients with pulmonary hypertension, the highest tertile of the FBG/HDL-C ratio was independently associated with a increased risk of 90-day mortality compared to the lowest tertile.
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