{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T13:15:15Z","timestamp":1773666915621,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"This research was funded by Vegenat Healthcare","award":["147\/20"],"award-info":[{"award-number":["147\/20"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>We aimed to study the possible association of stress hyperglycemia in COVID-19 critically ill patients with prognosis, artificial nutrition, circulating osteocalcin, and other serum markers of inflammation and compare them with non-COVID-19 patients. Fifty-two critical patients at the intensive care unit (ICU), 26 with COVID-19 and 26 non-COVID-19, were included. Glycemic control, delivery of artificial nutrition, serum osteocalcin, total and ICU stays, and mortality were recorded. Patients with COVID-19 had higher ICU stays, were on artificial nutrition for longer (p = 0.004), and needed more frequently insulin infusion therapy (p = 0.022) to control stress hyperglycemia. The need for insulin infusion therapy was associated with higher energy (p = 0.001) and glucose delivered through artificial nutrition (p = 0.040). Those patients with stress hyperglycemia showed higher ICU stays (23 \u00b1 17 vs. 11 \u00b1 13 days, p = 0.007). Serum osteocalcin was a good marker for hyperglycemia, as it inversely correlated with glycemia at admission in the ICU (r = \u22120.476, p = 0.001) and at days 2 (r = \u22120.409, p = 0.007) and 3 (r = \u22120.351, p = 0.049). In conclusion, hyperglycemia in critically ill COVID-19 patients was associated with longer ICU stays. Low circulating osteocalcin was a good marker for stress hyperglycemia.<\/jats:p>","DOI":"10.3390\/nu13093010","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T04:07:28Z","timestamp":1630382848000},"page":"3010","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Stress Hyperglycemia and Osteocalcin in COVID-19 Critically Ill Patients on Artificial Nutrition"],"prefix":"10.3390","volume":"13","author":[{"given":"Francisco","family":"Arrieta","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBERobn) & Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRyCIS), 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Martinez-Vaello","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuria","family":"Bengoa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-5012","authenticated-orcid":false,"given":"Marta","family":"Rosillo","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ang\u00e9lica","family":"de Pablo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Voguel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosario","family":"Pintor","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amaya","family":"Belanger-Quintana","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Mateo-Lobo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel","family":"Candela","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6425-2747","authenticated-orcid":false,"given":"Jos\u00e9 I.","family":"Botella-Carretero","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBERobn) & Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRyCIS), 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"108263","DOI":"10.1016\/j.diabres.2020.108263","article-title":"Clinical characteristics and outcomes of COVID-19 hospitalized patients with diabetes in the United Kingdom: A retrospective single centre study","volume":"165","author":"Alkundi","year":"2020","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"G67","DOI":"10.1530\/EJE-20-0377","article-title":"Endocrinology in the time of COVID-19: Remodelling diabetes services and emerging innovation","volume":"183","author":"Wake","year":"2020","journal-title":"Eur. J. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"108142","DOI":"10.1016\/j.diabres.2020.108142","article-title":"COVID-19 and diabetes: Knowledge in progress","volume":"162","author":"Hussain","year":"2020","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.2337\/dc20-0723","article-title":"Outcomes in Patients With Hyperglycemia Affected by COVID-19: Can We Do More on Glycemic Control?","volume":"43","author":"Sardu","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1016\/j.numecd.2020.05.014","article-title":"Diabetes as a risk factor for greater COVID-19 severity and in-hospital death: A meta-analysis of observational studies","volume":"30","author":"Mantovani","year":"2020","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.clnu.2018.08.037","article-title":"ESPEN guideline on clinical nutrition in the intensive care unit","volume":"38","author":"Singer","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1002\/ncp.10499","article-title":"Metabolic Complications Occur More Frequently in Older Patients Receiving Parenteral Nutrition","volume":"35","author":"Solomon","year":"2020","journal-title":"Nutr. Clin. Pract."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1016\/S0140-6736(09)60553-5","article-title":"Stress hyperglycaemia","volume":"373","author":"Dungan","year":"2009","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.nut.2018.06.027","article-title":"Update on glucose in critical care","volume":"59","author":"Lheureux","year":"2019","journal-title":"Nutrition"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1007\/s12020-017-1396-0","article-title":"Insulin and osteocalcin: Further evidence for a mutual cross-talk","volume":"59","author":"Bilotta","year":"2018","journal-title":"Endocrine"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E1173","DOI":"10.1210\/jc.2013-1203","article-title":"Associations of total and undercarboxylated osteocalcin with peripheral and hepatic insulin sensitivity and beta-cell function in overweight adults","volume":"98","author":"Gower","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/j.1365-2265.2011.04035.x","article-title":"Serum concentrations of osteocalcin, procollagen type 1 N-terminal propeptide and beta-CrossLaps in obese subjects with varying degrees of glucose tolerance","volume":"75","author":"Iglesias","year":"2011","journal-title":"Clin. Endocrinol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2019). 15. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2019. Diabetes Care, 42, S173\u2013S181.","DOI":"10.2337\/dc19-S015"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.clnu.2020.03.022","article-title":"ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection","volume":"39","author":"Barazzoni","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.bone.2015.05.046","article-title":"New insights into the biology of osteocalcin","volume":"82","author":"Zoch","year":"2016","journal-title":"Bone"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.2337\/dc06-0440","article-title":"Prospective study of diabetes and risk of hip fracture: The Nurses\u2019 Health Study","volume":"29","author":"Janghorbani","year":"2006","journal-title":"Diabetes Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s00223-016-0175-x","article-title":"Epidemiology of Fractures in Diabetes","volume":"100","author":"Frost","year":"2017","journal-title":"Calcif. Tissue Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1007\/s10096-020-03967-9","article-title":"Characteristics of laboratory indexes in COVID-19 patients with non-severe symptoms in Hefei City, China: Diagnostic value in organ injuries","volume":"39","author":"Li","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2823","DOI":"10.1007\/s00198-015-3197-8","article-title":"Association between osteocalcin and glucose metabolism: A meta-analysis","volume":"26","author":"Liu","year":"2015","journal-title":"Osteoporos. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.2337\/dci20-0024","article-title":"COVID-19 in People with Diabetes: Urgently Needed Lessons From Early Reports","volume":"43","author":"Riddle","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.2337\/dc20-1192","article-title":"Diabetes and COVID-19: Risks, Management, and Learnings from Other National Disasters","volume":"43","author":"Morris","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.diabet.2020.05.001","article-title":"Patients with diabetes are at higher risk for severe illness from COVID-19","volume":"46","author":"Targher","year":"2020","journal-title":"Diabetes Metab."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2102","DOI":"10.1007\/s00125-020-05209-1","article-title":"Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: A multi-centre retrospective study","volume":"63","author":"Wang","year":"2020","journal-title":"Diabetologia"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"486403","DOI":"10.1155\/2014\/486403","article-title":"Stress hyperglycemia, insulin treatment, and innate immune cells","volume":"2014","author":"Xiu","year":"2014","journal-title":"Int. J. Endocrinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1177\/0884533610392237","article-title":"Glucose control in the intensive care unit: A nutrition support perspective","volume":"26","author":"Krenitsky","year":"2011","journal-title":"Nutr. Clin. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s00134-004-2511-2","article-title":"Parenteral vs. enteral nutrition in the critically ill patient: A meta-analysis of trials using the intention to treat principle","volume":"31","author":"Simpson","year":"2005","journal-title":"Intensive Care Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1136\/ebmed-2014-110132","article-title":"CALORIES trial offers confirmatory evidence that parenteral nutrition does not cause infectious complications in critically ill patients","volume":"20","author":"Doig","year":"2015","journal-title":"Evid. Based Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S0140-6736(17)32146-3","article-title":"Enteral versus parenteral early nutrition in ventilated adults with shock: A randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2)","volume":"391","author":"Reignier","year":"2018","journal-title":"Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/MCC.0b013e3283052cdd","article-title":"Enteral vs. parenteral nutrition for the critically ill patient: A combined support should be preferred","volume":"14","author":"Heidegger","year":"2008","journal-title":"Curr. Opin. Crit. Care"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/9\/3010\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:54:39Z","timestamp":1760165679000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/9\/3010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,28]]},"references-count":29,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["nu13093010"],"URL":"https:\/\/doi.org\/10.3390\/nu13093010","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,28]]}}}