Background: The underlying mechanism of hyperglycemia in children with acute lymphoblastic leukemia (ALL) is insulin resistance. Although race and economic status have been linked to increased insulin resistance in children, these have not been explored as predictors of hyperglycemia in children with ALL. The objective of this study was to analyze race and income as predictors of hyperglycemia in a diverse sample of children hospitalized with ALL in the United States in the year 2016. Methods: We performed a secondary analysis of 18,077 hospitalizations of White, Black, and Hispanic children under the age of 21 years with ALL contained in a nationally representative database. Multilevel binary logistic regression models were constructed to estimate the relationships between race, median household income, age, sex, and obesity and the odds of hyperglycemia in hospitalized children with ALL. Results: Hyperglycemia occurred during 5.3% of the hospitalizations. Black children were 37% more likely to develop hyperglycemia than White children. The risk for hyperglycemia did not differ between Hispanic and White children. Residing in areas where annual median income was below $54,000 was associated with 1.4-fold increased odds of hyperglycemia, compared to the wealthiest areas. Older children, females, and those diagnosed with obesity were also at increased risk for hyperglycemia. Discussion: An association has been found between treatment-induced hyperglycemia and increased mortality. For this reason, the racial and economic differences in the risk for hyperglycemia identified in this study deserve further consideration.

背景：急性淋巴细胞白血病 (ALL) 儿童高血糖的潜在机制是胰岛素抵抗。尽管种族和经济状况与儿童胰岛素抵抗的增加有关，但尚未将其作为 ALL 儿童高血糖的预测因素进行探索。本研究的目的是分析种族和收入作为 2016 年美国 ALL 住院儿童的不同样本中高血糖的预测因素。方法：我们对 18,077 例 21 岁以下的白人、黑人和西班牙裔儿童住院进行了二次分析，ALL 包含在具有全国代表性的数据库中。构建多级二元逻辑回归模型以估计种族、家庭收入中位数、年龄、性别和肥胖与住院 ALL 儿童高血糖几率之间的关系。结果：5.3% 的住院期间发生了高血糖症。黑人儿童发生高血糖的可能性比白人儿童高 37%。西班牙裔儿童和白人儿童的高血糖风险没有差异。与最富裕的地区相比，居住在年收入中位数低于 54,000 美元的地区，高血糖的几率增加了 1.4 倍。年龄较大的儿童、女性和被诊断患有肥胖症的人患高血糖症的风险也增加。讨论：已发现治疗引起的高血糖与死亡率增加之间存在关联。因此，本研究中确定的高血糖风险的种族和经济差异值得进一步考虑。