| 于辉,孙冠媛,丁悦.超重 /肥胖 2型糖尿病病人动脉粥样硬化指数升高的危险因素及预警风险模型的建立[J].安徽医药,2025,29(10):2066-2070. |
| 超重 /肥胖 2型糖尿病病人动脉粥样硬化指数升高的危险因素及预警风险模型的建立 |
| Risk factors and early warning risk model for elevated atherogenic index of plasma in overweight/obese type 2 diabetes patients |
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| DOI：10.3969/j.issn.1009-6469.2025.10.031 |
| 中文关键词: 糖尿病， 2型 C反应蛋白(CRP) 同型半胱氨酸( Hcy) 低密度脂蛋白胆固醇(LDL-C) 肥胖 致动脉粥样硬化指数 预警风险模型 |
| 英文关键词: Diabetes mellitus,type 2 C-reactive protein (CRP) Homocysteine (Hcy) Low density lipoprotein (LDL-C) Obesi-ty Atherogenic index of plasma Early warning risk model |
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| 中文摘要: |
| :目的分析超重 /肥胖 2型糖尿病( T2DM)病人致动脉粥样硬化指数( AIP)升高的危险因素，并建立预警风险模型。方选取 2020年 12月至 2022年 12月于中国人民武装警察部队特色医学中心就诊的超重 /肥胖 T2DM病人 158例，根据其 AIP是法否升高分为正常组( 96例)、升高组( 62例)。采用独立样本 t检验及 χ2检验对超重 /肥胖 T2DM病人 AIP升高的单因素进行分析；采用二元 logistic回归模型分析超重 /肥胖 T2DM病人 AIP升高的危险因素；构建风险预测列线图模型，并验证其效能。结升高组与正常组比较糖化血红蛋白( HbA1c)［( 7.49±1.25)%比( 6.98±1.11)%］、空腹血糖( FBG)［( 9.53±2.13)mmol/L比(8果.21±1.56)mmol/L］、低密度脂蛋白( LDL-C)［(3.21±0.59)mmol/L比( 2.95±0.47)mmol/L］、血清 C反应蛋白( CRP)［(15.33±3.98) mg/L比(7.89±2.01)mg/L］及血清同型半胱氨酸(Hcy)水平［(21.69±4.33)μmol/L比(17.59±3.54)μmol/L］均升高， T2DM病程延长［( 12.38±3.14)年比( 10.29±2.35)年］(P<0.05)。二元 logistic回归模型显示，年龄、身体质量指数( BMI)、 T2DM病程、 FBG、 HbA1c、LDL-C、血清 CRP、血清 Hcy是超重 /肥胖 T2DM病人 AIP升高的危险因素( P<0.05)。 Bootstrap法内部验证结果显示， C-index指数为 0.87［95%CI:(0.80，0.94)］；受试者操作特征曲线(ROC曲线)结果显示，列线图风险模型预测 AIP升高的 AUC为 0.92［95%CI:(0.88，0.94)］灵敏度为 91.53%，特异度为 81.90%；Hosmer-Lemeshow拟合优度检验结果显示，风险预测列线图模型预测超重 /肥胖 T2DMAIP升高的一致性良好( χ2=0.26，P=0.539)。结论年龄、 BMI、T2DM病程、 FBG、HbA1c、LDL-C、病人，血清 CRP、血清 Hcy是超重 /肥胖 T2DM病人 AIP升高的危险性因素。基于危险因素建立的风险预测列线图模型具有较高预测效能。 |
| 英文摘要: |
| Objective To analyze the risk factors for elevated atherogenic index of plasma (AIP) in overweight/obese type 2 diabetesmellitus (T2DM) patients and to establish an early warning risk model.Methods A total of 158 overweight/obese T2DM patients whovisited Special Medical Center of Chinese People's Armed Police Force from December 2020 to December 2022 were selected and di-vided into normal group (96 cases) and elevated group (62 cases) according to their AIP. The univariate and multivariate analysis ofAIP elevation in overweight/obese T2DM patients were performed. The risk factors for AIP elevation in overweight/obese T2DM pa-tients were analyzed by binary logistic regression model. A Nomogram model was constructed for risk prediction and its efficacy wasverified.Results The comparison between the elevated group and the normal group showed that the levels of glycosylated hemoglobin(HbA1c) [(7.49±1.25) % vs. (6.98±1.11) %], fasting blood glucose (FBG) [(9.53±2.13) mmol/L vs. (8.21±1.56) mmol/L], low-density lipo-protein (LDL-C) [(3.21±0.59) mmol/L vs. (2.95±0.47) mmol/L], serum C-reactive protein (CRP) [(15.33±3.98) mg/L vs. (7.89±2.01) mg/ L] and serum homocysteine (Hcy) [(21.69±4.33) μmol/L vs. 17.59±3.54) μmol/L] were all increased. The course of T2DM was pro-longed [(12.38±3.14) years vs. (10.29±2.35) years] (P < 0.05). Binary logistic regression model showed that age, body mass index (BMI), course of T2DM, FBG, HbA1c, LDL-C, CRP, and serum Hcy were risk factors for increased AIP in overweight/obese T2DM patients (P < 0.05). The internal verification results of Bootstrap method showed that C-index was 0.87 [95%CI: (0.80, 0.94)]. Receiver operat-ing curve (ROC curve) results showed that the AUC of increased AIP predicted by the nomogram risk model was 0.92 [95%CI: (0.88,0.94)], sensitivity was 91.53%, and specificity was 81.90%. Hosmer-Lemeshow goodness of fit test showed that the Nomogram modelhad good agreement in predicting AIP increase in overweight/obese T2DM patients (χ2=0.26, P=0.539). Conclusions Age, BMI, course of T2DM, FBG, HbA1c, LDL-C, serum CRP and serum Hcy are risk factors for the increase of AIP in overweight/obese T2DMpatients. Nomogram model of risk prediction based on risk factors has high prediction efficiency. |
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