Risk Factors And Predictive Value Of Ischemic Cardiovascular Disease In Patients With Type 2 Diabetes

Objective This study explored the main risk factors for Ischemic cardiovascular disease(ICVD)in patients with Type 2 diabetes mellitus(T2DM).A nomogram model for the occurrence of ICVD in T2 DM patients was established and verified to provide a convenient and practical evaluation tool for screening patients with T2 DM at high risk of ICVD.Methods Used a cohort study.680 patients were collected with T2 DM who were treated in the outpatient and inpatient departments of the Endocrinology Department of the First Affiliated Hospital of Guangxi Medical University from October 2018 to December 2019 February were selected as the research subjects by combining prospective study and retrospective study.Clinical data were collected at the time of enrolment,and the patients were followed up for 2 years.SPSS 22.0 software was used for data analysis and statistics,and univariate analysis and binary logistic regression were used to screen the predictors.R language 4.0.3 was used to establish the nomogram model and draw the Receiver Operating characteristic Curve(ROC)for predicting the occurrence of ICVD in T2 DM.The Area Under the Curve(AUC)was calculated,and the Bootstrap re-sampling method was used for 1000 times for internal verification.C-index,AUC and standard curve were used to evaluate the prediction performance of the model.Results 1.In the early stage of this study,a total of 722 patients were included,due to some patients refusing to answer the phone,failing to come to the hospital for review on time,and complicated with other diseases.Among them,there were 15 cases of malignant tumor and other diseases,17 cases of refused to answer the phone,and 10 cases of automatic withdrawal,with a shedding rate of 5.81%.680 patients were included for statistical analysis.During the follow-up,52 patients developed ICVD and were included in the observation group.628 patients with simple T2 DM were enrolled as the control group.2.Univariate analysis of the influence of ICVD in T2 DM patients: VOI,FPG,ALT,AST,SCR,SUA,TG,Ty G,age of ICVD patients with T2 DM,the difference was statistically significant(P<0.05).Other indicators,such as DBP,SBP,weight,height,BMI,hipline,waistline,WHR,Hb A1 c,PLT,RBC,WBC,HB,HCT,ALP,LDL-C,TC,HDL-C,gender,drinking,education level and smoking had no significant effect on ICVD in T2 DM patients(P>0.05).3.Multivariate analysis on the influence of ICVD in patients with T2DM:the risk factors of ICVD in patients with T2 DM are age(OR=1.083,95%CI=1.046～1.121,P=0.000),Ty G(OR=1.780,95%CI=1.217～2.604,P=0.003),FPG(OR=1.119,95%CI=1.007～1.244,P=0.037),and SCR(OR=1.007,95%CI=1.002～1.011,P=0.003).4.Age,Ty G,FPG and SCR were used to establish the ICVD nomogram model of T2 DM patients.The AUC area of the model was 0.797(95%CI=0.739～0.854),and the corrected C index was 0.790,which had good predictive value.Conclusions 1.The development of ICVD in patients with T2 DM is affected by many factors,including VOI,FPG,ALT,AST,SCR,SUA,TG,Ty G and age.Age,Ty G,FPG and SCR were independent risk factors.2.The nomogram model established by age,Ty G,FPG and SCR has a good predictive value for the occurrence of ICVD in T2 DM patients,and provides a convenient evaluation tool for screening patients at high risk of ICVD in T2 DM patients.