Correlation Analysis Of Serum IGF-1 And IGFBP-3 With EGFR In Patients With Type 2 Diabetes And A Nomogram For The Prediction Of Diabetic Nephropathy Risk Among Patients With Type 2 Diabetes Mellitus

Object: To analyze the correlation of IGF-1 and IGFBP-3 with e GFR in type 2 diab etic patients.To develop a novel nomogram model that predicts the risk of DN incidence in patients with T2 DM.Methods: A total of 834 patients with T2 DM who were hospitali zed in the Endocrinology Department of the First Affiliated Hospital of Xinjiang Medical University from March 2021 to December 2021 were selected.After screening according to the exclusion criteria,706 subjects were finally included.Data collected before Nove mber 15,2021(n=521)were defined as the training set,and data collected after Novem ber 15,2021(n=185)were defined as the validation set.Clinical data and cervical vascu lar ultrasound results of all subjects were collected for statistical analysis.Results: Spear man correlation analysis showed that e GFR was positively correlated with IGF-1 and IGF BP-3 in all subjects(P= 0.044;P=0.004,respectively).We developed a linear regressio n model.In the multiple linear regression model,serum IGF-1 and IGFBP-3 were positiv ely correlated with e GFR(β 0.03,95% CI 0.01-0.06;P= 0.009 and β 1.29,95% CI 0.09-2.49;P=0.035).The results of the correlations were further validated.Through multivaria te Logistic regression analysis,Scr,Hypertension,Hb A1 c,BUN,BMI,TG,DPN were fo und as risk predictors and included in the nomogram.The c-index in the training set is 0.773,indicating its relatively good discriminative ability.Likewise,the c-index in the valid ation set is 0.758,which shows a satisfactory prediction effect.The calibration curves sho w that the agreement between predicted likelihoods and actual observations is very good i n training and validation sets.The ROC curve of this model has an AUC of 0.773(95% C I;0.726–0.821)for the training set and 0.758(95% CI;0.679–0.837)for the validation set.DCA showed that the nomogram has clinical application value.Conclusions: Serum IGF-1 and IGFBP-3 levels are positively correlated with e GFR in patients with T2 DM.We established a novel and simple nomogram incorporating seven factors to help predict DN morbidity risk in T2 DM patients.