基于生化指标构建2型糖尿病患者心脏舒张功能预测模型的研究  

A new model constructed using biochemical indices for predicting cardiac diastolic function in patients with type 2 diabetes mellitus

作　　者：李晨子 王守俊[1] LI Chenzi;WANG Shoujun(Department of Endocrinology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院内分泌科,450052

出　　处：《中国糖尿病杂志》2025年第3期173-177,共5页Chinese Journal of Diabetes

基　　金：郑州市协同创新项目(XTCX2023012)。

摘　　要：目的 利用生化指标构建预测T2DM患者心脏功能的新模型,旨在发现影响T2DM患者心脏功能的内在因素。方法 回顾性选取2023年1月至2024年1月于郑州大学第一附属医院内分泌科就诊的T2DM患者361例,依据心脏功能分为单纯T2DM组(n=117)和心室舒张功能下降组(n=244)。收集两组一般资料及生化指标,并完善心脏彩超检查,利用Logistic回归构建预测新模型,采用受试者工作特征(ROC)曲线下面积(AUC)评估模型精准度,Hosmer-Lemeshow拟合优度检验评估模型校准度。结果 心室舒张功能下降组年龄、DM病程、尿素、血肌酐(Scr)、25羟维生素D_(3)、TC、HDL-C高于T2DM组(P<0.05),TG、三酰甘油-葡萄糖指数、血尿酸(SUA)、e GFR低于T2DM组(P<0.05)。Logistic回归分析结果显示,DM病程、尿素、Scr、SUA、e GFR是T2DM患者心脏舒张功能下降的影响因素,构建预测模型为:y=7.054+0.097×lnDM病程+0.209×ln尿素-0.203×ln Scr-0.003×ln SUA-0.052×ln eGFR,AUC为0.832,敏感度为0.713,特异度为0.803,截断值为0.69,模型拟合良好,具有一定的预测价值。结论 T2DM患者心脏舒张功能的下降与DM病程、尿素、SUA、Scr、e GFR相关,构建的新模型对T2DM患者心脏功能预测效果好。Objective To establish a new model for predicting cardiac function in patients with type 2 diabetes mellitus(T2DM)by using biochemical indicators,in order to find the intrinsic factors affecting cardiac function in T2DM patients.Methods A total of 361 patients with T2DM admitted to the Department of Endocrinology of The First Affiliated Hospital of Zhengzhou University from January 2023 to January 2024 were retrospectively selected.They were divided into T2DM group(n=117)and decreased ventricular diastolic function group(n=244)according to cardiac function.General characteristics and biochemical indicators were collected in the two groups,as well as echocardiography.Logistic regression was used to construct a new prediction model.The area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the accuracy of the model,and the Hosmer-Lemeshow goodness-of-fit test was used to evaluate the calibration of the model.Results Age,DM duration,TC,urea,serum creatinine(Scr),25(OH)D_(3)and HDL-C were higher,while TG,triglyceride and glucose product index,serum uric acid(SUA)and glomerular filtration rate(eGFR)were lower in the ventricular diastolic function decline group than in the T2DM group(P<0.05).Logistic regression analysis showed that the duration of DM,urea,Scr,SUA and eGFR were the influencing factors for cardiac diastolic function decline inpatients with T2DM,and the prediction model was constructed as follows:y=7.054+0.097 Xln DM duration+0.209 X In urea-0.203Xln Scr-0.003Xln SUA-0.052Xln eGFR,AUC was 0.832,sensitivity was 0.713,specificity was 0.803,cut-off value was 0.69,and the model fited well and had certain predictive value.Conclusions The decline of cardiac diastolic function in patients with T2DM is related to DM duration,urea,SUA,Scr and eGFR.The new model has a good predictive effect on cardiac function in patients with T2DM and provides clinical value.

关 键 词：糖尿病 2型 心脏舒张功能 肾功能 心肾代谢综合征 

分 类 号：R587.1[医药卫生—内分泌]