Influencing factors and prediction model of the occurrence of dry eye disease in type 2 diabetes patients with peripheral neuropathy
Objective To investigate the influencing factors of dry eye disease in type 2 diabetes mellitus(T2DM)patients with peripheral neuropathy,and to construct a nomogram prediction model.Methods 78 T2DM patients with peripheral neuropathy were selected and divided into two groups based on the occurrence of dry eye disease:the dry eye group(18 patients,26 eyes)and the non-dry eye group(60 patients,94 eyes).Clinical data such as gender,age,duration of disease,eye involvement,concurrent hypertension,se-verity of neuropathy,lacrimal gland dysfunction,insulin deficiency,disease awareness level,medication adherence,inflammatory factors[Interleukin-1β(IL-1β),Interleukin-6(IL-6),Tumor Necrosis Factor-α(TNF-α)],fasting plasma glucose(FPG),and gly-cated hemoglobin(HbA1c)were compared between the two groups.Multifactorial logistic regression analysis was used to identify the in-dependent risk factors of the occurrence of dry eye disease in these patients.A nomogram model was constructed by using R4.3.0 soft-ware,and its discriminative ability was evaluated by using the Receiver Operating Characteristic(ROC)curve.The predictive perform-ance of model was validated with 1000 bootstrap resamples.Results Significant differences were observed between the two groups in terms of severity of neuropathy,lacrimal gland dysfunction,insulin deficiency,disease awareness level,medication adherence,IL-1 β,IL-6,TNF-α,FPG,and HbA1c levels(P＜0.05).Multifactorial logistic regression analysis revealed that severe neuropathy,lacrimal gland dysfunction,insulin deficiency,low disease awareness level,poor medication adherence,and high levels of IL-1β,IL-6,TNF-α,FPG,and HbA1c were independent risk factors for the occurrence of dry eye disease in T2DM patients with peripheral neuropathy(P＜0.05).The results of the ROC curve analysis showed that the AUC value of the multifactorial combined prediction model was 0.961(95％CI:0.931～0.992),indicating that the model has good discriminative ability.Bootstrap validation demonstrated that the deviation calibration curve of the model matched well with the ideal curve.Conclusion Severe neuropathy,lacrimal gland dysfunction,insulin de-ficiency,low disease awareness level,poor medication adherence,and high levels of IL-1β,IL-6,TNF-α,FPG,and HbA1c are inde-pendent risk factors for the occurrence of dry eye disease in T2DM patients with peripheral neuropathy.The constructed multifactorial combined prediction model has good discriminative ability and can effectively predict the risk of dry eye disease in these patients,which is of significant importance for clinical diagnosis and treatment.
Type 2 diabetes mellitusPeripheral neuropathyDry eye diseaseInfluencing factorsNomogramPrediction model
万方数据
维普
