Effect of triglyceride glucose index and uric acid level on carotid atherosclerosis in patients with type 2 diabetes mellitus and establishment of the risk nomogram model
Objective To explore the effect of triglyceride glucose(TyG)index and uric acid level on carotid athero-sclerosis in patients with type 2 diabetes mellitus(T2DM),and build a risk nomogram model for T2DM complicated with carotid atherosclerosis.Methods A total of 125 T2DM patients admitted to the First People's Hospital of Xinxiang City from January 2020 to December 2022 were selected as the research subjects.The patients were divided into the carotid atherosclerosis group(n=33)and the non-carotid atherosclerosis group(n=92)according to whether they had carotid atherosclerosis.The general clinical data such as gender,age,course of disease,body mass index(BMI),diastolic blood pressure(DBP),and systolic blood pressure(SBP)of patients were collected through the electronic medical record system.The levels of triglycerides(TG),fasting plasma glucose(FPG),creatinine(Cr),fasting insulin(FINS),glycosylated hemoglobin(HbA1c),high-densi-ty lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and total cholesterol(TC)were measured by using a fully automatic biochemical analyzer.The uric acid level was determined by using the uricase method.The risk factors of carotid atherosclerosis in T2DM patients were analyzed through univariate and multivariate logistic regression.R3.5.3 software was used to draw a nomogram model to predict carotid atherosclerosis in T2DM patients.The predictive performance of the nomogram model was validated by the receiver operating curve(ROC),and the accuracy of the model was tested by the Bootstrap method.Additionally,a total of 27 T2DM patients admitted to the First People's Hospital of Xinxiang City from January 2023 to June 2023 were selected to validate the predictive performance of the model.Results The univariate analysis showed that there were significant differences in the age,course of disease,Cr,FINS,FPG,TC,TG,TyG index and uric acid level of patients between the carotid atherosclerosis group and the non-carotid atherosclerosis group(P＜0.05);there was no statisti-cally significant difference in gender,BMI,DBP,SBP,HbA1c,HDL-C and LDL-C of patients between the two groups(P＞0.05).Multivariate logistic regression analysis showed that age ≥60 years,high Cr level,low FINS level,high TC level,high TyG index and high uric acid level were the risk factors for carotid atherosclerosis in T2DM patients(P＜0.05).The.The validation results of Bootstrap method for validating the early warning model established based on age,Cr,FINS,TC,TyG index and uric acid level to predict the risk of carotid atherosclerosis in T2DM patients showed that the C-index of the model was 0.762(95％confidence interval:0.728-0.808),and the area under the ROC curve,sensitivity,and specificity were 0.779,77.34％,and 82.46％,respectively.Among the 27 T2DM patients,8 cases developed carotid atherosclerosis,while the risk nomogram model predicted 7 cases of carotid arteriosclerosis.The ROC curve showed that the area under the curve,sensitivity and specificity were 0.785,80.47％and 75.36％,respectively.Conclusion High TyG index and high uric acid level are risk factors for T2DM patients with carotid atherosclerosis.The risk nomogram model constructed based on TyG index,uric acid level,age,Cr,FINS and TC has a good predictive effect on carotid atherosclerosis in T2DM patients.
triglyceride glucose indexuric acidtype 2 diabetes mellituscarotid atherosclerosisrisk nomogram model
维普
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