| 2型糖尿病并发糖尿病肾病的危险因素与预测模型构建及验证 |
| 投稿时间：2025-05-31 修订日期：2025-07-17 点此下载全文 |
| 引用本文：热娜古丽·热合曼,艾比拜·玉素甫.2型糖尿病并发糖尿病肾病的危险因素与预测模型构建及验证[J].医学研究杂志,2025,54(12):128-133 |
| DOI：
10.11969/j.issn.1673-548X.2025.12.022 |
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| 基金项目:省部共建中亚高发病成因与防治国家重点实验室开放课题项目(SKL-HIDCA-2024-RWS1) |
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| 中文摘要:目的 探究影响2型糖尿病(type 2diabetes mellitus,T2DM)并发糖尿病肾病(diabetic nephropathy,DN)的相关危险因素,建立风险预测模型。方法 回顾性分析2023年8月～2024年10月新疆医科大学第一附属医院收治的917例T2DM患者的临床资料,根据DN的诊断标准,将患者分为DN组(n=194)和非DN组(n=723),并对其进行单因素分析和多因素Logistic回归分析,并以受试者工作特征(receiver operating characteristic,ROC)曲线构建预测模型并进行验证。结果 单因素分析结果显示,尿微量白蛋白与肌酐比值(urinary microalbumin-to-creatinine ratio,ACR)、糖化血红蛋白(glycated hemoglobin,HbA1c)、胱抑素C(cystatin C,Cys-C)、胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)为T2DM合并DN的影响因素。多因素Logistic回归分析结果显示,ACR(OR=1.465,95% CI:1.320~1.626)、LDL-C(OR=1.997,95% CI:1.593~2.504)、HbA1c(OR=1.148,95% CI:1.068~1.234)、Cys-C(OR=2.470,95% CI:1.432~4.260)等均为T2DM合并DN的独立危险因素(P<0.05),IGF-1(OR=0.991,95% CI:0.987~0.995)为T2DM合并DN的独立保护因素(P<0.05)。Hosmer-Lemeshow检验结果显示,C指数为0.962,AUC值为0.852(95% CI:0.764~0.939),敏感度为92.33%,特异性为85.62%。结论 以ACR、LDL-C、IGF-1、HbA1c、Cys-C构建的预测模型具有良好预测效能。临床医生应重视对上述危险因素的控制和监测,以降低DN的发生风险。 |
| 中文关键词:2型糖尿病 糖尿病肾病 危险因素 预测模型 血清胰岛素样生长因子-1 胱抑素C |
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| Risk Factors and Predictive Models for Type 2 Diabetes Mellitus Complicated with Diabetic Nephropathy:Construction and Validation. |
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| Abstract:Objective To investigate the related risk factors influencing type 2diabetes mellitus (T2DM) complicated with diabetic nephropathy (DN), and establish a risk predictive model. Methods A retrospective analysis was conducted on clinical data of 917 T2DM patients admitted to The First Affiliated Hospital of Xinjiang Medical University from August 2023 to October 2024. Patients were divided into two groups according to the diagnostic criteria of DN:the DN group (n=194) and the non-DN group (n=723). Univariate analysis and multivariate Logistic regression analysis were performed, and a predictive model was constructed and validated using the receiver operating characteristic (ROC) curve. Results The results of univariate analysis showed that the urinary microalbumin-to-creatinine ratio (ACR), glycated hemoglobin (HbA1c), cystatin C (Cys-C), insulin-like growth factor-1 (IGF-1), low-density lipoprotein cholesterol (LDL-C) were the influencing factor for T2DM complicated with DN. The results of multivariate Logistic regression analysis showed that ACR (OR=1.465,95% CI:1.320-1.626), LDL-C (OR=1.997,95% CI:1.593-2.504), HbA1c (OR=1.148,95% CI:1.068-1.234), and Cys-C (OR=2.470,95% CI:1.432-4.260) were the independent risk factors for T2DM complicated with DN (P<0.05). Conversely, IGF-1 (OR=0.991,95% CI:0.987-0.995) was the independent protective factor for T2DM complicated with DN (P<0.05). The results of Hosmer-Lemeshow test showed that the C-index was 0.962, with AUC value was 0.852 (95% CI:0.764-0.939), the sensitivity was 92.33%, and the specificity was 85.62%. Conclusion The predictive model constructed with ACR, LDL-C, IGF-1, HbA1c and Cys-C demonstrated excellent predictive efficacy. Clinical practitioners should prioritize controlling and monitoring these risk factors to reduce the incidence of DN. |
| keywords:Type 2 diabetes mellitus Diabetic nephropathy Risk factors Prediction model Serum insulin-like growth factor-1 Cystatin C |
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