山东医药2023，Vol.63Issue(34)：31-37,7.DOI:10.3969/j.issn.1002-266X.2023.34.007
基于血清瘦素/脂联素构建的列线图模型对老年糖尿病患者并发认知衰弱的预测价值
Establishment of a nomogram predictive model based on serum leptin-to-adiponectin ratio for cognitive frailty in elderly patients with type 2 diabetes mellitus
摘要
Abstract
Objective To observe the changes of serum leptin(LEP)and adiponectin(APN)levels in elderly pa-tients with type 2 diabetes mellitus(T2DM)complicated with cognitive frailty(CF),to establish a nomogram predictive model based on serum LEP-to-APN(L/A)ratio for CF in elderly patients with T2DM and to predict its value.Methods A total of 321 elderly patients with T2DM were enrolled as the research objects(observation group),and patients were di-vided into the CF group and non-CF group according to whether CF occurred.In addition,100 healthy people undergoing physical examination during the same period were selected as the control group.Serum levels of LEP,APN,and L/A ratio between the observation group and the control group,and the demographic,clinical data,and the serum levels of LEP,APN,and L/A ratio between the CF group and non-CF group were compared.Multivariate Logistic regression model was used to analyze the independent risk factors for concurrent CF in elderly patients with T2DM.The receiver operating char-acteristic(ROC)curve was drawn to evaluate the predictive value of L/A ratio for concurrent CF in elderly patients with T2DM.A nomogram predictive model based on L/A ratio for concurrent CF in elderly patients with T2DM was estab-lished,and internal validation was conducted.Results Compared with the control group,the serum LEP level and the L/A ratio increased significantly,and the serum APN level decreased in the observation group(Z=-7.723,-6.404,-9.145,all P<0.05).Of 321 elderly patients with T2DM,85 cases had CF,with an incidence of 26.48%.Multivariate Logistic regression analysis showed that age≥75 years,depression,malnutrition,the elevated level of HbA1c and L/A ra-tio were independent risk factors for concurrent CF in elderly patients with T2DM(all P<0 05).According to the ROC curve analysis,the area under the curve(AUC),specificity,sensitivity and optimal cut-off value of L/A ratio in predict-ing the concurrent CF in elderly patients with T2DM were 0.798(95%CI:0.750-0.840),85.59%,65.88%and 1.18,respectively.The nomogram prediction model based on L/A ratio constructed by the above five risk factors dis-played good discrimination with a C-index of 0.853(95%CI:0.809-0.897).The calibration curve showed that the pre-dicted probability of the model was close to the actual probability and had good consistency.According to decision curve analysis,when the threshold was 0.1-0.8,the nomogram prediction model had good clinical practicality.Conclusions L/A ratio increases in elderly patients with T2DM,and it is an independent risk factor for concurrent CF in elderly pa-tients with T2DM.L/A ratio has a certain value in predicting concurrent CF in elderly patients with T2DM,and the nomo-gram prediction model based on L/A ratio has a high predictive ability for concurrent CF in elderly patients with T2DM.关键词
糖尿病,2型/认知衰弱/瘦素/脂联素/列线图/老年人Key words
diabetes mellitus,type 2/cognitive frailty/Leptin-to-adiponectin ratio/nomogram/the elderly分类
医药卫生引用本文复制引用
王中君,陈金逸,李敏香..基于血清瘦素/脂联素构建的列线图模型对老年糖尿病患者并发认知衰弱的预测价值[J].山东医药,2023,63(34):31-37,7.基金项目
海南省卫生健康行业课题(22A200090). （22A200090）
