广东医学2024，Vol.45Issue(6)：744-750,7.DOI:10.13820/j.cnki.gdyx.20234620
血清血尿酸及甲状腺激素与2型糖尿病患者发生动脉粥样硬化性心血管疾病的关系
Correlations between serum uric acid,thyroid hormones,and atherosclerotic cardiovascular disease in type 2 dia-betes patients
摘要
Abstract
Objective To investigate the relationship between serum uric acid(SUA)levels,thyroid hormones,and the occurrence of atherosclerotic cardiovascular disease(ASCVD)in patients with type 2 diabetes mellitus(T2DM),and to construct a risk prediction model for occurrence.Methods A retrospective study was conducted on 326 T2DM patients treated in the Department of Endocrinology at Lishui People's Hospital from May 2020 to May 2023.Patients were divided into the occurrence group(n=152)and non-occurrence group(n=174)based on whether ASCVD occurred.Clinical data and serum levels of SUA and thyroid hormones(TT3,TT4,FT3,FT4,TSH)were collected for all sub-jects.Univariate and multivariate logistic regression analyses were used to analyze the risk factors for ASCVD in T2DM pa-tients,and a risk nomogram prediction model for ASCVD in T2DM patients was constructed based on these factors.Results There were statistically significant differences in age,fasting blood glucose,duration of diabetes,triglycerides,SUA,and TSH levels between the two groups(P＜0.05).However,there were no differences in other variables between the two groups(P＞0.05).Binary logistic regression analysis showed that older age,longer duration of diabetes,higher triglyceride levels,higher SUA levels,and higher TSH levels were independent risk factors for ASCVD in T2DM patients(P＜0.05).The ROC curve analysis results showed that the area under the ROC curve AUC of age,duration of diabetes,triglycerides,SUA,TSH,and the nomogram prediction model were 0.711,0.702,0.668,0.755,0.965,and 0.987,respectively,indicating good predictive value for ASCVD in T2DM patients.When the cut-off values were determined,the sensitivities were 0.638,0.539,0.638,0.730,0.941,and 0.960,respectively,and the specificities were 0.690,0.799,0.644,0.661,0.943,and 0.954,respectively.Bootstrap validation of the nomogram prediction model(B=1 000)showed that the bias-corrected prediction curve overlapped well with the ideal curve,with a C-index of 0.975,indicating good predictive ability of the model.Decision curve analysis showed that the threshold probability range of the model was 0.01 to 0.98,with a net benefit rate＞0.Conclusion Serum SUA and thyroid hormone levels are important indicators for predicting ASCVD in T2DM patients,and the constructed risk nomogram prediction model has good predic-tive performance and clinical application value.关键词
2型糖尿病/血尿酸/甲状腺激素水平/动脉粥样硬化性心血管疾病/影响因素/预测模型Key words
type 2 diabetes/blood uric acid/thyroid hormone levels/atherosclerotic cardiovascular disease/influencing factors/prediction model分类
医药卫生引用本文复制引用
叶斌,季晓珍,朱向盈,季美霞..血清血尿酸及甲状腺激素与2型糖尿病患者发生动脉粥样硬化性心血管疾病的关系[J].广东医学,2024,45(6):744-750,7.基金项目
2022年浙江省卫生健康科技计划(2022ZH022) （2022ZH022）
