Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study

Rong Shi, Zheyun Niu, Birong Wu, Taotao Zhang, Dujie Cai, Hui Sun, Yuhong Hu, Ruohui Mo, Fan Hu School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Fan HuSchool of Public Health, Shanghai University of Traditiona...

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Autores principales:	Shi R, Niu Z, Wu B, Zhang T, Cai D, Sun H, Hu Y, Mo R, Hu F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	diabetic nephropathy diabetic retinopathy predictors nomogram type 2 diabetes mellitus Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/06b617d0f28844ee9606d130dc873fdd
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spelling	oai:doaj.org-article:06b617d0f28844ee9606d130dc873fdd2021-12-02T05:14:11ZNomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study1178-7007https://doaj.org/article/06b617d0f28844ee9606d130dc873fdd2020-04-01T00:00:00Zhttps://www.dovepress.com/nomogram-for-the-risk-of-diabetic-nephropathy-or-diabetic-retinopathy--peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Rong Shi, Zheyun Niu, Birong Wu, Taotao Zhang, Dujie Cai, Hui Sun, Yuhong Hu, Ruohui Mo, Fan Hu School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Fan HuSchool of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaTel +8613585828140Fax +862151322466Email joyking2003@163.comPurpose: This study aimed to develop a diabetic nephropathy (DN) or diabetic retinopathy (DR) incidence risk nomogram in China’s population with type 2 diabetes mellitus (T2DM) based on a community-based sample.Methods: We carried out questionnaire evaluations, physical examinations and biochemical tests among 4219 T2DM patients in Shanghai. According to the incidence of DN and DR, 4219 patients in our study were divided into groups of T2DM patients with DN or DR, patients with both, and patients without any complications. We successively used least absolute shrinkage and selection operator regression analysis and logistic regression analysis to optimize the feature selection for DN and DR. To ensure the accuracy of the results, we carried out multivariable logistic regression analysis of the above significant risk factors on the sample data for both DN and DR. The selected features were included to establish a prediction model. The C-index, calibration plot, curve analysis and internal validation were used to validate the distinction, calibration, and clinical practicality of the model.Results: The predictors in the prediction model included disease course, body mass index (BMI), total triglycerides (TGs), systolic blood pressure (SBP), postprandial blood glucose (PBG), haemoglobin A1C (HbA1c) and blood urea nitrogen (BUN). The model displayed moderate predictive power with a C-index of 0.807 and an area under the receiver operating characteristic curve of 0.807. In internal verification, the C-index reached 0.804. The risk threshold was 16– 75% according to the analysis of the decision curve, and the nomogram could be applied in clinical practice.Conclusion: This DN or DR incidence risk nomogram incorporating disease course, BMI, TGs, SBP, PBG, HbA1c and BUN can be used to predict DN or DR incidence risk in T2DM patients. The research team has developed an online app based on a clinical prediction model incorporating risk factors for rapid and simple prediction.Keywords: diabetic nephropathy, diabetic retinopathy, predictors, nomogram, type 2 diabetes mellitusShi RNiu ZWu BZhang TCai DSun HHu YMo RHu FDove Medical Pressarticlediabetic nephropathydiabetic retinopathypredictorsnomogramtype 2 diabetes mellitusSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 13, Pp 1215-1229 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic nephropathy diabetic retinopathy predictors nomogram type 2 diabetes mellitus Specialties of internal medicine RC581-951
spellingShingle	diabetic nephropathy diabetic retinopathy predictors nomogram type 2 diabetes mellitus Specialties of internal medicine RC581-951 Shi R Niu Z Wu B Zhang T Cai D Sun H Hu Y Mo R Hu F Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study
description	Rong Shi, Zheyun Niu, Birong Wu, Taotao Zhang, Dujie Cai, Hui Sun, Yuhong Hu, Ruohui Mo, Fan Hu School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Fan HuSchool of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaTel +8613585828140Fax +862151322466Email joyking2003@163.comPurpose: This study aimed to develop a diabetic nephropathy (DN) or diabetic retinopathy (DR) incidence risk nomogram in China’s population with type 2 diabetes mellitus (T2DM) based on a community-based sample.Methods: We carried out questionnaire evaluations, physical examinations and biochemical tests among 4219 T2DM patients in Shanghai. According to the incidence of DN and DR, 4219 patients in our study were divided into groups of T2DM patients with DN or DR, patients with both, and patients without any complications. We successively used least absolute shrinkage and selection operator regression analysis and logistic regression analysis to optimize the feature selection for DN and DR. To ensure the accuracy of the results, we carried out multivariable logistic regression analysis of the above significant risk factors on the sample data for both DN and DR. The selected features were included to establish a prediction model. The C-index, calibration plot, curve analysis and internal validation were used to validate the distinction, calibration, and clinical practicality of the model.Results: The predictors in the prediction model included disease course, body mass index (BMI), total triglycerides (TGs), systolic blood pressure (SBP), postprandial blood glucose (PBG), haemoglobin A1C (HbA1c) and blood urea nitrogen (BUN). The model displayed moderate predictive power with a C-index of 0.807 and an area under the receiver operating characteristic curve of 0.807. In internal verification, the C-index reached 0.804. The risk threshold was 16– 75% according to the analysis of the decision curve, and the nomogram could be applied in clinical practice.Conclusion: This DN or DR incidence risk nomogram incorporating disease course, BMI, TGs, SBP, PBG, HbA1c and BUN can be used to predict DN or DR incidence risk in T2DM patients. The research team has developed an online app based on a clinical prediction model incorporating risk factors for rapid and simple prediction.Keywords: diabetic nephropathy, diabetic retinopathy, predictors, nomogram, type 2 diabetes mellitus
format	article
author	Shi R Niu Z Wu B Zhang T Cai D Sun H Hu Y Mo R Hu F
author_facet	Shi R Niu Z Wu B Zhang T Cai D Sun H Hu Y Mo R Hu F
author_sort	Shi R
title	Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study
title_short	Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study
title_full	Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study
title_fullStr	Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study
title_full_unstemmed	Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study
title_sort	nomogram for the risk of diabetic nephropathy or diabetic retinopathy among patients with type 2 diabetes mellitus based on questionnaire and biochemical indicators: a cross-sectional study
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/06b617d0f28844ee9606d130dc873fdd
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Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study

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