老年2型糖尿病患者视网膜病变风险预测模型的构建与应用

Construction and application of risk prediction model for retinopathy in elderly patients with type 2 diabetes mellitus

目的探讨老年T2DM患者DR的危险因素并构建相关预测模型。方法选取2021年1月至2023年3月于我院内分泌科治疗的老年T2DM患者426例,根据是否合并DR分为单纯T2DM组(n=322)和合并DR组(DR,n=104)。比较两组一般资料及生化指标。结果DR组DM病程≥10年、高血压病、糖尿病周围神经病变(DPN)、吸烟史、Hb A1c、血尿酸(SUA)及高度近视率高于T2DM组(P<0.05)。Pearson相关分析显示,老年T2DM患者DR与DM病程≥10年、Hb A1c、高血压病、DPN、吸烟史、SUA及高度近视呈正相关(P<0.05)。Logistic回归分析显示,DM病程≥10年、Hb A1c、高血压、DPN、吸烟史、SUA及高度近视是老年T2DM患者发生DR的危险因素。受试者工作特征曲线分析显示,老年T2DM患者发生DR的曲线下面积为0.863,敏感度为78.8%,特异度为81.1%。结论DM病程≥10年、高血压病、DPN、吸烟史、Hb A1c、SUA及高度近视是老年T2DM患者发生DR的危险因素,老年T2DM患者发生DR的预测模型准确性良好。

Objective To investigate the risk factors of diabetic retinopathy(DR)in elderly patients with type 2 diabetes mellitus(T2DM)and establish the related prediction model.Methods A total of 426 elderly T2DM patients admitted to the Endocrinology Department of our hospital from January 2021 to March 2023 were enrolled in this study and divided into DR group(n=104)and T2DM group(n=322)according to the occurrence of DR.Results The DM duration≥10 years,hypertension,DPN,smoking,HbA1c,SUA,and high myopia were higher in the DR group than in the T2DM group(P<0.05).Pearson correlation analysis showed that DR was positively correlated with DM duration≥10 years,HbA1c,hypertension,DPN,smoking,SUA and high myopia in elderly T2DM patients(P<0.05).Logistic regression analysis showed that DM duration≥10 years,HbA1c,hypertension,DPN,smoking history,SUA,and high myopia were risk factors for DR in elderly T2DM patients.The analysis of the working characteristic curve of the subjects showed that the area under the curve for the occurrence of DR in elderly T2DM patients was 0.863,with a sensitivity of 78.8%and a specificity of 81.1%.Conclusions The duration of diabetes≥10 years,hypertension,DPN,smoking,HbA1c,SUA and high myopia are risk factors for the occurrence of DR in elderly patients with T2DM.The prediction model of DR has good accuracy in elderly patients with T2DM.