Nomogram analysis of the influencing factors of cardiovascular and cerebrovascular diseases in patients with type 2 diabetes mellitus

Abstract

Objective To investigate the influencing factors of cardiovascular and cerebrovascular diseases in patients with type 2 diabetes mellitus(T2DM), and to evaluate the influencing factors. Methods From January to December of 2015, 936 in-hospital patients with T2DM were enrolled in the study.Case report form(CRF)was designed and the data of general demographic characteristics, disease history, physiological and biochemical test results, cardiovascular and cerebrovascular diseases were included.Patients in this study were diagnosed according to the diagnostic criteria which was developed by Chinese Medical Association, Society of Cardiovascular Diseases and 4th National Conference on Cerebravascular Diseases.Logistic regression analysis was used to screen the influencing factors of cardiovascular and cerebrovascular diseases, and the Nomogram method was used to score each factors. Results (1)The number of T2DM patients combined with cardiovascular disease were 143 cases(15.3%), while 793 cases(84.7%)without cardiovascular disease.Age, gender, disease length, systolic blood pressure(SBP), fasting blood glucose(FBG), postprandial blood glucose(PBG), glycosylated hemoglobin(HbA1c), blood urea nitrogen(BUN), creatinine and uric acid were significantly different between two groups(P<0.001). (2)Logistic regression showed that OR for age was 1.04(95%CI: 1.02-1.06); OR for women was 0.61(95%CI: 0.43-0.88); OR for every 1 mm Hg increase in SBP was 1.02(95%CI: 1.01-1.03). OR for FBG, PBG, HbA1c and BUN was 1.08(95%CI: 1.01-1.15), 1.08(95%CI: 1.01-1.11), 1.19(95%CI: 1.07-1.33), 2.16(95%CI: 1.32-3.53)respectively.All factors were statistically significant(all P<0.05). (3)Logistic analysis showed age(OR: 1.04, 95%CI: 1.01-1.06), gender(OR: 1.55, 95%CI: 1.05-2.30), SBP(OR: 1.02, 95%CI: 1.00-1.03), HbA1c(OR: 1.21, 95%CI: 1.07-1.37), BUN(OR: 1.80, 95%CI: 1.08-3.01)were independent risk factors for cardiovascular and cerebrovascular disease(all P<0.05). (4)Nomogram model analysis showed that the factor score range from 81 to 208, the corresponding risk rate range was from 0.05 to 0.60.T2DM patients with higher score have greater risk for cardiovascular and cerebrovascular disease.(5)The area under the predictive power curve of of Nomogram model(AUC)was 0.688(95%CI: 0.617-0.720, P<0.001). Conclusions Age, sex, SBP, HbA1c and BUN are independent influence factors for cardiovascular and cerebrovascular diseases.The model of Nomogram is more direct evaluation method for cerebrovascular disease, which will helpful to prevent and treat cardiovascular and cerebrovascular disease for patients with type 2 diabetes mellitus. Key words: Cardiovascular diseases; Cerebrovascular diseases; Diabetes mellitus, type; Nomograms