Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model
Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model
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Logistic回归结合决策树模型分析中国西部地区2型糖尿病患者颈动脉内膜中层厚度的危险因素
DOI：
10.1186/s13098-020-0517-8
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发表时间：
2020-01-28
影响因子：
4.8
通讯作者：
Han, Yuan-Yuan
中科院分区：
文献类型：
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作者：
Zhou, Yuan-Yuan;Qiu, Hong-Mei;Han, Yuan-Yuan
背景心血管疾病（CVD）是2型糖尿病（T2 DM）患者发病和死亡的主要原因。颈动脉内膜中层厚度（CIMT）被认为是动脉粥样硬化的临床前阶段。因此，有必要识别CIMT的相关危险因素，以促进CVD的早期预防。既往研究表明，内脏脂肪面积（VFA）是T2 DM和CVD的危险因素。然而，很少有研究关注VFA对T2 DM相关CIMT的影响。此外，考虑到体脂分布具有地区和种族异质性，本研究的目的是探讨VFA和其他危险因素对中国西部地区T2 DM相关CIMT的预测价值。根据CIMT值将1372例T2 DM患者分为CIMT（−）组（n = 965）和CIMT（+）组（n = 407）。结果单因素分析显示，性别、吸烟状况、年龄、心率、收缩压（SBP）、舒张压（DBP）、身高、体重、体重指数（BMI）、腰围、臀围、腰臀比、VFA、皮下脂肪面积、2-h C肽、血肌酐、尿素氮、尿酸水平两组间差异均有显著性（均P < 0.05）。Logistic回归分析显示，吸烟、VFA增高、女性和BMI增高是危险因素（OR值分别为5.759、1.364、2.239、1.186）。在决策树模型中，吸烟是根节点，其次是性别，腰围，VFA和慢性肾脏病（CKD）的importants.ConclusionsIn除了吸烟，性别和BMI，VFA有一个显着的影响CIMT与T2 DM在中国西部汉族人群。此外，决策树模型可以帮助临床医生做出更有效的决策，其简单直观，值得在未来的医学研究中推广。注册日期2019年11月24日-Retrologic registered，http://www.chictr.org.cn/index.aspx.
BackgroundCardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with type 2 diabetes (T2DM). Carotid intima-media thickness (CIMT) is considered a preclinical stage of atherosclerosis. Therefore, it is necessary to identify the related risk factors for CIMT to facilitate the early prevention of CVD. Previous studies have shown that visceral fat area (VFA) is a risk factor for T2DM and CVD. However, few studies have focused on the effects of VFA on CIMT associated with T2DM. Moreover, considering that the body fat distribution shows regional and racial heterogeneity, the purpose of this study was to investigate the predictive value of VFA and other risk factors for CIMT associated with T2DM in Western China.MethodsIn a cross-sectional study, a total of 1372 patients with T2DM were divided into the CIMT (−) group (n = 965) and the CIMT (+) group (n = 407) based on CIMT values. In addition to the univariate analyses, logistic regression analysis and a decision tree model were simultaneously performed to establish a correlation factor model for CIMT.ResultsUnivariate analyses showed that sex, smoking status, age, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), height, weight, body mass index (BMI), waist circumference, hip circumference, waist-hip ratio, VFA, subcutaneous fat area, and the levels of 2-h C-peptide, serum creatinine, urea nitrogen and uric acid were significantly different between the two groups (allp< 0.05). Smoking, increased VFA, female sex and increased BMI were risk factors in the logistic regression analyses (OR = 5.759, OR = 1.364, OR = 2.239, OR = 1.186, respectively). In the decision tree model, smoking was the root node, followed by sex, waist circumference, VFA and chronic kidney disease (CKD) in order of importance.ConclusionsIn addition to smoking, sex and BMI, VFA has a significant effect on CIMT associated with T2DM in the Chinese Han population in Western China. In addition, the decision tree model could help clinicians make more effective decisions, with its simplicity and intuitiveness, making it worth promoting in future medical research.Trial registrationChiCTR, ChiCTR1900027739. Registered 24 November 2019-Retrospectively registered, http://www.chictr.org.cn/index.aspx.