Obesity-related indices as predictors of lower extremity arterial disease in type 2 diabetes mellitus.

IF 3.7 3区医学 Q2 Medicine Endocrine Pub Date : 2025-02-01 Epub Date: 2024-10-04 DOI:10.1007/s12020-024-04039-0

Xin-Yue Xu, Hong-Yan Wu, Qiong Wei

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Abstract

Purpose: The aim of this study was to investigate the relationship between obesity and lower extremity arterial disease (LEAD) in patients with type 2 diabetes mellitus (T2DM).

Methods: This retrospective study included 1821 patients with type 2 diabetes: 364 patients with LEAD and 1457 patients without LEAD. The patients were divided into training and internal test cohorts in a 7:3 ratio. LASSO regression analysis was used in the training cohort to filter relevant variables. Univariate and multivariate regression analyses were conducted to assess independent risk factors. A diagnostic nomogram was constructed and its discrimination was evaluated using the area under the ROC curve (AUC). The consistency was assessed using a calibration plot. The clinical application of the nomogram was evaluated by performing a decision curve analysis (DCA) and validated by an internal test cohort of the training cohorts.

Results: The LEAD group exhibited significantly higher values in obesity-related indices compared to the non-LEAD group, including waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), conicity index (CI), body adiposity index (BAI), and abdominal volume index (AVI). Multivariate analysis identified BMI, CI, BAI, and other parameters as independent risk factors for LEAD. A nomogram was constructed, and the AUC value of the nomogram was 0.746 in the training cohort and 0.663 in the internal test cohort.

Conclusion: Obesity-related indices are associated with LEAD in patients with T2DM. Therefore, it is important to manage waist circumference and weight to reduce the risk of LEAD in patients with T2DM.

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预测 2 型糖尿病患者下肢动脉疾病的肥胖相关指数。

目的：本研究旨在探讨肥胖与 2 型糖尿病（T2DM）患者下肢动脉疾病（LEAD）之间的关系：这项回顾性研究包括 1821 名 2 型糖尿病患者：364 名患有下肢动脉疾病的患者和 1457 名未患有下肢动脉疾病的患者。患者按 7:3 的比例分为训练组和内部测试组。在训练队列中使用 LASSO 回归分析筛选相关变量。进行了单变量和多变量回归分析，以评估独立的风险因素。构建了诊断提名图，并使用 ROC 曲线下面积（AUC）评估了其区分度。使用校准图评估其一致性。通过进行决策曲线分析（DCA）评估了提名图的临床应用，并通过培训队列的内部测试队列进行了验证：结果：与非 LEAD 组相比，LEAD 组的肥胖相关指数值明显更高，包括腰围 (WC)、腰臀比 (WHR)、腰高比 (WHTR)、圆锥指数 (CI)、体脂指数 (BAI) 和腹围指数 (AVI)。多变量分析确定 BMI、CI、BAI 和其他参数是导致 LEAD 的独立风险因素。我们构建了一个提名图，训练队列的提名图AUC值为0.746，内部测试队列的AUC值为0.663：结论：肥胖相关指数与 T2DM 患者的 LEAD 有关。结论：肥胖相关指数与 T2DM 患者的 LEAD 有关，因此，控制腰围和体重对降低 T2DM 患者的 LEAD 风险非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.