血清胰高血糖素样肽-1与糖尿病颈动脉粥样硬化关系及风险列线图的建立OA

Objective:To explore whether there is a connection between glucagon-like peptide-1(GLP-1)in the serum of patients with type 2 diabetes and carotid atherosclerosis,and to construct a nomogram model that can predict the risk of type 2 diabetes complicated with carotid atherosclerosis.Method:A retrospective study was conducted on 120 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology of Dahua Hospital,Xuhui District,Shanghai from December 2023 to January 2025.Based on the results of the color Doppler ultrasound examination of the cervical vessels received during hospitalization,they were divided into two groups:those with carotid atherosclerotic plaques were classified into the carotid atherosclerosis group,while those without obvious plaque formation were included in the simple type 2 diabetes group.The general clinical data and biochemical indicators of the two groups were compared.logistic regression was used to analyze the influencing factors of carotid atherosclerosis,and a risk prediction nomogram model was constructed simultaneously.The discriminative efficacy of the model was evaluated by the receiver operating characteristic(ROC)curve,and its accuracy was quantified by the area under the curve(AUC).And the net benefits of the model under different threshold probabilities were evaluated through decision curve analysis(DCA)to determine its clinical application value.Result:Among the 120 T2DM patients included in the study,69 cases(57.5％)were complicated with carotid atherosclerosis and 51 cases(42.5％)were patients with simple type 2 diabetes.Intergroup comparisons showed that there were statistically significant differences in age,gender,height,glucagon-like peptide-1(GLP-1),systolic blood pressure,fasting plasma glucose(FPG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin(HbA1c)between the two groups(P＜0.05).Multivariate logistic regression analysis showed that decreased GLP-1 level,elevated fasting blood glucose and elevated total cholesterol were all independent risk factors for type 2 diabetes mellitus complicated with carotid atherosclerosis(P＜0.05).Based on the above statistically significant variables,a nomogram prediction model is constructed.The area under the ROC curve of this model was 0.91(95％CI:0.86～0.96),indicating that its discriminative ability was good.The P value of the Hosmer-Lemeshow test was 0.323,suggesting that the model had good calibration and stability.The results of decision curve analysis(DCA)show that the model presents positive net benefits within a wide range of threshold probabilities,indicating that it has potential clinical application value.Conclusion:Decreased GLP-1 level,elevated fasting blood glucose level and elevated total cholesterol level are all independent risk factors for carotid atherosclerosis in patients with type 2 diabetes,and the differences are statistically significant(P＜0.05).The predictive model constructed based on the above variables has good discriminative efficacy and clinical application potential for this disease combination.