ArticleFrontiers in endocrinology2025
Predicting diabetic cardiomyopathy in type 2 diabetes: development and validation of a nomogram based on clinical and echocardiographic parameters.
Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
Objective: Diabetic cardiomyopathy (DCM) is a myocardial dysfunction disorder driven by diabetes-associated metabolic disorders, significantly elevating the risk of heart failure in patients with type 2 diabetes mellitus (T2DM). We aimed to develop and validate a nomogram for individualized DCM risk prediction in T2DM populations. Methods: This retrospective study enrolled 525 consecutive T2DM patients admitted to our hospital (June 2022-June 2024). Participants were randomly allocated to training (70%) or validation (30%) cohorts. Baseline clinical characteristics, laboratory profiles, and echocardiographic parameters were collected. Predictors were identified via univariate then multivariate logistic regression, followed by nomogram construction. Model validation included: (1) internal validation via 1000 bootstrap resamples; (2) discrimination assessed by the area under the receiver operating characteristic curve (AUC-ROC); (3) calibration evaluated using calibration plots and the Hosmer-Lemeshow goodness-of-fit test; (4) clinical utility determined by decision curve analysis (DCA) and clinical impact curves (CIC). Results: Six independent predictors-age, duration of type 2 diabetes mellitus (T2DM Duration), systolic blood pressure (SBP), urinary albumin-to-creatinine ratio (UACR), left atrial diameter (LAD), and left ventricular posterior wall thickness at end-diastole (LVPWd)-were incorporated. The model showed excellent discrimination: AUC 0.947 (95% CI: 0.916-0.967) in training and 0.922 (95% CI: 0.870-0.956) in validation cohorts. Calibration indicated strong agreement (Hosmer-Lemeshow χ² = 9.2119, Conclusions: This nomogram integrates routine clinical/echocardiographic parameters to predict DCM risk in T2DM patients, facilitating individualized risk stratification and guiding early cardioprotective interventions in high-risk populations. Clinical Trial Registration: https://www.chictr.org.cn/index.html, identifier ChiCTR2400093755.
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