Construction of a nomogram model to predict the development of retinopathy in type 2 diabetes mellitus based on systemic inflammatory indicators

This study examined the association between the incidence of diabetic retinopathy (DR) in male with type 2 diabetes mellitus (T2DM) and the levels of the systemic immunoin-flammatory index (SII), platelet/lymphocyte ratio (PLR), and neutrophil/lymphocyte ratio (NLR). A total of 719 T2DM men participated in this study. Patients’ basic information, physical examinations, and laboratory examinations were collected. DR in T2DM men was screened for independent influencing variables using both univariate and multivariate logistic regression analysis. A 7:3 ratio of random numbers was used to divide participants into Training cohort (n = 503) and Validation cohort (n = 216). There were 106 (14.74%) DR patients among 719 T2DM men. NLR, PLR and SII levels were significantly higher in DR patients than in non-DR patients in the training cohort (p < 0.05). DR occurrence in T2DM men was predicted by the area under curves (AUCs) of NLR, PLR and SII of 0.721, 0.745 and 0.751, respectively. Age, diabetic neuropathy (DN), diabetic kidney disease (DKD), fasting glucose (FPG), glycated albumin (GA), ultrasensitive C-reactive protein (hsCRP), NLR, PLR and SII were the independent risk factors for DR in T2DM men (p < 0.05). On the basis of these ten independent risk variables, a nomogram model was constructed for DR prediction. The AUCs for the training and validation cohorts were 0.982 and 0.981, respectively. In both the training and validation cohorts, the Hosmer-Lemeshow test showed a good fit. Also, clinical decision curves supported the model’s clinical benefit. DR occurrence in T2DM men is independently influenced by the peripheral blood systemic inflammatory indexes NLR, PLR and SII. With good predictive performance and clinical utility, a nomogram based on inflammatory clinical features can provide a preliminary assessment of DR occurrence in T2DM men.

Type 2 diabetes mellitus; Diabetic retinopathy; Systemic inflammatory indexes; Nomogram; Risk factors

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