Correlations between serum uric acid,thyroid hormones,and atherosclerotic cardiovascular disease in type 2 dia-betes patients

YE Bin; JI Xiao-zhen; ZHU Xiang-ying; JI Mei-xia

doi:10.13820/j.cnki.gdyx.20234620

Abstract：Objective To investigate the relationship between serum uric acid(SUA)levels,thyroid hormones,and the occurrence of atherosclerotic cardiovascular disease(ASCVD)in patients with type 2 diabetes mellitus(T2DM),and to construct a risk prediction model for occurrence.Methods A retrospective study was conducted on 326 T2DM patients treated in the Department of Endocrinology at Lishui People's Hospital from May 2020 to May 2023.Patients were divided into the occurrence group(n=152)and non-occurrence group(n=174)based on whether ASCVD occurred.Clinical data and serum levels of SUA and thyroid hormones(TT3,TT4,FT3,FT4,TSH)were collected for all sub-jects.Univariate and multivariate logistic regression analyses were used to analyze the risk factors for ASCVD in T2DM pa-tients,and a risk nomogram prediction model for ASCVD in T2DM patients was constructed based on these factors.Results There were statistically significant differences in age,fasting blood glucose,duration of diabetes,triglycerides,SUA,and TSH levels between the two groups(P＜0.05).However,there were no differences in other variables between the two groups(P＞0.05).Binary logistic regression analysis showed that older age,longer duration of diabetes,higher triglyceride levels,higher SUA levels,and higher TSH levels were independent risk factors for ASCVD in T2DM patients(P＜0.05).The ROC curve analysis results showed that the area under the ROC curve AUC of age,duration of diabetes,triglycerides,SUA,TSH,and the nomogram prediction model were 0.711,0.702,0.668,0.755,0.965,and 0.987,respectively,indicating good predictive value for ASCVD in T2DM patients.When the cut-off values were determined,the sensitivities were 0.638,0.539,0.638,0.730,0.941,and 0.960,respectively,and the specificities were 0.690,0.799,0.644,0.661,0.943,and 0.954,respectively.Bootstrap validation of the nomogram prediction model(B=1 000)showed that the bias-corrected prediction curve overlapped well with the ideal curve,with a C-index of 0.975,indicating good predictive ability of the model.Decision curve analysis showed that the threshold probability range of the model was 0.01 to 0.98,with a net benefit rate＞0.Conclusion Serum SUA and thyroid hormone levels are important indicators for predicting ASCVD in T2DM patients,and the constructed risk nomogram prediction model has good predic-tive performance and clinical application value.