Construction of a Nomogram to Predict the Risk of Type 2 Diabetes in the Elderly Based on the REACTION Database

FU Xiaomin; LIU Jing; LI Nan; MIAO Xinyu; SUN Banruo; CHEN Kang; AN Ping; GU Zhaoy-an; LIU Hongzhou; YAN Shuangtong

doi:10.3969/j.issn.1002-3429.2025.10.009

Abstract：Objective To investigate the predictive value of a nomogram for the risk of type 2 diabetes mellitus(T2DM)in the elderly.Methods Individual case data of T2DM patients from December 2011 to October 2014 were extrac-ted from REACTION database.A total of 4 726 elderly people without T2DM at baseline examination were included.All sub-jects were divided into two groups according to whether they were diagnosed with T2DM.Univariate and multivariate Cox pro-portional hazards regression models were used to determine the independent risk factors affecting the onset of T2DM,and a no-mogram was constructed based on the results of multivariate analysis.R software(4.4.0)was used for analysis.The receiver operating characteristic(ROC)curve was used to evaluate the discrimination of the nomogram in predicting the risk of T2DM in the elderly at 5-and 10-year follow-up,and the calibration curve was used to evaluate its calibration.Results The analy-sis results of univariate and multivariate Cox proportional hazards regression model showed that the hazard ratio(HR)of uni-variate and multivariate analyses of gender was 1.394 4(P=0.013 5)and1.375 1(P=0.014 2)respectively.The HR of univariate and multivariate analyses of high-density lipoprotein cholesterol was 0.681 2(P=0.008 5),and 0.701 4(P=0.006 5)respectively.The HR of univariate and multivariate analyses of serum creatinine(Scr)was 1.009 6(P=0.021 0),and 1.009 4(P=0.022 0)respectively.The HR of univariate and multivariate analyses of fasting blood glucose was 1.175 7(P=0.006 7)and 1.115 0(P=0.003 8).Gender,fasting blood glucose,Scr and high-density lipoprotein cholesterol were used to construct a nomogram for predicting the risk of T2DM in the elderly.ROC curve analysis showed that the area under the ROC curve of the nomogram for predicting the risk of T2DM in the elderly at 5-and 10-year follow-up was 0.766 and 0.750 respectively,indicating that the nomogram model had moderate discrimination.The calibration curve showed that the probability of T2DM onset predicted by the nomogram model was in good agreement with the actual observation results.Conclusion The nomogram constructed based on REACTION database is a reliable prediction tool,which can effectively pre-dict the risk of T2DM in the elderly.