Analysis of risk factors and construction of risk prediction model for sarcopenia in patients with diabetes complicated with heart failure

ZHAO Li-juan; GUO Hui; HAO Hai-hong

doi:10.3969/j.issn.1672-5301.2025.02.010

Abstract：Objective To analyze the risk factors of sarcopenia(SP)in patients with diabetes mellitus complicated with heart failure,and to establish a risk prediction model.Methods A total of 200 patients with diabetes combined with heart failure admitted to Xingtai Central hospital from November 2023 to March 2024 were selected as the study objects.The patients were divided into SP group and Non-SP group according to the presence or absence of SP,and the clinical data of the two groups were compared.The risk factors of SP in patients with diabetes combined with heart failure were analyzed by binary multivariate Logistic regression,and the risk prediction model was constructed and verified.Results The incidence of SP was 36％.Compared with Non-SP group,the proportion of age,diabetes course,fasting blood glucose,hemoglobin A1c(HbA1c)and cardiac function grade Ⅲ/Ⅳ in SP group were higher than those in Non-SP group,and body mass index(BMI),left ventricular ejection fraction(LVEF),calf circumference,blood potassium,skeletal muscle mass,visceral fat area and bone mineral content in SP group were lower than those in Non-SP group(P＜0.05).Logistic analysis showed that age was an independent risk factor for SP in patients with diabetes combined with heart failure,and high BMI,high skeletal muscle mass and high LVEF were protective factors(P＜0.05).According to the Logistic regression analysis results,SP risk curve model was constructed,and ROC curve was drawn to verify the differentiation of the model.The results showed that the area under ROC curve,sensitivity,specificity were 0.903(0.855-0.952),76.39％and 90.63％.The calibration curve of the nomogram model was close to the actual curve,and the Hosmer-Lemeshow test was P＞0.05.External verification showed that the area under ROC curve,sensitivity and specificity under ROC curve were 0.904(0.830-0.978),88.24％and 79.07％.The calibration curve was close to the actual curve,and the Hosmer-Lemeshow test was P＞0.05.Conclusion Based on the age,BMI,skeletal muscle mass and LVEF of patients with diabetes and heart failure,the neagram model of SP occurrence was constructed with good differentiation and accuracy.