Risk Factors Analysis of Ischemic Leukoencephalopathy in Elderly Patients with Diabetes

doi:10.3969/j.issn.1009-0126.2025.05.024

Abstract：Objective To investigate the characteristics and risk factors of ischemic leukoencephalopathy in elderly patients with diabetes. Methods A retrospective study was conducted on 640 elderly diabetic patients admitted to the Department of Endocrinology of Huai'an First People's Hospital from January 2017 to December 2023. The patients were divided into two groups based on the presence or absence of ischemic leukoencephalopathy: the ischemic leukoencephalopathy group (n=272) and the control group (n=368). General clinical data between the two groups were compared. Multivariate logistic regression analysis was used to identify risk factors for ischemic leukoencephalopathy in elderly diabetic patients, a nomogram prediction model was constructed, and the predictive value of the model was evaluated. Results The proportions of age, age ≥80 years, glycosylated hemoglobin (HbA1c), HbA1c >8.75%, hypertension, stroke, carotid intima-media thickness (CIMT), and CIMT >1.26 mm were significantly higher in the ischemic leukoencephalopathy group than in the control group (P < 0.01). Age ≥80 years (OR=2.352, 95%CI:1.620–3.414, P=0.000), HbA1c >8.75% (OR=2.293, 95%CI:1.622–3.243, P=0.000), and CIMT >1.26 mm (OR=2.082, 95%CI:1.471–2.945, P=0.000) were independent risk factors for ischemic leukoencephalopathy in elderly diabetic patients. A nomogram prediction model for ischemic leukoencephalopathy in elderly diabetic patients was constructed. The area under the ROC curve (AUC) was 0.801 (95%CI:0.761–0.842) in the training set and 0.782 (95%CI:0.716–0.849) in the validation set. The Hosmer-Lemeshow goodness-of-fit test showed good fitting (χ²=9.124, P=0.361). Calibration curve analysis showed high consistency between the predicted probability and actual occurrence probability in both the training and validation sets. Conclusion Age, HbA1c, hypertension, stroke, and carotid intima-media thickness are related factors for ischemic leukoencephalopathy in elderly diabetic patients.