Development and validation of a nomogram prediction model for hypertension-diabetes comorbidity based on chronic disease management in the community

[Risk factors for ketoacidosis in children/adolescents with type 1 diabetes mellitus and establishment of a predictive model]

OBJECTIVES

To investigate the risk factors for diabetic ketoacidosis (DKA) in children/adolescents with type 1 diabetes mellitus (T1DM) and to establish a model for predicting the risk of DKA.

METHODS

A retrospective analysis was performed on 217 children/adolescents with T1DM who were admitted to General Hospital of Ningxia Medical University from January 2018 to December 2021. Among the 217 children/adolescents,169 cases with DKA were included as the DKA group and 48 cases without DKA were included as the non-DKA group. The risk factors for DKA in the children/adolescents with T1DM were analyzed, and a nomogram model was established for predicting the risk of DKA in children/adolescents with T1DM.

RESULTS

For the 217 children/adolescents with T1DM, the incidence rate of DKA was 77.9% (169/217). The multivariate logistic regression analysis showed that high levels of random blood glucose, hemoglobin A1c (HbA1c), blood ketone body, and triglyceride on admission were closely associated with the development of DKA in the children/adolescents with T1DM (OR=1.156, 3.2031015, 20.131, and 9.519 respectively; P<0.05). The nomogram prediction model had a C-statistic of 0.95, with a mean absolute error of 0.004 between the risk of DKA predicted by the nomogram model and the actual risk of DKA, indicating that the model had a good overall prediction ability.

CONCLUSIONS

High levels of random blood glucose, HbA1c, blood ketone body, and triglyceride on admission are closely associated with the development of DKA in children/adolescents with T1DM, and targeted intervention measures should be developed to reduce the risk of DKA.

The relationship between hypertriglyceridemic wait-to-height ratio and hypertension-diabetes comorbidity among older adult

Objective

Limited information is available on the effect of hypertriglyceridemic waist-to-height ratio (HTHWH) and hypertension-diabetes comorbidity (HAD) in older adult people. We aimed to explore the relationship between HTHWH and HAD for the co-management of hypertension and diabetes mellitus in the older adult.

Methods

A cross-sectional study, randomized cluster sampling from 10 community health service centers, and multivariate logistic regression were used in this study. A total of 3,501 participants aged 65 years or older recruited between January 2019 and December 2019 completed the study.

Results

Among 3,501 participants, the median age was 69.96 years, and 42.50% were men. A total of 1,207 subjects were in the HTHWH group, and the prevalence rate of HAD was 17.23% in this group. Multivariate logistic regression analysis showed that, as compared with the normal group, the risk of HAD in the HTHWH group increased by 2.05 times (OR = 3.05, 95% CI: 2.06-4.51). The risks of hypertension or diabetes mellitus (HOD), hypertension, and diabetes mellitus were also increased in the HTHWH group, with their ORs (95%CIs) being 1.82 (1.44-2.29), 1.73 (1.38-2.17), and 2.28 (1.66-3.13), respectively.

Conclusion

HTHWH significantly increases the risk of HAD and can be used as a reliable tool to screen the high-risk population for HAD.