Diabetes, metabolic syndrome and obesity : targets and therapy
Identifying Patients with Rapid Progression to Diabetic Retinopathy in Type 2 Diabetes: A Simple Prediction Model for Community Settings
By Zhao J, Kang Z, Niu D and 13 others.
Abstract
Background
Diabetic retinopathy (DR) progression in community-based type 2 diabetes (T2D) remains challenging to predict. This multi-site cohort study aimed to identify novel metabolic risk factors beyond glucose control and develop a resource-adaptable model for prioritizing DR risk screening.
Methods
A prospective, multi-site study was conducted among patients with T2D from 2021 to 2023 across 14 community health centers in Northwestern China (Shaanxi). Baseline and follow-up data on demographic, medical history, and laboratory data were collected. DR was assessed by trained retinal specialists through fundus photography and slit-lamp bio-microscopy. LASSO-penalized logistic regression with 10-fold cross-validation was first performed to identify candidate predictors, followed by multivariable logistic regression to construct the prediction model. Model discrimination was evaluated using receiver operating characteristic (ROC) curve analysis and bootstrap internal validation. Clinical characteristics before and after onset of DR were analyzed using the paired-sample Wilcoxon test.
