Combined SHR and SIRI biomarkers predict increased coronary heart disease risk in type 2 diabetes.

0 MEDICINE, RESEARCH & EXPERIMENTAL
Zixuan Guo, Siqi Song, Hao Cheng, Changxu Xie, Meng Zhang, Mengyang Pei, Mengting Liu, Zican Shen
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Abstract

Coronary heart disease (CHD) is a leading cause of morbidity and mortality; patients with type 2 diabetes mellitus (T2DM) are at particularly high risk, highlighting the need for reliable biomarkers for early detection and risk stratification. We investigated whether combining the stress hyperglycemia ratio (SHR) and systemic inflammation response index (SIRI) improves CHD detection in T2DM. In this retrospective cohort of 943 T2DM patients undergoing coronary angiography, associations of SHR and SIRI with CHD were evaluated using multivariable logistic regression and restricted cubic splines; robustness was examined with subgroup and sensitivity analyses. Discriminative performance was assessed by receiver operating characteristic (ROC) analysis and reclassification metrics (integrated discrimination improvement [IDI], net reclassification improvement [NRI]). Internal validation used bootstrapping, with calibration and discrimination yielding apparent and bias-corrected estimates. Of 943 patients, 600 had CHD. Multivariable models showed SHR (OR=1.68; 95% CI, 1.14-2.46; p=0.008) and SIRI (OR=2.17; 95% CI, 1.54-3.05; p<0.001) were independently associated with CHD, with nonlinear relationships (p for nonlinearity <0.05). Findings were consistent across subgroups and sensitivity analyses. The combined SHR-SIRI model achieved an AUC of 0.813 (95% CI, 0.783-0.843), outperforming SHR alone (AUC=0.773; 95% CI, 0.740-0.805) and SIRI alone (AUC=0.745; 95% CI, 0.713-0.778), and significantly improved NRI and IDI (p <0.05). All models showed strong discrimination and calibration. In conclusion, SHR and SIRI are independently associated with CHD in T2DM, and their combination enhances early identification of high-risk individuals.

联合SHR和SIRI生物标志物预测2型糖尿病患者冠心病风险增加。
冠心病(CHD)是发病率和死亡率的主要原因;2型糖尿病(T2DM)患者的风险特别高,因此需要可靠的生物标志物进行早期检测和风险分层。我们研究了应激性高血糖比(SHR)和全身炎症反应指数(SIRI)联合检测是否能改善T2DM患者的冠心病检测。在这项943例接受冠状动脉造影的T2DM患者的回顾性队列研究中,使用多变量logistic回归和限制性三次样条评估SHR和SIRI与冠心病的关系;采用亚组分析和敏感性分析检验稳健性。通过受试者工作特征(ROC)分析和重分类指标(综合判别改善[IDI]、净重分类改善[NRI])评估鉴别表现。内部验证使用自举法,通过校准和区分产生明显的和偏差校正的估计。在943名患者中,600名患有冠心病。多变量模型显示SHR (OR=1.68; 95% CI, 1.14-2.46; p=0.008)和SIRI (OR=2.17; 95% CI, 1.54-3.05
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CiteScore
1.10
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