{"title":"Development and validation of a risk prediction model integrating WWI and lipocalin-2 for cognitive impairment in patients with type 2 diabetes.","authors":"Kunyu Liu, Tong Niu, Junru Zhou, Ruoyu Sun, Shaohua Wang, Yang Yuan","doi":"10.1186/s40001-026-04164-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the associations of the weight-adjusted waist index (WWI) and plasma lipocalin-2 (LCN2) with Montreal Cognitive Assessment (MoCA) -defined mild cognitive impairment (MCI) and to develop a risk prediction model in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>In this cross-sectional study, 410 patients were included. Anthropometric parameters, metabolic indices, plasma LCN2 levels, and neuropsychological test data were collected. Participants were randomly divided into a training cohort (70%) and a validation cohort (30%). Cognitive function was assessed using neuropsychological tests. MCI was defined based on MoCA scores (< 26). Predictors selected using LASSO regression were subsequently entered into multivariable logistic models. Model performance-including discrimination, calibration, and clinical utility-was evaluated in both cohorts.</p><p><strong>Results: </strong>WWI and plasma LCN2 levels were significantly higher in participants with MCI than in those with normal cognition (both P < 0.01). After adjustment for demographic and metabolic factors, WWI (OR = 1.753, 95% CI 1.337-2.299) and plasma LCN2 (per SD increase; OR = 1.680, 95% CI 1.255-2.248) remained independently associated with MCI. A multivariable model incorporating age, gender, education, WWI, and LCN2 demonstrated satisfactory discrimination [area under the curve (AUC) = 0.745 (95% CI 0.688-0.802) in the training cohort and 0.774 (95% CI 0.693-0.854) in the validation cohort], with acceptable calibration in both cohorts. The model showed higher discrimination than models based on individual predictors alone.</p><p><strong>Conclusion: </strong>WWI and LCN2 are independently and jointly associated with MCI in T2DM, and their integration may improve risk stratification for cognitive impairment. These obesity- and inflammation-related markers may serve as complementary indicators to support cognitive risk assessment in diabetes care.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":4.8000,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Medical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40001-026-04164-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate the associations of the weight-adjusted waist index (WWI) and plasma lipocalin-2 (LCN2) with Montreal Cognitive Assessment (MoCA) -defined mild cognitive impairment (MCI) and to develop a risk prediction model in patients with type 2 diabetes mellitus (T2DM).
Methods: In this cross-sectional study, 410 patients were included. Anthropometric parameters, metabolic indices, plasma LCN2 levels, and neuropsychological test data were collected. Participants were randomly divided into a training cohort (70%) and a validation cohort (30%). Cognitive function was assessed using neuropsychological tests. MCI was defined based on MoCA scores (< 26). Predictors selected using LASSO regression were subsequently entered into multivariable logistic models. Model performance-including discrimination, calibration, and clinical utility-was evaluated in both cohorts.
Results: WWI and plasma LCN2 levels were significantly higher in participants with MCI than in those with normal cognition (both P < 0.01). After adjustment for demographic and metabolic factors, WWI (OR = 1.753, 95% CI 1.337-2.299) and plasma LCN2 (per SD increase; OR = 1.680, 95% CI 1.255-2.248) remained independently associated with MCI. A multivariable model incorporating age, gender, education, WWI, and LCN2 demonstrated satisfactory discrimination [area under the curve (AUC) = 0.745 (95% CI 0.688-0.802) in the training cohort and 0.774 (95% CI 0.693-0.854) in the validation cohort], with acceptable calibration in both cohorts. The model showed higher discrimination than models based on individual predictors alone.
Conclusion: WWI and LCN2 are independently and jointly associated with MCI in T2DM, and their integration may improve risk stratification for cognitive impairment. These obesity- and inflammation-related markers may serve as complementary indicators to support cognitive risk assessment in diabetes care.
期刊介绍：
European Journal of Medical Research publishes translational and clinical research of international interest across all medical disciplines, enabling clinicians and other researchers to learn about developments and innovations within these disciplines and across the boundaries between disciplines. The journal publishes high quality research and reviews and aims to ensure that the results of all well-conducted research are published, regardless of their outcome.
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