Abstract:

Objective To investigate the predictive value of high-density lipoprotein cholesterol（HDL-C） on the risk of cerebral ischemic stroke（CIS） in patients with type 2 diabetes mellitus（T2DM）. Methods From January 2020 to February 2022，298 patients with T2DM were enrolled from Nanjing First Hospital，which included 150 patients with T2DM only（control group） and 148 patients with T2DM complicated with CIS（CIS group）. The clinical data and clinical laboratory determination results were collected. Multivariate Logistic regression analysis was used to evaluate the risk factors of CIS in T2DM patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of HDL-C in determining CIS in T2DM patients. R software was used to establish a nomogram model for predicting CIS in T2DM patients. Results HDL-C，non-high-density lipoprotein cholesterol（non-HDL-C），triglyceride（TG）/HDL-C，serum amyloid A（SAA）/apolipoprotein A1（apo A1），glycated hemoglobin A_1c（HbA_1c），hypertension and age were independent risk factors for CIS in T2DM patients. ROC curve was drawn using HDL-C as the predictor. The area under curve（AUC） of HDL-C on the risk of CIS in T2DM patients was 0.62，the optimal cut-off value was 0.63，and the sensitivity and specificity were 34.5% and 93.3%，respectively. When risk factors were included in the nomogram model，the C-index was 0.859. ROC curve analysis results showed that the AUC of CIS judged by the nomogram model for T2DM was 0.859，and the calibration curve analysis results showed that the predicted results were in good agreement with the actual results，which had good goodness of fit（P=0.180）. Conclusions The established nomogram model can identify the high-risk group of CIS in T2DM patients，and it is necessary to focus on the group of T2DM with low HDL-C level.

Key words: High-density lipoprotein cholesterol, Type 2 diabetes mellitus, Cerebral ischemic stroke