Predictive value of cardiac markers, atherogenic index of plasma and cardiometabolic index for coronary heart disease in type 2 diabetes mellitus patients with normal body mass index.

BACKGROUND: Prior research has established type 2 diabetes mellitus (T2DM) as a risk factor for the onset of coronary heart disease (CHD). Nevertheless, the impact of abnormal lipid metabolism on the development of CHD in individuals with a normal body mass index (BMI) remains uncertain. The objective of our study was to examine risk factors for CHD in T2DM patients with normal BMI and construct predictive model.

METHODS: Multivariate logistic and LASSO regression analyses were utilized to examine the independent risk factors associated with CHD. A calibration, decision curve analysis (DCA), and precision-recall (PR) curves were employed to assess the model's goodness of fit.

RESULTS: Seven independent risk factors, namely the duration of T2DM, FBG, HbA1c, NT-proBNP, sST2, AIP, and CMI, contributed to the development of CHD in T2DM patients with normal BMI by logistic and LASSO regression analysis. These factors were utilized to construct a robust and dependable nomogram model for predicting CHD risk with the likelihood-ratio test (χ2 = 309.52; P < 0.001), C index (0.964; 95 % CI: 0.945 - 0.983; P < 0.001), and hosmer-lemeshow goodness fit (χ2 = 3.7675; P = 0.878).

CONCLUSIONS: Our findings indicated that impaired lipid metabolism in T2DM patients with a normal BMI is closely linked to the onset of CHD. Effective management strategies, including strict glycemic control, vigilant monitoring of myocardial markers, and regulation of blood lipids and visceral fat, are essential for reducing the incidence of CHD in T2DM patients with normal BMI.