Development and Validation of a Risk Nomogram Model for Predicting Constipation in Patients with Type 2 Diabetes Mellitus

Abstract

Purpose Constipation is a common complication of diabetic patients, which has a negative impact on their own health. This study aims to establish and internally validate the risk nomogram of constipation in patients with type 2 diabetes mellitus (T2DM) and to test its predictive ability. Patients and Methods This retrospective study included 746 patients with T2DM at two medical centers. Among the 746 patients with T2DM, 382 and 163 patients in the Beilun branch of the First Affiliated Hospital of Zhejiang University were enrolled in the training cohort and the validation cohort, respectively. A total of 201 patients in the First Affiliated Hospital of Nanchang University were enrolled in external validation cohorts. The nomogram was established by optimizing the predictive factors through univariate and multivariable logistic regression analysis. The prediction performance of the nomogram was measured by the area under the receiver operating characteristic curve (AUROC), the calibration curve, and the decision curve analysis (DCA). Furthermore, its applicability was internally and independently validated. Results Among the 16 clinicopathological features, five variables were selected to develop the prediction nomogram, including age, glycated hemoglobin (HbA1c), calcium, anxiety, and regular exercise. The nomogram revealed good discrimination with an area under the receiver operating characteristic curve (AUROC) of 0.908 (95% CI = 0.865–0.950) in the training cohort, and 0.867 (95% CI = 0.790–0.944) and 0.816 (95% CI = 0.751–0.881) in the internal and external validation cohorts, respectively. The calibration curve presented a good agreement between the prediction by the nomogram and the actual observation. The DCA revealed that the nomogram had a high clinical application value. Conclusion In this study, the nomogram for pretreatment risk management of constipation in patients with T2DM was developed which could help in making timely personalized clinical decisions for different risk populations.

Influencing Factors of Constipation in Elderly Patients With Intracerebral Hemorrhage: Implication for Clinical Care

“…It is well known that surgery, sedation, and limb paralysis can lead to longer bed rest and less exercise. This may lead to loss of appetite, weakened intestinal peristalsis function, and abdominal muscle relaxation, affecting defecation when the abdominal pressure is insufficient, resulting in constipation (Gu et al, 2023;Yuan et al, 2023). This is common in elderly hospitalized patients with intracerebral hemorrhage.…”

Risk factor analysis and nomogram for predicting gastroparesis in patients with type 2 diabetes mellitus

“…Nomograms can provide personalized and accurate risk assessment compared with other clinical prediction models, providing a convenient and effective decision-making method [ 12 ]. Nomograms have been used for the clinical prediction of multiple diseases, including gastric cancer [ 13 ], hepatocellular carcinoma [ 14 ], liver cirrhosis [ 15 ], pulmonary arterial hypertension [ 16 ], and diabetes [ 17 ]. Only a few studies have used nomograms to assess the occurrence of gastroparesis in individuals surffering with T2DM.…”