The Influencing Factors of Type 2 Diabetes Mellitus (T2DM) Combined with Cardiac Autonomic Neuropathy and Their Predictive Value Based on Ewing Test

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a widespread metabolic disorder characterized with various multifaceted complications, among which cardiac autonomic neuropathy (CAN) stands out as a significant concern. The CAN affects the autonomic nerves that regulate heart function, thereby exposing individuals with T2DM to considerable risks. The study aims to investigate the influencing factors of T2DM combined with CAN and their predictive value based on Ewing test. Methods: This study was conducted between March and November 2021. The clinical data of 119 T2DM patients were analyzed retrospectively. These patients were categorized into the diabetes cardiac autonomic neuropathy positive (DCAN⁺) and negative (DCAN^-) groups based on Ewing test results. The results from venous blood test of the two groups were compared respectively. Various biochemical parameters, including fasting plasma glucose, insulin levels, and lipid profiles were determined. Logistic regression was employed to identify factors influencing T2DM combined with CAN, and the predictive performance of the model was subsequently evaluated. Results: Patients in the DCAN⁺ group exhibited higher age, body mass index, diabetic duration, prevalence of coronary heart disease, and peripheral neuritis compared to the DCAN^- group (p < 0.05). Additionally, DCAN⁺ individuals had elevated levels of serum uric acid (SUA), fasting insulin (FINS), and homeostasis model assessment-β (HOMA-β) (p < 0.05). Multivariate logistic regression highlighted age, diabetic duration, peripheral neuritis, SUA, FINS, and HOMA-β as significant risk factors for DCAN. The predictive model demonstrated good diagnostic accuracy, with HOMA-β exhibiting particularly high clinical value (p < 0.01). Conclusions: Age, diabetic duration, peripheral neuritis, SUA, FINS, and HOMA-β emerged as influential risk factors for DCAN and demonstrated high diagnostic value with particular emphasis on the contribution of the HOMA-β. Establishing a model based on risk factors effectively predicts the risk of DCAN. Targeted measures should be taken to reduce the incidence of DCAN and improve the prognosis and quality of life of T2DM patients.