基于Lorenz散点图及三维RR散点图心率变异性构建列线图模型预测2型糖尿病心脏自主神经病变

doi:10.3969/j.issn.1006-6233.2025.06.29

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Abstract Objective: To investigate the predictive value of heart rate variability (HRV)-constructed column-linear graphical models based on Lorenz scatterplot and three-dimensional RR scatterplot for cardiac autonomic neuropathy (DCAN) in type 2 diabetes mellitus (T2DM). Methods: Totally 103 patients with T2DM admitted between April 2021 and March 2024 were selected for retrospective analysis, all patients underwent Lorenz scatterplot and 3D RR scatterplot analyses, patients were divided into DCAN and NDCAN groups based on cardiovascular reflexology test (CART), and the differences in HRV indices between the two groups were compared, and the correlation between scatterplot HRV indices and time domain indices was analysedWe constructed a column-line graph model of scatterplot HRV indexes by R software, and evaluated the predictive value of the model for the occurrence of DCAN in T2DM patients. Results: The standard deviation of 24-h normal sinus intervals (SDNN), long axis (L0), short axis (W), long-short axis ratio (L0/W) of Lorenz scatter plot, long axis of three-dimensional RR scatter plot in stereospace (L), long axis of two-dimensional graph in the xoy plane (L1), and long axis on the x-axis of the quadratic projection (L2) of DCAN group were lower than that of NDCAN group, and the difference was statistically significant (P<0.05); Pearson correlation analysis showed that L0, W, L, L1, L2 were positively correlated with SDNN (r=0.933, 0.227, 0.272, 0.931, 0.932, P<0.001), and the correlation between L0/W and SDNN was not statistically significant (r=0.054, P=0.586); and multifactorial analysis showed that L0, L1,L2 were independent influences on the occurrence of DCAN in T2DM patients (P<0.05); a 3-factor predictive model Ln(P/1-P)=11.127-0.005*L0-0.003*L1-0.010*L2 was established for the combined application, and the Hosmer-Lemeshow goodness-of-fit test was performed on the model, with P=0.842>0.05, theThe area under the ROC curve was calculated to be 0.942 with a 95% CI of 0.899 to 0.985, and the decision curves showed that the net patient benefit was higher in both cases than in the other two extreme curves, and that the model yielded a better clinical benefit with a threshold probability of 0.02 to 0.92. Conclusion: The column-linear graphical model constructed on the basis of Lorenz scatterplot and three-dimensional RR scatterplot HRV indicators (L0, L0/W, L1) has a high predictive value for the occurrence of DCAN in patients with T2DM, and the model can help to identify patients at high risk of DCAN at an early stage.

Key words： Type 2 diabetes mellitus Lorenz scatter plot Three-dimensional RR scatter plot Heart rate variability Nomogram model Cardiac autonomic neuropathy

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	LI Chunyan
	ZHONG Ye
	CHAI Juanjuan
	et al

Cite this article:

LI Chunyan,ZHONG Ye,CHAI Juanjuan, et al. Prediction of Cardiac Autonomic Neuropathy in T2DM by Constructing a Column-Linear Graphical Model Based on Lorenz Scatterplot and Three-Dimensional RR Scatterplot Heart Rate Variability[J]. HeBei Med, 2025, 31(6): 1033-1038.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.06.29 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I6/1033

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