Predict and prevent microvascular complications of type 2 diabetes: a cross-sectional and longitudinal study in Chinese communities

PurposeThis study investigates the incidence, predictors, and preventive strategies for microvascular complications in type 2 diabetes patients in community settings.MethodsData were collected from 3,008 type 2 diabetes patients enrolled across 31 clinics in Beijing and Hebei. Prevalence and inciden...

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Main Authors: Zhaoxiang Liu, Lianhao Zhou, Wenhui Zhao, Lixia Jin, Jinping Zhang, Yajing Zhang, Yufeng Li, Guixia Deng, Jiquan He, Xinghua Zhao, Wenli Zheng, Yong Tian, Ji Wu, Jianzhong Xiao, Jiandong Gao
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1541663/full
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author Zhaoxiang Liu
Lianhao Zhou
Wenhui Zhao
Lixia Jin
Jinping Zhang
Yajing Zhang
Yufeng Li
Guixia Deng
Jiquan He
Xinghua Zhao
Wenli Zheng
Yong Tian
Ji Wu
Ji Wu
Jianzhong Xiao
Jianzhong Xiao
Jiandong Gao
Jiandong Gao
author_facet Zhaoxiang Liu
Lianhao Zhou
Wenhui Zhao
Lixia Jin
Jinping Zhang
Yajing Zhang
Yufeng Li
Guixia Deng
Jiquan He
Xinghua Zhao
Wenli Zheng
Yong Tian
Ji Wu
Ji Wu
Jianzhong Xiao
Jianzhong Xiao
Jiandong Gao
Jiandong Gao
author_sort Zhaoxiang Liu
collection DOAJ
description PurposeThis study investigates the incidence, predictors, and preventive strategies for microvascular complications in type 2 diabetes patients in community settings.MethodsData were collected from 3,008 type 2 diabetes patients enrolled across 31 clinics in Beijing and Hebei. Prevalence and incidence of diabetic kidney disease (DKD), diabetic retinopathy (DR), and diabetic peripheral neuropathy (DPN) were assessed. Predictors were identified using XGBoost and Cox regression, and the impact of lifestyle and multifactorial interventions (MFI) was analyzed.ResultsThe prevalence of DKD, DR, and DPN were 39.5%, 26.2%, and 27.1%, respectively, with incidences of 74, 21, and 28 per 1000-person year. XGBoost identified that diabetes duration, age, HbA1c, FBG, triglyceride, BP, serum creatinine, proteinuria, aspirin and statin use were associated with those microvascular complications. The risk of DKD increased more rapidly as HbA1c exceeded 7.5% and decreased as blood pressure was maintained below 120/70 mmHg. Cox regression models showed that community-based intervention, including lifestyle modifications, were associated with a lower risk of DR and DPN. The study also found that higher variability in HbA1c and albumin-to-creatinine ratio (ACR) was associated with an increased risk of microvascular complications.ConclusionsCommunity-based interventions significantly reduce the of DR and DPN, highlighting the need for individualized glycemic and BP management in primary care. The findings emphasize the importance of comprehensive management strategies to prevent the development and progression of microvascular complications in type 2 diabetes patients.Clinical trial registrationhttp://www.chictr.org.cn/, identifier ChiCTR-TRC-13003222.
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spelling doaj-art-6959552baca040b8ba3a0f08618d05752025-08-20T02:49:50ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-03-011610.3389/fendo.2025.15416631541663Predict and prevent microvascular complications of type 2 diabetes: a cross-sectional and longitudinal study in Chinese communitiesZhaoxiang Liu0Lianhao Zhou1Wenhui Zhao2Lixia Jin3Jinping Zhang4Yajing Zhang5Yufeng Li6Guixia Deng7Jiquan He8Xinghua Zhao9Wenli Zheng10Yong Tian11Ji Wu12Ji Wu13Jianzhong Xiao14Jianzhong Xiao15Jiandong Gao16Jiandong Gao17Department of Endocrinology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, ChinaDepartment of Electronic Engineering, Tsinghua University, Beijing, ChinaDepartment of Endocrinology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, ChinaDepartment of Endocrinology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, ChinaDepartment of Endocrinology, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Endocrinology, Beijing Pinggu District Hospital, Beijing, ChinaDepartment of Endocrinology, Beijing Pinggu District Hospital, Beijing, ChinaDepartment of Endocrinology, Beijing Pinggu District Yukou Community Central Health Center, Beijing, ChinaDepartment of Endocrinology, Beijing Pinggu District Xiagezhuang Township Hospital, Beijing, ChinaDepartment of Endocrinology, Beijing Huairou District Yangsong Township Hospital, Beijing, ChinaDepartment of Endocrinology, Beijing Daxing District Yinghai Community Central Health Center, Beijing, ChinaDepartment of Endocrinology, Beijing Huairou Hospital, Beijing, ChinaDepartment of Electronic Engineering, Tsinghua University, Beijing, China0Center for Big Data and Clinical Research, Institute for Precision Medicine, Tsinghua University, Beijing, ChinaDepartment of Endocrinology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China1Center for Intelligent Healthcare, Institute for Precision Medicine, Tsinghua University, Beijing, ChinaDepartment of Electronic Engineering, Tsinghua University, Beijing, China0Center for Big Data and Clinical Research, Institute for Precision Medicine, Tsinghua University, Beijing, ChinaPurposeThis study investigates the incidence, predictors, and preventive strategies for microvascular complications in type 2 diabetes patients in community settings.MethodsData were collected from 3,008 type 2 diabetes patients enrolled across 31 clinics in Beijing and Hebei. Prevalence and incidence of diabetic kidney disease (DKD), diabetic retinopathy (DR), and diabetic peripheral neuropathy (DPN) were assessed. Predictors were identified using XGBoost and Cox regression, and the impact of lifestyle and multifactorial interventions (MFI) was analyzed.ResultsThe prevalence of DKD, DR, and DPN were 39.5%, 26.2%, and 27.1%, respectively, with incidences of 74, 21, and 28 per 1000-person year. XGBoost identified that diabetes duration, age, HbA1c, FBG, triglyceride, BP, serum creatinine, proteinuria, aspirin and statin use were associated with those microvascular complications. The risk of DKD increased more rapidly as HbA1c exceeded 7.5% and decreased as blood pressure was maintained below 120/70 mmHg. Cox regression models showed that community-based intervention, including lifestyle modifications, were associated with a lower risk of DR and DPN. The study also found that higher variability in HbA1c and albumin-to-creatinine ratio (ACR) was associated with an increased risk of microvascular complications.ConclusionsCommunity-based interventions significantly reduce the of DR and DPN, highlighting the need for individualized glycemic and BP management in primary care. The findings emphasize the importance of comprehensive management strategies to prevent the development and progression of microvascular complications in type 2 diabetes patients.Clinical trial registrationhttp://www.chictr.org.cn/, identifier ChiCTR-TRC-13003222.https://www.frontiersin.org/articles/10.3389/fendo.2025.1541663/fulltype 2 diabetesmachine learningdiabetes kidney diseasediabetic retinopathydiabetic peripheral neuropathy
spellingShingle Zhaoxiang Liu
Lianhao Zhou
Wenhui Zhao
Lixia Jin
Jinping Zhang
Yajing Zhang
Yufeng Li
Guixia Deng
Jiquan He
Xinghua Zhao
Wenli Zheng
Yong Tian
Ji Wu
Ji Wu
Jianzhong Xiao
Jianzhong Xiao
Jiandong Gao
Jiandong Gao
Predict and prevent microvascular complications of type 2 diabetes: a cross-sectional and longitudinal study in Chinese communities
Frontiers in Endocrinology
type 2 diabetes
machine learning
diabetes kidney disease
diabetic retinopathy
diabetic peripheral neuropathy
title Predict and prevent microvascular complications of type 2 diabetes: a cross-sectional and longitudinal study in Chinese communities
title_full Predict and prevent microvascular complications of type 2 diabetes: a cross-sectional and longitudinal study in Chinese communities
title_fullStr Predict and prevent microvascular complications of type 2 diabetes: a cross-sectional and longitudinal study in Chinese communities
title_full_unstemmed Predict and prevent microvascular complications of type 2 diabetes: a cross-sectional and longitudinal study in Chinese communities
title_short Predict and prevent microvascular complications of type 2 diabetes: a cross-sectional and longitudinal study in Chinese communities
title_sort predict and prevent microvascular complications of type 2 diabetes a cross sectional and longitudinal study in chinese communities
topic type 2 diabetes
machine learning
diabetes kidney disease
diabetic retinopathy
diabetic peripheral neuropathy
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1541663/full
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