Prognostic nutritional index and diabetic peripheral neuropathy in type 2 diabetes: a machine learning approach.

Background: The prognostic nutritional index (PNI), an indicator of nutritional status, has been linked to various diabetic complications. However, its relationship with diabetic peripheral neuropathy (DPN) remains unclear. This study aimed to explore the association between PNI and DPN using machin...

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Publicado en:Nutrition & Metabolism Vol. 22; no. 1; pp. 1 - 11
Autores principales: Wu, Ya, Dong, Danmeng, Liu, Yang, Xie, Xiaoyun
Formato: research tables/charts Journal Article
Publicado: BioMed Central 3/25/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 3/25/2025
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      pub: BioMed Central
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        atl: Prognostic nutritional index and diabetic peripheral neuropathy in type 2 diabetes: a machine learning approach.
      aug:
        au:
          Wu, Ya
          Dong, Danmeng
          Liu, Yang
          Xie, Xiaoyun
        affil: https://ror.org/03rc6as71 Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 200072, Shanghai, China
      sug:
        subj:
          Diabetes Mellitus, Type 2 Complications
          Diabetic Neuropathies Prognosis
          Diabetic Neuropathies Prevention and Control
          Diabetic Neuropathies Risk Factors
          Nutritional Status
          Nutritional Assessment
          Machine Learning
          Risk Assessment
          Human
          Male
          Female
          Middle Age
          Aged
          Albumins Blood
          Lymphocyte Count
          Random Forest
          Models, Theoretical
          Multivariate Analysis
          Multiple Logistic Regression
          Odds Ratio
          Confidence Intervals
          Neural Conduction
          T-Tests
          Chi Square Test
          Spearman's Rank Correlation Coefficient
          Kruskal-Wallis Test
          Statistical Significance
          Data Analysis Software
          Descriptive Statistics
          Funding Source
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: The prognostic nutritional index (PNI), an indicator of nutritional status, has been linked to various diabetic complications. However, its relationship with diabetic peripheral neuropathy (DPN) remains unclear. This study aimed to explore the association between PNI and DPN using machine learning (ML) approaches. Methods: A total of 625 patients with type 2 diabetes (T2D) were enrolled, with 282 diagnosed with DPN. PNI was calculated based on serum albumin and lymphocyte count. Random forest (RF) and eXtreme Gradient Boosting (XGBoost) models were developed to predict DPN using clinical and biochemical data. SHapley Additive exPlanations (SHAP) were applied to determine feature importance. Multivariate logistic regression was used to evaluate the relationship between PNI quartile and DPN risks. Results: Both RF and XGBoost models exhibited strong performance. The RF model achieved a recall of 78.4%, specificity of 87.8%, and accuracy of 84.0%, while the XGBoost model showed a recall of 77.4%, specificity of 92.1%, and accuracy of 84.8%. SHAP analysis identified lower PNI as a key factor for DPN. Multivariate logistic regression revealed that patients in the lowest PNI quartile had a significantly higher DPN risk compared to those in the highest quartile (OR: 3.271, 95% CI: 1.782–6.006, P < 0.001). Additionally, lower PNI levels were associated with impaired peripheral nerve function, including reduced motor and sensory nerve conduction velocity and action potential amplitudes. Conclusions: Lower PNI levels were associated with increased DPN risk and poorer nerve function, highlighting the importance of nutritional status in DPN management. Further longitudinal studies are needed to confirm these findings.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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