Predictive modeling and risk assessment of pancreatic β-cell dysfunction in type 2 diabetes

Type 2 diabetes mellitus (T2DM) is a widespread metabolic disorder driven in part by pancreatic β-cell dysfunction. This study aims to identify key determinants of β-cell impairment in T2DM patients and develop a predictive risk model to enhance clinical management strategies. This retrospective study included 120 patients newly diagnosed with T2DM who were admitted to our hospital between March 2023 and March 2024. We measured fasting plasma glucose, fasting insulin, and other relevant metabolic indicators. Insulin resistance and β-cell function were evaluated using the homeostasis model assessment (homeostasis model assessment insulin-resistance and homeostasis model assessment-β). To identify independent risk factors, we performed both univariate and multivariate stepwise regression analyses, and subsequently constructed predictive models based on the results. The cohort exhibited moderate insulin resistance (homeostasis model assessment insulin-resistance: 2.93 ± 0.77) and significant β-cell dysfunction (homeostasis model assessment-β: 33.74 ± 11.46). Regression analysis identified age, body mass index (BMI), sedentary lifestyle, and triglyceride levels as independent predictors of insulin resistance (P < .05), yielding the following model: logit (1) = 2.371 + 0.862 × age + 0.612 × BMI + 0.598 × sedentary + 0.237 × triglyceride. Similarly, age, BMI, and sedentary behavior were independently associated with β-cell dysfunction (P < .05), leading to the model: logit (2) = 29.562 + 2.947 × age + 9.570 × BMI + 3.205 × sedentary. Newly diagnosed T2DM patients frequently present with insulin resistance and β-cell impairment. High-risk subgroups include individuals aged ≥ 40, those with elevated BMI, physical inactivity, and dyslipidemia. The proposed predictive models may aid in early risk stratification and personalized intervention.