Using Machine Learning to Predict Abnormal Carotid Intima-Media Thickness in Type 2 Diabetes

Abstract

Carotid intima-media thickness (c-IMT) is a reliable risk factor for cardiovascular disease risk in type 2 diabetes (T2D) patients. The present study aimed to compare the effectiveness of different machine learning methods and traditional multiple logistic regression in predicting c-IMT using baseline features and to establish the most significant risk factors in a T2D cohort. We followed up with 924 patients with T2D for four years, with 75% of the participants used for model development. Machine learning methods, including classification and regression tree, random forest, eXtreme gradient boosting, and Naïve Bayes classifier, were used to predict c-IMT. The results showed that all machine learning methods, except for classification and regression tree, were not inferior to multiple logistic regression in predicting c-IMT in terms of higher area under receiver operation curve. The most significant risk factors for c-IMT were age, sex, creatinine, body mass index, diastolic blood pressure, and duration of diabetes, sequentially. Conclusively, machine learning methods could improve the prediction of c-IMT in T2D patients compared to conventional logistic regression models. This could have crucial implications for the early identification and management of cardiovascular disease in T2D patients.

Keywords: carotid intima-media thickness; logistic regression; machine learning; type 2 diabetes mellitus.

Figure 1

Flowchart of sample selection from the Cardinal Tien Hospital Diabetes Study Cohort.

Figure 2

Proposed machine learning scheme in the cohort.

Figure 3

Integrated importance ranking of all risk factors predicting carotid intima-media thickness in patient with type 2 diabetes.