Objective To explore the related factors of diabetic retinopathy (DR) in young and middle-aged patients with type 2 diabetes mellitus (T2DM), construct a nomogram prediction model, and evaluate its efficacy. Methods The clinical data of 537 young and middle-aged T2DM patients were collected. The patients were divided into the DR group (n=217) or the non-DR group (n=320) according to the presence or absence of DR. The clinical data of the two groups were compared. A multivariate logistic regression model was used to analyze the influencing factors of DR in young and middle-aged T2DM patients, and a nomogram prediction model was constructed. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive efficacy of the model. Results The duration of T2DM, family history of diabetes, urinary albumin-to-creatinine ratio, diabetic peripheral neuropathy, body mass index, subcutaneous fat area, fasting C-peptide, cystatin C, and lymphocyte-to-monocyte ratio were independent related factors for DR in young and middle-aged T2DM patients. The area under the ROC curve of the nomogram prediction model constructed based on the above related factors was 0.766 (95% CI: 0.726-0.806), with a sensitivity of 77.9%, a specificity of 64.1%, and a maximum Youden index of 0.419. Conclusion The duration of T2DM, family history of diabetes, urinary albumin-to-creatinine ratio, diabetic peripheral neuropathy, body mass index, subcutaneous fat area, fasting C-peptide, cystatin C, and lymphocyte-to-monocyte ratio are independent related factors for DR in young and middle-aged T2DM patients. The nomogram model constructed based on the above related factors demonstrates acceptable predictive efficacy.

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