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.

Background: Myocardial perfusion scintigraphy (MPS) is an important tool for evaluating ischemia in diabetic populations. However, applications of advanced predictive models like multivariate adaptive regression splines (MARS) to estimate summed stress scores (SSS) are lacking. Methods: In this study, 1028 diabetic women undergoing Thallium-201 MPS were analyzed. The dataset was split into training (80%) and testing (20%) subsets. MARS and multiple linear regression (MLR) models were constructed to predict SSS, and their performance was evaluated using root mean square error (RMSE), relative absolute error (RAE), root relative squared error (RRSE), Mean Absolute Percentage Error (MAPE), and Symmetric Mean Absolute Percentage Error (SMAPE). Results: On the testing dataset, the MARS model outperformed the MLR model across all metrics, with an RMSE of 3.25 compared to 3.89 for MLR, an RAE of 0.52 vs. 0.64, and an RRSE of 0.53 vs. 0.67. Similar trends were observed in MAPE (18.7% vs. 22.1%) and SMAPE (17.3% vs. 20.5%). Conclusions: The superior predictive accuracy of the MARS model suggests its potential to enhance non-invasive myocardial risk stratification in diabetic women.