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Construction and validation of a risk diagnostic model for diabetes in rural elderly individuals with both hypertension and dyslipidemia:an analysis based on the Hosmer-Lemeshow test
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Ying ZHOU1, Zhihua YIN2, Jiayi LIU2, Siyu SHEN2, Peini HU2, Lei SHI3, 4, 5, Xuelian LI2, Wei ZHANG2
Chinese Journal of Public Health | 2026, 42(6) : 730 - 737
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Chinese Journal of Public Health | 2026, 42(6): 730-737
• Survey and Report •
Construction and validation of a risk diagnostic model for diabetes in rural elderly individuals with both hypertension and dyslipidemia:an analysis based on the Hosmer-Lemeshow test
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Ying ZHOU1, Zhihua YIN2, Jiayi LIU2, Siyu SHEN2, Peini HU2, Lei SHI3, 4, 5, Xuelian LI2, Wei ZHANG2
Affiliations
  • 1Department of Preventive Health Care, Anfeng Town Health Center, Dongtai City, Yancheng 224225, China
  • 2Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
  • 3School of Health Management, Guangzhou Medical University, Guangzhou 511436, China
  • 4Social Science Key Laboratory of Guangdong Higher Education Institutes for Health Management Policy and Precision Health Services, Guangzhou 510515, China
  • 5Social Science Key Laboratory of Guangdong Higher Education Institutes for Health Governance Based on Big Data Utilization, Guangzhou 511436, China
Published: 2026-06-10 doi: 10.11847/zgggws1148397
Outline
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Objective

To construct and validate a risk diagnostic model for diabetes in rural elderly individuals with both hypertension and dyslipidemia, thus providing a scientific basis for the prevention and control of the co-morbidity of hypertension, hyperglycemia, and dyslipidemia in rural elderly people in China.

Methods

With the data of 583 rural elderly individuals with hypertension and dyslipidemia from the 2015 China Health and Retirement Longitudinal Study (CHARLS) as the training set, a multivariate unconditional logistic regression model was adopted to analyze the influencing factors of diabetes in rural elderly individuals with hypertension and dyslipidemia and construct a risk diagnostic model. The goodness-of-fit of the model was tested via the Hosmer-Lemeshow method. The physical examination data of 1 185 elderly individuals who aged 65 and above and had both hypertension and dyslipidemia and complete outcome variables and key variables in Anfeng town, Dongtai city, Jiangsu province were used for external validation. Receiver operating characteristic (ROC) curves, calibration curves, and decision curves were established. The restricted cubic spline (RCS) model was employed to analyze the dose-response relationships of the Chinese visceral adiposity index (CVAI) and white blood cell count with the prevalence of diabetes in rural elderly individuals with both hypertension and dyslipidemia.

Results

The results of the analysis on CHARLS data showed that CVAI, alcohol consumption status, and white blood cell count were the main factors influencing the prevalence of diabetes among rural elderly individuals with both hypertension and dyslipidemia (all P < 0.05). The results of the RCS model analysis showed that CVAI and white blood cell count were linearly positively correlated with the risk of diabetes (non-linear test P = 0.964 and 0.755), and the risk of diabetes increased linearly with the increase in CVAI and white blood cell count. The Hosmer-Lemeshow goodness-of-fit test (P = 0.739), the ROC curve of the external validation set [AUC (95%CI): 0.924 (0.910–0.939)], the calibration curve, and the decision curve all indicated that the risk diagnostic model constructed in this study for diabetes has good performance.

Conclusions

The risk diagnostic model for diabetes in rural elderly individuals with both hypertension and dyslipidemia, which is constructed in this study, has excellent performance and clinical benefits. In this population, drinkers as well as those with higher CVAI and white blood cell count should be regarded as the key groups for diabetes prevention.

diabetes  /  risk diagnostic model  /  hypertension  /  dyslipidemia  /  comorbidity  /  rural elderly people
周颖, 尹智华, 刘佳宜, 沈思雨, 胡佩妮, 石磊, 李雪莲, 张薇. 高血压和血脂异常共病农村老年人糖尿病患病风险诊断模型的构建及验证: 基于Hosmer-Lemeshow法. 中国公共卫生, 2026 , 42 (6) : 730 -737 . DOI: 10.11847/zgggws1148397
Ying ZHOU, Zhihua YIN, Jiayi LIU, Siyu SHEN, Peini HU, Lei SHI, Xuelian LI, Wei ZHANG. Construction and validation of a risk diagnostic model for diabetes in rural elderly individuals with both hypertension and dyslipidemia:an analysis based on the Hosmer-Lemeshow test[J]. Chinese Journal of Public Health, 2026 , 42 (6) : 730 -737 . DOI: 10.11847/zgggws1148397
Year 2026 volume 42 Issue 6
94
37
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Article Info
doi: 10.11847/zgggws1148397
  • Receive Date:2025-07-07
  • Online Date:2026-10-23
  • Published:2026-06-10
Article Data
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History
  • Received:2025-07-07
  • Revised:2025-11-10
  • Accepted:2026-01-24
Affiliations
    1Department of Preventive Health Care, Anfeng Town Health Center, Dongtai City, Yancheng 224225, China
    2Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
    3School of Health Management, Guangzhou Medical University, Guangzhou 511436, China
    4Social Science Key Laboratory of Guangdong Higher Education Institutes for Health Management Policy and Precision Health Services, Guangzhou 510515, China
    5Social Science Key Laboratory of Guangdong Higher Education Institutes for Health Governance Based on Big Data Utilization, Guangzhou 511436, China

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SHI Lei, E-mail:
LI Xuelian,
ZHANG Wei, E-mail:
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表12种不同金属材料的力学参数
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Family
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Number of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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