{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:20:35Z","timestamp":1787721635272,"version":"build-2784847793"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association between static balance function parameters and prediabetes, and to develop a nomogram integrating center-of-pressure path length, Romberg ratios, and sex, thereby evaluating its potential as a candidate functional screening tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional observational design was adopted. A total of 97 patients with prediabetes and 44 age-matched healthy controls were consecutively enrolled from January 2024 to June 2025 at the Third People\u2019s Hospital Affiliated to Fujian University of Traditional Chinese Medicine. General characteristics and static balance parameters under four sensory conditions were compared between groups. Variables were first screened via Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by multivariable logistic regression to identify independent associations. A nomogram was then constructed. Model discrimination and calibration were assessed using the receiver operating characteristic curve, Hosmer\u2013Lemeshow test, and 1000-bootstrap internal validation (corrected C-statistic, calibration slope\/intercept, Brier score). Effect sizes were quantified using Cohen\u2019s d.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the healthy control group, the prediabetes group exhibited significantly higher values for Y-COP and COP-PL under Condition\u00a01, RRA and RRT under Condition\u00a02\/1, as well as Y-COP, COP-EA, and COP-PL under Conditions\u00a03 and\u00a04 (all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05). LASSO regression retained T1 COP-PL, T3 COP-PL, T4\/T3 RRA, and RRT as candidate variables. Multivariable logistic regression showed that female sex (vs. male, OR\u00a0=\u00a00.208, 95%\u00a0CI: 0.044\u20130.973; P\u00a0=\u00a00.046), T1 COP-PL (per unit increase, OR\u00a0=\u00a00.990, 95%\u00a0CI: 0.980\u20130.999), T3 COP-PL (per unit increase, OR\u00a0=\u00a01.016, 95%\u00a0CI: 1.008\u20131.023), and T4\/T3 RRA (per unit increase, OR\u00a0=\u00a01.013, 95%\u00a0CI: 1.007\u20131.020) were independently associated with prediabetes. A nomogram incorporating these variables yielded an AUC of 0.972. After bootstrap internal validation, the corrected AUC was 0.964 (95%\u00a0CI: 0.941\u20130.991), with a calibration slope of 0.806, intercept of \u20130.011, and Brier score of 0.075, indicating good discrimination and calibration. Cohen\u2019s dvalues for T1 COP-PL, T3 COP-PL, and T4\/T3 RRA were \u20130.40, 1.45, and 1.39, respectively, reflecting moderate to large effect sizes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Static balance indices including T1 COP-PL, T3 COP-PL, and T4\/T3 RRA are associated with prediabetes. The nomogram combining these measures with sex demonstrated robust performance in internal validation, offering a functional perspective that may aid in the auxiliary screening of prediabetes. Nevertheless, as a cross-sectional exploratory study, these associations do not imply causality, and the model requires external validation before its clinical generalizability can be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1921238","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:43:14Z","timestamp":1787719394000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of static balance parameters with prediabetes: a cross-sectional study and nomogram development"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhishan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Preventive Treatment of Disease, The Third Affiliated People\u2019s Hospital of Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]},{"name":"Clinical Research Center for Traditional Chinese Medicine (TCM) Clinical Medicine in Diabetes and Lipid Disorders of Fujian Province","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangliang","family":"Huang","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"Emergency Department, The Third Affiliated People\u2019s Hospital of Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingran","family":"Liang","sequence":"additional","affiliation":[{"name":"College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanya","family":"Xie","sequence":"additional","affiliation":[{"name":"College of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaoyun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Preventive Treatment of Disease, Affiliated People\u2019s Hospital of Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingyu","family":"Li","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingjing","family":"Gao","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dehong","family":"Pan","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyu","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luyi","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changbin","family":"You","sequence":"additional","affiliation":[{"name":"College of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxiang","family":"Liu","sequence":"additional","affiliation":[{"name":"College of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Preventive Treatment of Disease, The Third Affiliated People\u2019s Hospital of Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]},{"name":"College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujiao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Preventive Treatment of Disease, The Third Affiliated People\u2019s Hospital of Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]},{"name":"Clinical Research Center for Traditional Chinese Medicine (TCM) Clinical Medicine in Diabetes and Lipid Disorders of Fujian Province","place":["Fuzhou, China"]},{"name":"College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60283-9","article-title":"Prediabetes: a high-risk state for diabetes development","volume":"379","author":"Tab\u00e1k","year":"2012","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2022.110145","article-title":"Frailty is associated with the progression of prediabetes to diabetes and elevated risks of cardiovascular disease and all-cause mortality in individuals with prediabetes and diabetes: Evidence from two prospective cohorts","volume":"194","author":"He","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"B3","article-title":"Research progress on balance function in patients with type 2 diabetes mellitus","volume":"28","author":"Li","year":"2021","journal-title":"China Modern Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2024.10.001","article-title":"Standing balance impairment in persons with type 2 diabetes is predicted by peripheral neuropathy and vestibulopathy","volume":"19","author":"Lopatin","year":"2025","journal-title":"Prim Care Diabetes"},{"key":"B5","first-page":"6","article-title":"Analysis of static balance function in patients with type 2 diabetes mellitus","volume":"40","author":"Jia","year":"2019","journal-title":"J Capital Med Univ"},{"key":"B6","article-title":"Characteristics of static balance function in elderly patients with type 2 diabetes mellitus under different blood pressure status","volume":"31","author":"Guo","year":"2021","journal-title":"Rehabil Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1186\/s13018-023-04129-1","article-title":"The influence of diabetes and age-related degeneration on body balance control during static standing: a study based on plantar center-of-pressure trajectories and principal component analysis","volume":"18","author":"Hu","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.768185","article-title":"Impact of body mass index on static postural control in adults with and without diabetes: a cross-sectional study","volume":"12","author":"Yin","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2022.2055168","article-title":"Postural performance assessment in aging people with diabetes and diabetic peripheral neuropathy using a Wii balance board","volume":"45","author":"Vargas Matamala","year":"2023","journal-title":"Disabil Rehabil"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S547267","article-title":"Static balance in prediabetic subjects: correlation study involving glucose indicators, insulin resistance and postural stability indices","volume":"18","author":"Wang","year":"2025","journal-title":"Int J Gen Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.19538\/j.nk2021080106","article-title":"Guidelines for the prevention and treatment of type 2 diabetes in China (2020 Edition) (Part 1)","volume":"41","year":"2021","journal-title":"Chin J Pract Intern Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.13820\/j.cnki.gdyx.20241667","article-title":"Expert consensus on balance function assessment and clinical application of rehabilitation equipment based on pressure sensor recognition","volume":"46","author":"Chen","year":"2025","journal-title":"Guangdong Med J"},{"key":"B13","first-page":"59","volume-title":"Diseases of the Inner Ear","author":"Liu","year":"2006"},{"key":"B14","article-title":"The role of the balance triad and central integration in human balance","volume":"17","author":"Huang","year":"2009","journal-title":"J Audiology Speech Pathol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.1674-5809.2019.12.004","article-title":"Clinical observation of decreased static balance function in patients with impaired glucose regulation","volume":"11","author":"Lu","year":"2019","journal-title":"Chin J Diabetes"},{"key":"B16","article-title":"Mechanisms of balance dysfunction in diabetic patients","volume":"9","author":"Zhou","year":"2011","journal-title":"Chin J Otology"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0744","article-title":"Older subjects with diabetes and prediabetes are frequently unaware of having distal sensorimotor polyneuropathy: the KORA F4 study","volume":"36","author":"Bongaerts","year":"2013","journal-title":"Diabetes Care"},{"key":"B18","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1002\/acn3.531","article-title":"Diabetes and obesity are the main metabolic drivers of peripheral neuropathy","volume":"5","author":"Callaghan","year":"2018","journal-title":"Ann Clin Transl Neurol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2018.01.031","article-title":"Inflammation role in sensory neuropathy in Chinese patients with diabetes\/prediabetes","volume":"166","author":"Zeng","year":"2018","journal-title":"Clin Neurol Neurosurg"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/ene.70283","article-title":"The relationship between prediabetes and peripheral neuropathy-a systematic review and meta-analysis","volume":"32","author":"Riahi","year":"2025","journal-title":"Eur J Neurol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3693","article-title":"Neuropathy in prediabetes","volume":"39","author":"Ziegler","year":"2023","journal-title":"Diabetes Metab Res Rev"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.023446","article-title":"Prediabetes and type 2 diabetes are associated with generalized microvascular dysfunction: the Maastricht Study","volume":"134","author":"S\u00f6rensen","year":"2016","journal-title":"Circulation"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3390\/life13030644","article-title":"Microvascular and endothelial dysfunction in prediabetes","volume":"13","author":"Lamprou","year":"2023","journal-title":"Life (Basel)"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2024.102942","article-title":"Frailty and risk of microvascular disease in adults with prediabetes","volume":"18","author":"Zhong","year":"2024","journal-title":"Diabetes Metab Syndr"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20140604","article-title":"Impact of diabetic complications on balance and falls: contribution of the vestibular system","volume":"96","author":"D'Silva","year":"2016","journal-title":"Phys Ther"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2022.108131","article-title":"Prevalence and risk factors for diabetic retinopathy in prediabetes in Asian Indians","volume":"36","author":"Rajalakshmi","year":"2022","journal-title":"J Diabetes Complications"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1055\/a-1678-7092","article-title":"Association between prediabetes and retinopathy: a meta-analysis","volume":"53","author":"Jin","year":"2021","journal-title":"Horm Metab Res"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S468359","article-title":"Impact of glycemic control on shoulder proprioception in type 2 diabetes mellitus: mediating the connection-insights from a cross-sectional analysis","volume":"17","author":"Alshahrani","year":"2024","journal-title":"J Multidiscip Healthc"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.66","article-title":"Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004","volume":"169","author":"Agrawal","year":"2009","journal-title":"Arch Intern Med"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3389\/fcdhc.2024.1346716","article-title":"Type 2 diabetes is linked to higher physiologic markers of effort during exercise","volume":"5","author":"Huebschmann","year":"2024","journal-title":"Front Clin Diabetes Healthc"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S361698","article-title":"The evaluation of gait and balance for patients with early diabetic peripheral neuropathy: a cross-sectional study","volume":"15","author":"Jiang","year":"2022","journal-title":"Risk Manag Healthc Policy"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1159\/000371846","article-title":"Sensor-based interactive balance training with visual joint movement feedback for improving postural stability in diabetics with peripheral neuropathy: a randomized controlled trial","volume":"61","author":"Grewal","year":"2015","journal-title":"Gerontology"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.humov.2023.103153","article-title":"Diabetic older women without peripheral neuropathy amplify body sway but are capable of improving postural stability during a saccadic gaze task","volume":"92","author":"Rodrigues","year":"2023","journal-title":"Hum Mov Sci"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.6118\/jmm.24004","article-title":"Sarcopenic obesity: a comprehensive approach for postmenopausal women","volume":"30","author":"Park","year":"2024","journal-title":"J Menopausal Med"},{"key":"B35","article-title":"Analysis of risk factors for elevated intraocular pressure after cataract surgery in elderly patients and construction of a nomogram model","volume":"14","author":"Cheng","year":"2025","journal-title":"Trans Med J"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1921238\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:43:22Z","timestamp":1787719402000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1921238\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":35,"alternative-id":["10.3389\/fendo.2026.1921238"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1921238","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]},"article-number":"1921238"}}