Аннотация
Diabetes mellitus is strongly associated with cardiovascular dysfunction and remains one of the leading contributors to morbidity and mortality worldwide. Early identification of diabetes-related cardiovascular alterations is essential for timely risk stratification and personalized clinical management. In the present study, an interpretable machine learning framework for diabetes classification in patients with cardiovascular disease was developed using routinely available clinical, biochemical, renal, and echocardiographic parameters. A retrospective dataset consisting of 131 cardiovascular patients was included in the final analysis, comprising 65 patients with diabetes mellitus and 66 patients without diabetes. Demographic, metabolic, renal, and cardiovascular variables, including age, body mass index (BMI), glycated hemoglobin (HbA1c), glucose concentration, estimated glomerular filtration rate (eGFR), troponin level, heart rate, and left ventricular ejection fraction (EF), were included in the analysis. Multiple supervised machine learning algorithms, including Logistic Regression, Support Vector Machine (SVM), Gradient Boosting, and Random Forest, were implemented and compared using repeated stratified cross-validation. Among the evaluated models, Random Forest demonstrated the highest classification performance, achieving a mean ROC AUC of 0.880 ± 0.050. Statistical analysis revealed significantly elevated HbA1c, glucose, and troponin levels together with reduced ejection fraction values in diabetic patients. Explainable artificial intelligence analysis using SHAP and partial dependence plots identified glucose concentration, HbA1c, age, and renal function as the dominant contributors to diabetes classification. Nonlinear relationships between metabolic and cardiovascular variables were additionally observed. The obtained findings demonstrate that interpretable machine learning approaches can provide effective discrimination between diabetic and non-diabetic cardiovascular patients while maintaining clinically meaningful interpretability. The proposed framework may contribute to future intelligent clinical decision-support systems and personalized cardiovascular risk assessment strategies.