摘要
Abstract
Objective To analyze the risk factors for the development of type 3c diabetes mellitus(T3cDM)in pa-tients with moderately severe acute pancreatitis(MSAP)and severe acute pancreatitis(SAP),and to construct and vali-date a predictive model.Methods Totally 411 patients with MSAP/SAP were selected and followed up for at least 3 months after the onset of acute pancreatitis(AP)to record the occurrence of T3cDM.Data were collected on general char-acteristics,laboratory parameters within 24 hours of admission,disease-related scores,and complications.Indicators with statistically significant differences between T3cDM and non-T3cDM patients were included in LASSO and multivariate Lo-gistic regression analyses to identify independent risk factors for T3cDM in MSAP/SAP patients.A nomogram prediction model incorporating these independent risk factors was constructed and validated internally using bootstrap methods,receiv-er operating characteristic(ROC)curves,calibration curves,and Hosmer-Lemeshow goodness-of-fit tests.The clinical util-ity of the model was assessed using decision curve analysis(DCA).Results Among the 411 patients,113 developed T3cDM and 298 did not.Thirty-one indicators showed statistically significant differences between T3cDM and non-T3cDM patients.LASSO and multivariate Logistic regression analyses revealed that elevated neutrophil percentage,elevated tri-glycerides,elevated total cholesterol,and pancreatic necrosis were independent risk factors for T3cDM in MSAP/SAP pa-tients(all P<0.05).The nomogram prediction model demonstrated high discriminative ability after 1,000 bootstrap inter-nal validations.ROC curve analysis indicated good discrimination,and the calibration curve was close to the reference line.The Hosmer-Lemeshow goodness-of-fit test showed good model fit.DCA revealed high net benefit and clinical utility across a wide range of risk thresholds.Conclusions Elevated neutrophil percentage,elevated triglycerides,elevated to-tal cholesterol,and pancreatic necrosis are associated with the development of T3cDM in MSAP/SAP patients.The nomo-gram prediction model constructed based on these risk factors exhibits good discrimination,calibration,and clinical utility.关键词
中度重症急性胰腺炎/重症急性胰腺炎/胰源性糖尿病/危险因素/列线图Key words
moderately severe acute pancreatitis/severe acute pancreatitis/type 3c diabetes mellitus/risk fac-tors/nomogram分类
医药卫生
