基于REACTION数据库构建列线图预测老年人2型糖尿病发病风险OA
Construction of a Nomogram to Predict the Risk of Type 2 Diabetes in the Elderly Based on the REACTION Database
目的 探讨列线图对老年人2 型糖尿病发病风险的预测作用.方法 提取REACTION数据库2011 年12 月至2014 年10 月2 型糖尿病个人病例数据,纳入在基线检查时无2 型糖尿病的老年人共4 726 名.根据是否诊断为2 型糖尿病,将所有研究对象分成2 组.分别采用单因素和多因素Cox比例风险回归模型分析确定影响2 型糖尿病发病的独立危险因素,根据多因素分析结果构建列线图,采用R软件(4.4.0)进行分析.采用受试者工作特征(ROC)曲线评估列线图在随访5 年和10 年预测老年人2 型糖尿病发病风险的区分度,采用校准曲线评估其校准度.结果 单因素和多因素 Cox 比例风险回归模型分析结果显示,性别单因素分析的风险比(HR)为1.394 4,P=0.013 5,多因素分析的 HR 为 1.375 1,P=0.014 2.高密度脂蛋白胆固醇单因素分析的 HR 为0.681 2,P=0.008 5,多因素分析的HR为0.701 4,P=0.006 5.血肌酐单因素分析的HR为 1.009 6,P=0.021 0,多因素分析的HR为1.009 4,P=0.022 0.空腹血糖单因素分析HR为 1.175 7,P=0.006 7,多因素分析的HR为1.115 0,P=0.003 8.性别、空腹血糖、血肌酐、高密度脂蛋白胆固醇用于构建预测老年人2 型糖尿病发病风险的列线图.ROC曲线分析显示,列线图在随访5、10 年时预测老年人2 型糖尿病发病风险的曲线下面积分别为0.766、0.750,表明列线图具有适中的区分度.校准曲线表明,列线图预测老年人2 型糖尿病发病风险的概率与实际观测结果之间具有良好的一致性.结论 基于REACTION数据库构建的列线图是一个较为可靠的预测工具,能够有效预测老年人2 型糖尿病的发病风险.
Objective To investigate the predictive value of a nomogram for the risk of type 2 diabetes mellitus(T2DM)in the elderly.Methods Individual case data of T2DM patients from December 2011 to October 2014 were extrac-ted from REACTION database.A total of 4 726 elderly people without T2DM at baseline examination were included.All sub-jects were divided into two groups according to whether they were diagnosed with T2DM.Univariate and multivariate Cox pro-portional hazards regression models were used to determine the independent risk factors affecting the onset of T2DM,and a no-mogram was constructed based on the results of multivariate analysis.R software(4.4.0)was used for analysis.The receiver operating characteristic(ROC)curve was used to evaluate the discrimination of the nomogram in predicting the risk of T2DM in the elderly at 5-and 10-year follow-up,and the calibration curve was used to evaluate its calibration.Results The analy-sis results of univariate and multivariate Cox proportional hazards regression model showed that the hazard ratio(HR)of uni-variate and multivariate analyses of gender was 1.394 4(P=0.013 5)and1.375 1(P=0.014 2)respectively.The HR of univariate and multivariate analyses of high-density lipoprotein cholesterol was 0.681 2(P=0.008 5),and 0.701 4(P=0.006 5)respectively.The HR of univariate and multivariate analyses of serum creatinine(Scr)was 1.009 6(P=0.021 0),and 1.009 4(P=0.022 0)respectively.The HR of univariate and multivariate analyses of fasting blood glucose was 1.175 7(P=0.006 7)and 1.115 0(P=0.003 8).Gender,fasting blood glucose,Scr and high-density lipoprotein cholesterol were used to construct a nomogram for predicting the risk of T2DM in the elderly.ROC curve analysis showed that the area under the ROC curve of the nomogram for predicting the risk of T2DM in the elderly at 5-and 10-year follow-up was 0.766 and 0.750 respectively,indicating that the nomogram model had moderate discrimination.The calibration curve showed that the probability of T2DM onset predicted by the nomogram model was in good agreement with the actual observation results.Conclusion The nomogram constructed based on REACTION database is a reliable prediction tool,which can effectively pre-dict the risk of T2DM in the elderly.
傅晓敏;闫双通;刘静;李楠;苗新宇;孙般若;陈康;安平;谷昭艳;柳洪宙
100853 北京,中国人民解放军总医院第一医学中心干部诊疗科100853 北京,中国人民解放军总医院国家老年疾病临床研究中心中国人民解放军总医院第二医学中心内分泌科100853 北京,中国人民解放军总医院第一医学中心干部诊疗科100853 北京,中国人民解放军总医院国家老年疾病临床研究中心中国人民解放军总医院第二医学中心内分泌科100853 北京,中国人民解放军总医院国家老年疾病临床研究中心中国人民解放军总医院第二医学中心内分泌科100853 北京,中国人民解放军总医院国家老年疾病临床研究中心中国人民解放军总医院第二医学中心内分泌科100853 北京,中国人民解放军总医院第一医学中心内分泌科100853 北京,中国人民解放军总医院第一医学中心内分泌科100853 北京,中国人民解放军总医院国家老年疾病临床研究中心中国人民解放军总医院第二医学中心内分泌科056002 河北邯郸,邯郸市第一医院内分泌科
临床医学
2型糖尿病老年人列线图性别空腹血糖血肌酐高密度脂蛋白胆固醇预测模型
Type 2 diabetes mellitusElderlyNomogramGenderFasting blood glucoseSerum creatinineHigh density lipoprotein cholesterolPrediction model
《临床误诊误治》 2025 (10)
51-58,8
国家老年疾病临床医学研究中心(中国人民解放军总医院)资助项目(NCRCG-PLAGH-2024010)河北省医学科学课题计划资助(20231924)
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