上海预防医学2025，Vol.37Issue(8)：669-675,681,8.DOI:10.19428/j.cnki.sjpm.2025.250028
上海市40岁及以上社区人群慢性阻塞性肺疾病发病列线图风险预测模型构建
Development of a nomogram-based risk prediction model for chronic obstructive pulmonary disease incidence in community-dwelling population aged 40 years and above in Shanghai
摘要
Abstract
[Objective]To develop a nomogram-based risk prediction model for chronic obstructive pulmonary disease(COPD)incidence among the community-dwelling population aged 40 years old and above,so as to provide targeted references for the screening and prevention of COPD.[Methods]Based on a natural population cohort in suburban Shanghai,a total of 3 381 randomly selected participants aged≥40 years underwent pulmonary function tests between July and October 2021.Cox stepwise regression analysis was used to develop overall and gender-specific risk prediction models,along with the construction of corresponding risk nomograms.Model predictive performance was evaluated using the C-indice,area under the curve(AUC)values,and Brier score.Stability was assessed through 10-fold cross-validation and sensitivity analysis.[Results]A total of 3 019 participants were included,with a median follow-up duration of 4.6 years.The COPD incidence density was 17.22 per 1 000 person-years,significantly higher in males(32.04/1 000 person-years)than that in females(7.38/1 000 person-years)(P<0.001).The overall risk prediction model included the variables such as gender,age,education level,BMI,smoking,passive smoking,and respiratory comorbidities.The male-specific model incorporated the variables such as age,BMI,respiratory comorbidities,and smoking,while the female-specific model included age,marital status,respiratory comorbidities,and pulmonary tuberculosis history.The C-indices for the overall,male-specific,and female-specific models were 0.829,0.749,and 0.807,respectively.The 5-year AUC values were 0.785,0.658,and 0.811,with Brier scores of 0.103,0.176,and 0.059,respectively.Both 10-fold cross-validated C-indices and sensitivity analysis(excluding participants with a follow-up duration of<6 months)yielded C-indices were above 0.740.[Conclusion]This study developed concise and practical overall and gender-specific COPD risk prediction models and corresponding nomograms.The models demonstrated robust performance in predicting COPD incidence,providing a valuable reference for identifying high-risk populations and formulating targeted screening and personalized management strategies.关键词
慢性阻塞性肺疾病/预测模型/列线图/队列研究/社区人群Key words
chronic obstructive pulmonary disease/prediction model/nomogram/cohort study/community-based population分类
医药卫生引用本文复制引用
张艺璇,赵琦,王琴,赵根明,姜永根,王娜,吴毅凌,臧金鑫,苏旭燕,尹欣,李静,罗炜,俞敏君,王伟..上海市40岁及以上社区人群慢性阻塞性肺疾病发病列线图风险预测模型构建[J].上海预防医学,2025,37(8):669-675,681,8.基金项目
国家自然科学基金(82073634) （82073634）
国家重点研发计划精准医学重点专项(2017YFC0907000) （2017YFC0907000）
