腹腔镜外科杂志2025，Vol.30Issue(12)：889-894,909,7.DOI:10.13499/j.cnki.fqjwkzz.2025.12.889
腹腔镜袖状胃切除术治疗代谢相关脂肪性肝病疗效的预测模型构建
Construction of a prediction model for the efficacy of laparoscopic sleeve gastrectomy in the treatment of metabolic dysfunction-associated fatty liver disease
摘要
Abstract
Objective:To develop a prediction model based on least absolute shrinkage and selection operator(LASSO)regres-sion for assessing the efficacy of laparoscopic sleeve gastrectomy(LSG)in the treatment of metabolic dysfunction-associated fatty liver disease(MAFLD),thereby providing a basis for preoperative evaluation.Methods:A retrospective cohort of 293 MAFLD patients who underwent LSG from Jun.2019 to Jun.2024 was included.Patients were randomly divided into a training set(n=206)and an internal validation set(n=87)at a 7∶3 ratio.Clinical efficacy was assessed 12 months postoperatively.Based on relevant efficacy criteria,patients in the training set were categorized into an ineffective group(n=46)and an effective group(n=160).Univariate analysis and LASSO regression were used to screen variables.A multivariate logistic regression model was constructed and presented as a nomogram.The model's performance was evaluated using receiver operating characteristic(ROC)curve,calibration curve,Hosmer-Lemeshow test,and decision curve analysis(DCA).Results:The LASSO-logistic regression model identified body mass index(OR=2.755),ho-meostasis model assessment of insulin resistance(OR=1.759),fibrosis-4 index(OR=3.103),and liver stiffness measurement(OR=1.343)as independent risk factors for ineffective treatment of MAFLD after LSG(P<0.05).The constructed nomogram prediction model demonstrated good predictive efficacy in both training and validation sets,with areas under the ROC curve of 0.907 and 0.879,respectively.The Hosmer-Lemeshow test indicated good calibration(P>0.05).DCA suggested that when the risk threshold exceeded 0.1,the prediction model provided significant additional clinical net benefit.Conclusions:The constructed nomogram prediction model demonstrates high predictive performance,good calibration,and positive clinical net benefit in both training and validation sets.It can effectively identify high-risk patients and provides scientific basis for preoperative evaluation and individualized treatment decision-making.关键词
代谢相关脂肪性肝病/袖状胃切除术/腹腔镜检查/预测模型Key words
Metabolic dysfunction-associated fatty liver disease/Sleeve gastrectomy/Laparoscopy/Predictive model分类
医药卫生引用本文复制引用
张硕,梁关友,杜晨辉,曹新岭..腹腔镜袖状胃切除术治疗代谢相关脂肪性肝病疗效的预测模型构建[J].腹腔镜外科杂志,2025,30(12):889-894,909,7.基金项目
省部共建中亚高发病成因与防治国家重点实验室基金资助项目(SKL-HIDCA-2023-26) （SKL-HIDCA-2023-26）
新疆医科大学第一附属医院青年科研启航专项基金面上项目(2024YFY-QKMS-04) （2024YFY-QKMS-04）
