摘要
目的:分析中国人群2型糖尿病5年发病风险的危险因素,构建列线图预测模型并验证其有效性。方法:从Dryad Digital Repository数据库中收集2010年~2016年间在中国11个城市的32个站点接受健康体检参与者的体检及随访资料。随机分为建模组(n=22936)与验证组(n=9830)。在建模组中,根据Cox回归模型进行单因素与多因素的分析确定独立危险因素,采用R软件构建列线图预测模型。通过验证组数据对所构建的模型进行验证,并采用AUC值、C指数和校准曲线对模型的准确度与性能进行评估。结果:多因素回归模型提示首次调查时的空腹血糖值、甘油三酯水平、吸烟史和饮酒史是中国人群2型糖尿病5年发病风险的独立风险预测因子。在建模组中AUC值为0.776(95%CI:0.699-0.849),C指数为0.783(95%CI:0.706-0.856)。同样,在验证组中,AUC值为0.743(95%CI:0.665-0.824),C指数为0.764(95%CI:0.667-0.846),均提示该模型具有较好的判别能力。中国人群2型糖尿病5年发病风险校正曲线提示在预测值和实际值之间具备良好的一致性。结论:该列线图模型可较为直观、准确地预测中国人群2型糖尿病的5年发病风险。
Objective:To analyze 5-yearrisk factors of type 2 diabetes in Chinese population,to construct aprediction model ofnomogram and verify its validity.Methods: The physical examination and follow-up data of the participants who received physical examination at 32 sites in 11 cities in China from 2010 to 2016 were collected from the Dryad Digital Repository database.There were two groups in this study,namely,modeling group(n=22936)and validation group(n=9830).In the modeling group,the independent risk factors were determined by single factor and multifactor analysis based on Cox regression model,and the nomogram prediction model was constructed by R software.Moreover,the established model was verified by the data of validation group and the accuracy and performance of the model were evaluated by AUC value,C-index and calibration curve.Results: The multivariate regression model suggested that fasting blood glucose,triglyceride,smoking history and drinking history were independent risk predictors for 5-year risk of type 2 diabetes in Chinese population.In the modeling group,AUC was 0.776(95%CI 0.699-0.849),and C-index was 0.783(95%CI 0.706-0.856).Similarly,in the validation group,the AUC value was 0.743(95%CI 0.665-0.824)with the C-index of 0.764(95%CI 0.667-0.846),suggesting that the model shows a good discrimination ability.The 5-year adjusted risk curve of type 2 diabetes in Chinese population indicates a good consistency between the predicted value and the actual value.Conclusion: The nomogram model can predict the 5-year risk of type 2 diabetes in Chinese population intuitively and accurately.
作者
蔡昕添
张德莲
洪静
朱晴
吴婷
李南方
CAI Xin-tian;ZHANG De-lian;HONG Jing;ZHU Qing;WU Ting;LI Nan-fang(Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region,National Health Committee Key Laboratory of Hypertension Diagnosis and Treatment Research,Urumqi 830001,Xinjiang,China)
出处
《海南医学院学报》
CAS
2020年第15期1179-1184,1190,共7页
Journal of Hainan Medical University
基金
新疆维吾尔自治区区域协同创新专项(上海合作组织科技伙伴计划及国际科技合作计划)项目(2018E01014)。
关键词
中国人群
2型糖尿病
危险因素
列线图
Chinese population
Type 2 diabetes
Risk factors
Nomogram
