摘要
目的:构建常熟市城乡居民骨质疏松症(OP)的预测模型,并对其进行验证。方法:选取2018年4月至2021年3月常熟市第一人民医院影像科双能X线骨密度检测数据库中的2270例人群作为研究对象,根据T值分为OP组(T≤-2.5,337例),骨量减少组(-2.5<T<-1.0,701例)和骨量正常组(T≥1.0,1232例),比较3组一般人口学资料、临床特征、握力、血常规指标、肝功能、肾功能、血钙、血磷、25羟基维生素D[25(OH)D3]、甲状旁腺激素(PTH)水平,采用二元logistic回归分析OP的相关影响因素,运用R语言rms软件包绘制预测OP的列线图模型,采用Bootstrap法进行内部与外部验证,采用受试者工作特征曲线(ROC)分析OP列线图预测模型的预测能力。结果:OP组年龄、女性、糖尿病、认知障碍、睡眠时长≥9 h、碱性磷酸酶、PTH高于骨量减少组,规律补充钙剂、规律摄入含钙奶制品、握力、血钙、25(OH)D3低于骨量减少组(P<0.05);骨量减少组年龄、女性、糖尿病、认知障碍、睡眠时长≥9 h、碱性磷酸酶、PTH高于骨量正常组,规律补充钙剂、规律摄入含钙奶制品、握力、血钙、25(OH)D3低于骨量正常组(P<0.05);二元logistic回归分析结果显示:年龄、女性、糖尿病、认知障碍、睡眠时长≥9 h、碱性磷酸酶、PTH是OP的相关危险因素,规律补充钙剂、规律摄入含钙奶制品、握力、血钙、25(OH)D3是OP的相关保护因素(P<0.05);基于以上各影响因素绘制预测OP的列线图模型显示其预测风险能力指数(C-index)为0.944,具有良好的区分度;ROC分析发现,预测OP的列线图模型的ROC下面积(AUC)为0.944(95%CI:0.923~0.960),提示预测OP的列线图模型区分度及预测能力均较好;采用Bootstrap法绘制内部校准图发现,校准曲线贴近标准曲线,提示预测OP的列线图模型与实际观测结果有较好的一致性;外部验证显示其预测死亡风险的AUC为0.950(95%CI:0.945~0.999),外部校准图发现校准曲线�
Objective:To construct a prediction model for osteoporosis(OP)in urban and rural residents in Changshu City and validate it.Methods:A total of 2,270 cases from the imaging department of the First People’s Hospital of Changshu with dual-energy X-ray bone density testing database from April 2018 to March 2021 were selected as the study population and divided into OP group(T≤-2.5,337 cases),bone loss group(-2.5<T<-1.0,701 cases)and normal bone mass group(T≥-1.0,1,232 cases)according to T value,comparing the 3 groups’general demographic data,clinical characteristics,grip strength,routine blood indicators,liver function,renal function,blood calcium,blood phosphorus,25 hydroxyvitamin D[25(OH)D3]and parathyroid hormone(PTH)levels.Binary logistic regression was used to analyze the influencing factors associated with OP,using the R language rms software package to draw a column line graph model for predicting OP.Bootstrap method was used for internal and external validation,and the receiver operating characteristic(ROC)curve was used to analyze the predictive ability of the OP column line graph prediction model.Results:The OP group had higher age,female,diabetes,cognitive impairment,sleep duration≥9 h,alkaline phosphatase,and PTH than the bone loss group,and lower regular calcium supplementation,regular intake of calcium-containing dairy products,grip strength,blood calcium,and 25(OH)D3 than the bone loss group(P<0.05);the bone loss group had higher age,female,diabetes,cognitive impairment,sleep duration≥9 h,alkaline phosphatase,and PTH than the normal bone mass group,and lower regular calcium supplementation,regular intake of calcium-containing dairy products,grip strength,blood calcium,and 25(OH)D3 than the normal bone mass group(P<0.05).Binary logistic regression analysis showed that age,female,diabetes,cognitive impairment,sleep duration≥9 h,alkaline phosphatase,and PTH were risk factors associated with OP,and regular calcium supplementation,regular intake of calcium-containing dairy products,grip streng
作者
范佳
王健
沈耀亮
何晟
顾叶
季立标
钱骅雯
朱肇基
周文军
叶宏伟
Fan Jia;Wang Jian;Shen Yaoliang;He Sheng;Gu Ye;Ji Libiao;Qian Huawen;Zhu Zhaoji;Zhou Wenjun;Ye Hongwei(Changshu Hospital Affiliated to Soochow University/Changshu NO.1 People’s Hospital,Changshu 215500,China;Wuxi Second Geriatric Hospital,Wuxi 214174,China;Changshu NO.3 People’s Hospital,Changshu 215500,China)
出处
《广西医科大学学报》
CAS
2023年第9期1556-1563,共8页
Journal of Guangxi Medical University
基金
江苏省重点研发计划(社会发展)专项资金项目(No.BE2021673)
常熟市卫健委科技计划项目(No.csws202110,No.csws201906)。
关键词
骨质疏松症
影响因素
预测模型
预测能力
osteoporosis
influencing factors
predictive model
predictive ability
