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Quantifying the Functional Gap in Alkaptonuria Through Machine Learning and Clinical Data Integration.

Anna Visibelli1, Rebecca Finetti1, Bianca Roncaglia1

  • 1Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy.

Bioengineering (Basel, Switzerland)
|June 26, 2026
PubMed
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This summary is machine-generated.

Alkaptonuria (AKU) patients are functionally older than their chronological age, with a 15-year average functional age gap. This metric helps assess AKU

Area of Science:

  • Rare inherited metabolic disorders
  • Musculoskeletal health
  • Biostatistics and data analysis

Background:

  • Alkaptonuria (AKU) causes progressive musculoskeletal damage and chronic pain.
  • Functional heterogeneity is a key characteristic of AKU patients.
  • Quantifying functional variability is crucial for AKU management.

Purpose of the Study:

  • Introduce and validate the functional age gap as a metric for AKU.
  • Explore clinical predictors of functional age gap severity.
  • Assess the utility of functional age gap in AKU patient assessment.

Main Methods:

  • Utilized the ApreciseKUre database with 134 AKU patients.
  • Calculated functional age using HAQ-DI and KOOS scores against normative data.
Keywords:
alkaptonuriadata integrationfunctional gapmachine learningprecision medicinerare diseases

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  • Employed a bagging ensemble of decision trees and SHapley Additive exPlanations for analysis.
  • Main Results:

    • 94.8% of AKU patients exhibited a positive functional age gap, averaging 15 years older.
    • The predictive model showed moderate, stable classification performance (64%).
    • Key predictors included age, AKUSSI spinal/joint pain, Schober test, and hip/knee activity.

    Conclusions:

    • The functional age gap is a valuable, interpretable metric for describing functional status in AKU.
    • It serves as a hypothesis-generating tool for AKU research.
    • Further validation in larger, longitudinal cohorts is needed for predictive utility.