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多变量模型用于预测ACTH刺激测试,以使用以前的测试结果来诊断上腺功能不足
Neil Richard Lawrence1,2, Muhammad Fahad Arshad1,3, Riccardo Pofi4
1Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield S10 2TN, UK.
Journal of the Endocrine Society
|November 9, 2023
概括
以前的上皮质激素激素刺激测试 (AST) 结果与新的基线皮质醇相结合,可以比单独的基线皮质醇更好地预测未来的AST结果. 这有助于监测上腺功能衰竭的恢复.
科学领域:
- 内分泌学 在内分泌学.
- 临床化学 临床化学
背景情况:
- 上腺皮质激素激素刺激试验 (AST) 对于诊断上腺功能不全至关重要.
- 监测下丘脑-垂体-上腺轴的恢复通常需要重复的AST.
研究的目的:
- 开发和验证AST结果的预测模型.
- 该模型旨在使用先前的AST数据和新的基线皮质醇水平来预测未来的AST结果.
主要方法:
- 这是一项追溯的纵向队列研究,涉及至少两名AST患者.
- 用向后变量选择的多项式回归被用于模型开发.
- 175名成年人 (258名AST) 的数据用于开发,111名患者用于验证.
主要成果:
- 以前的基线皮质醇,以前的30分钟皮质醇和新的基线皮质醇显著改善了对新30分钟皮质醇的预测.
- 与单独使用新基线皮质醇 (R2 = 0.53,AUC = 0.88) 相比,开发的模型显示出更高的预测准确性 (R2 = 0.71,AUC = 0.97).
结论:
- 将以前的AST结果与新的基线皮质醇结合起来,可以更准确地预测未来的AST结果.
- 在线计算器可用于预测模型的外部验证.
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