基于机器学习和孟德尔随机化,探索冠状动脉疾病中CRP和淋巴细胞的预测值
Yuan Liu1,2, Xin Yuan1,2, Yu-Chan He1,2
1Department of Cardiology, Liuzhou People's Hospital, Affiliated of Guangxi Medical University, Liuzhou, Guangxi, China.
Frontiers in cardiovascular medicine
|September 26, 2024
概括
白细胞子集和C反应蛋白 (CRP) 预测冠状动脉疾病 (CAD). 高淋巴细胞计数和低CRP水平减少主要的不良心血管事件,而高CRP与低淋巴细胞表明预后不佳.
科学领域:
- 心血管医学 心血管医学
- 免疫学 免疫学 免疫学
- 遗传学 遗传学 是一个
背景情况:
- 冠状动脉疾病 (CAD) 仍然是全球死亡的主要原因.
- 确定可靠的生物标志物用于CAD风险预测对于有效的预防和管理至关重要.
- 白细胞子集和C反应蛋白 (CRP) 参与了与动脉样硬化相关的炎症过程.
研究的目的:
- 调查白细胞子集和C反应蛋白 (CRP) 在冠状动脉疾病 (CAD) 中的预测价值.
- 为了确定特定白细胞子集,CRP和CAD风险之间的因果关系.
- 评估在CAD患者中CRP和淋巴细胞水平的综合诊断和预后效用.
主要方法:
- 进行了孟德尔随机化 (MR) 分析,使用了46664名接受冠状动脉血管造影的患者的数据.
- 倾向性得分匹配 (PSM),逻辑回归,LASSO回归和随机森林 (RF) 算法用于风险因素评估.
- 接收器操作特征 (ROC) 曲线评估了模型的灵敏度和特异性,并补充了36个月生存分析.
主要成果:
- 基细胞数量,CRP水平和淋巴细胞数量通过逆方差权 (IVW) 分析被确定为CAD的显著风险因素.
- 在LASSO,后勤回归和射频分析中,CRP和淋巴细胞计数始终被确定为CAD风险因素,无论是在PSM前后.
- 淋巴细胞和CRP水平的组合表明PSM后的高诊断值 (0.85).
- 生存分析表明,高淋巴细胞计数和低CRP水平与重大心血管不良事件 (MACE) 的风险降低有关 (P < 0.001).
结论:
- 淋巴细胞,CRP和CAD之间存在因果关系.
- 结合CRP和淋巴细胞水平的评估为CAD提供了显著的诊断价值.
- 较高的CRP水平与较低的淋巴细胞计数相结合,与CAD患者的预后较差有关.
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