在自身抗体阳性个体中,I型糖尿病的预测:绩效,时间和金钱都很重要
Lauric A Ferrat1,2, Erin L Templeman3, Andrea K Steck4
1Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK. lauric.ferrat@unige.ch.
Diabetologia
|May 10, 2025
概括
预测1型糖尿病风险涉及模型性能,成本和参与者时间之间的权衡. 代谢测量具有很高的准确性,但增加了费用,而遗传风险得分在早期最具影响力.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 临床预测建模临床预测建模
背景情况:
- 对临床1型糖尿病的有效预测对于管理自身抗体阳性个体至关重要.
- 风险分层和监测需要准确的预测模型.
研究的目的:
- 为了比较基于表现,成本和参与者时间的1型糖尿病预测模型.
- 确定风险分层和监测的最佳模型.
主要方法:
- 开发了1943年的Cox模型,使用遗传风险评分 (GRS2),自身抗体,BMI,年龄和代谢措施.
- 从TrialNet研究中对3967名自身抗体阳性亲属进行了培训和验证模型.
- 对预测性能,成本 (56美元至293美元) 和参与者时间 (10-165分钟) 的模型进行了比较.
主要成果:
- 包括代谢指标在内的模型以小差异 (<3%) 显示出最佳表现.
- 代谢测试需要大量的成本和时间,其性能与HbA1c或Index60模型相美.
- 遗传风险评分 (GRS2) 在临床前早期阶段表现出最高的影响力和歧视力.
结论:
- 成本效益分析揭示了权衡,使得量身定制的风险选策略成为可能.
- 为有效预测1型糖尿病风险确定了降低成本的选择.
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