开发和验证一种基于Nomogram的风险预测模型,用于2型糖尿病患者的老年人糖尿病视网膜病变的风险预测
Meitong Chen1,2, Tongtong Niu2, Yan Sun2
1School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province, 121001, People's Republic of China.
概括
一个新的名图准确地预测了老年2型糖尿病患者 (T2DM) 中的糖尿病视网膜病变 (DR) 风险,使用可访问的变量,为这个脆弱群体实现早期干预.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 老年病的医生 老年病的医生
背景情况:
- 糖尿病视网膜病变 (DR) 是2型糖尿病 (T2DM) 的常见并发症.
- 在老年T2DM患者中,对DR的风险预测还未得到充分研究.
- 早期干预对于管理DR和预防视力丧失至关重要.
研究的目的:
- 开发和验证一种名谱,用于识别患有DR高风险的老年T2DM患者.
- 为早期临床干预和个性化风险管理提供一个工具.
主要方法:
- 对1912名老年T2DM患者 (≥60岁) 的回顾性队列研究.
- 使用最小绝对收缩和选择操作员 (LASSO) 回归和多变量后勤回归.
- 使用ROC-AUC,校准图,H-L测试和决策曲线分析 (DCA) 评估的诺莫图表表表现.
- 在独立队列 (n=476) 上进行的外部验证.
主要成果:
- 655名 (34.3%) 患者被诊断患有DR.
- 确定了关键预测因素:T2DM持续时间,HbA1c,PLR,eGFR和NPAR.
- 诺莫格拉姆显示强大的歧视 (AUC:0.823导出,0.808内部验证,0.788外部验证).
- 强大的校准和有利的临床实用性被证明.
结论:
- 经过验证的名图是早期DR风险分层在老年T2DM患者的务实工具.
- 通过整合可访问的变量,它有助于个性化风险缓解策略.
- 实施可以帮助减少DR在这个高风险人群中的发病率.
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