单细胞对中国成年人冠心病的预测价值:基于人口的队列研究
Jianfeng Pei1, Maryam Zaid1, Yiling Wu2
1Department of Epidemiology, Fudan University School of Public Health, Shanghai, China.
BMJ open
|September 15, 2025
概括
一个新的单细胞计数模型有效地预测了冠心病 (CHD) 风险. 这种简单,低成本的工具有助于识别高风险个体,以便及时进行预防性干预.
科学领域:
- 心血管疾病流行病学
- 生物标志物发现发现
- 预防性心脏病学 预防性心脏病学
背景情况:
- 冠心病 (CHD) 风险预测对于实施预防策略至关重要.
- 需要简单,低成本的工具来快速识别高风险个体.
- 单细胞数量及其与高密度脂蛋白胆固醇 (MHR) 的比例是潜在的生物标志物.
研究的目的:
- 开发和验证使用单细胞计数和MHR.CHD风险的预测模型和评分系统.
- 评估这些模型在识别患心血管疾病高风险的个体方面的表现.
- 评估基于单细胞的风险分层工具的临床实用性.
主要方法:
- 基于人口的前性队列研究 (上海郊区成人队列和生物库,SSACB) 共有44,013名无心血管疾病的参与者.
- 开发了三种预测模型和评分系统,使用单细胞计数或MHR的逐步考克斯回归.
- 通过10倍交叉验证进行内部验证,并在单独的子队列中进行外部验证.
主要成果:
- 单细胞计数和MHR与心脏病风险有显著的关联.
- 基于单细胞的模型 (模型2) 显示出良好的区分 (AUC ~0.72-0.75) 和校准,用于4年内CHD预测.
- 性能与使用HDL-C或MHR的模型相似,得分算法的结果类似.
结论:
- 一个基于单细胞的模型可以作为一种简单,低成本和精心校准的工具来进行心血管疾病风险分层.
- 外部验证显示有限的概括性,表明需要进一步验证.
- 在临床广泛采用之前,建议进行未来的多中心验证和重新校准.
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