使用基于图形的神经网络框架在现实世界的人口超重和肥胖的疾病进展子类型的特征
Yao An Lee1, Yu Huang2,3,4,5, Hao Dai2,3
1Department of Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA.
medRxiv : the preprint server for health sciences
|November 26, 2025
概括
这项研究使用电子健康记录确定了三种不同的肥胖进展亚现象. 类似葡萄糖-1受体激动剂 (GLP-1RAs) 在这些群体中表现出不同的效果,突出了针对肥胖的个性化治疗潜力.
科学领域:
- 肥胖研究的研究.
- 精准医学是一门精准的医学.
- 现实世界的证据.
背景情况:
- 肥胖是一种复杂的疾病,具有不同的个人风险和治疗反应.
- 关于长期肥胖进展异质性及其对相关结果和治疗疗效的影响的研究有限.
研究的目的:
- 通过使用电子健康记录 (EHRs) 在10年内在现实人口中识别肥胖进展亚现象.
- 为了评估葡萄糖类-1受体激动剂 (GLP-1RAs) 治疗效应 (HTE) 在主要肥胖相关疾病的已识别的亚表型中的异质性.
主要方法:
- 使用EHR数据对超重或肥胖的成年人进行了回顾性队列研究.
- 开发了一个图形神经网络 (GNN) 模型来识别肥胖进展的亚现象.
- 模拟了一项目标试验,在每个亚表型内比较GLP-1RA用户和非用户,以评估疾病结果.
主要成果:
- 确定了三种子类型:渐进型,中间型和稳定型,具有不同的BMI轨迹和基线特征.
- 在各个亚表型中观察到与肥胖相关的并发症风险和全因死亡率的显著差异 (p < 0.001).
- GLP-1RA的使用与两个亚表型的心力衰竭风险降低以及在渐进组中慢性病风险的潜在增加有关.
结论:
- 来自EHRs的肥胖进展子类型显示了临床风险和治疗反应的显著异质性.
- 截然不同的BMI轨迹组表明,在肥胖管理中,数据驱动,表型导向的护理具有潜力.
- 这些发现突显了GLP-1RA治疗效果的有意义的差异,支持精密肥胖医学和需要对HTE进行前性验证.
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