开发和验证一种风险预测模型,用于2型糖尿病疼痛的糖尿病外围神经病变:一个多中心的回顾性研究
Yanpi Li1,2, Xiyun Wang1, Huimin Hu3
1Beijing University of Chinese Medicine, Beijing, China.
Frontiers in endocrinology
|December 15, 2025
概括
一个新的临床模型预测了2型糖尿病患者 (T2DM) 患有疼痛性糖尿病外围神经病变 (PDPN) 的风险. 这种工具有助于在初级保健机构的早期识别和干预.
科学领域:
- 内分泌学和新陈代谢学
- 神经学 神经学
- 在医疗保健中的数据科学.
背景情况:
- 糖尿病外围神经病变 (DPN) 是2型糖尿病 (T2DM) 的常见并发症.
- 疼痛性糖尿病外围神经病变 (PDPN) 显著影响患者的生活质量和医疗保健成本.
- 早期识别和干预对于管理PDPN进展至关重要.
研究的目的:
- 开发和验证一种用于预测T2DM患者PDPN风险的临床模型.
- 促进初级保健中早期检测和干预策略.
- 创建一个临床上可解释的风险评估工具.
主要方法:
- 利用了1984名T2DM患者的数据.
- 应用合成少数超样本技术 (SMOTE) 和最小绝对收缩和选择操作员 (LASSO) 回归用于特征选择.
- 使用交叉验证开发和评估了六个预测模型 (LR,RF,XGBoost,LightGBM,ANN,SVM).
- 为了预测器的可解释性,采用了SHapley添加式解释 (SHAP) 并构建了一个动态的名ogram.
主要成果:
- 确定了PDPN风险的十个关键预测变量.
- 后勤回归 (LR) 模型表现出强的表现,AUC-ROC为0.894.
- 通过SHAP分析,肌肉骨疾病和HbA1c被确定为最有影响力的预测因素.
- 为了临床应用,创建了一个用户友好的,动态的基于Web的nomogram.
结论:
- 成功开发和验证了在T2DM患者中PDPN风险预测的临床解释模型.
- 动态名图允许个性化风险估计.
- 模型和名图可以支持在常规临床实践中及时干预.
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