对常规实验室检查进行数据挖掘可预测埃及丙型肝炎病毒（G4）感染的糖尿病患者的肝病进展：一项对71806例患者的队列研究

Data mining of routine laboratory tests can predict liver disease progression in Egyptian diabetic patients with hepatitis C virus (G4) infection: a cohort study of 71 806 patients.

作者信息

Saad Yasmin, Awad Abobakr, Alakel Wafaa, Doss Wahid, Awad Tahany, Mabrouk Mahasen

机构信息

Department of Endemic Medicine and Hepatology, Faculty of Medicine.

Department of Computer Science, Faculty of Computers and Information, Cairo University, Cairo, Egypt.

出版信息

Eur J Gastroenterol Hepatol. 2018 Feb;30(2):201-206. doi: 10.1097/MEG.0000000000001008.

DOI:10.1097/MEG.0000000000001008

PMID:29099423

Abstract

OBJECTIVES

Hepatitis C virus (HCV) and diabetes mellitus (DM) are prevalent diseases worldwide, associated with significant morbidity, mortality, and mutual association. The aims of this study were as follows: (i) find the prevalence of DM among 71 806 Egyptian patients with chronic HCV infection and its effect on liver disease progression and (ii) using data mining of routine tests to predict hepatic fibrosis in diabetic patients with HCV infection.

PATIENTS AND METHODS

A retrospective multicentered study included laboratory and histopathological data of 71 806 patients with HCV infection collected by Egyptian National Committee for control of viral hepatitis. Using data mining analysis, we constructed decision tree algorithm to assess predictors of fibrosis progression in diabetic patients with HCV.

RESULTS

Overall, 12 018 (16.8%) patients were diagnosed as having diabetes [6428: fasting blood glucose ≥126 mg/dl (9%) and 5590: fasting blood glucose ≥110-126 mg/dl (7.8%)]. DM was significantly associated with advanced age, high BMI and α-fetoprotein (AFP), and low platelets and serum albumin (P≤0.001). Advanced liver fibrosis (F3-F4) was significantly correlated with DM (P≤0.001) irrespective of age. Of 16 attributes, decision tree model for fibrosis showed AFP was most decisive with cutoff of 5.25 ng/ml as starting point of fibrosis. AFP level greater than cutoff in patients was the first important splitting attribute; age and platelet count were second important splitting attributes.

CONCLUSION

(i) Chronic HCV is significantly associated with DM (16.8%). (ii) Advanced age, high BMI and AFP, low platelets count and albumin show significant association with DM in HCV. (iii) AFP cutoff of 5.25 is a starting point of fibrosis development and integrated into mathematical model to predict development of liver fibrosis in diabetics with HCV (G4) infection.

摘要

目的

丙型肝炎病毒（HCV）和糖尿病（DM）是全球范围内的常见疾病，与显著的发病率、死亡率以及相互关联有关。本研究的目的如下：（i）在71806例埃及慢性HCV感染患者中找出DM的患病率及其对肝病进展的影响，以及（ii）利用常规检测的数据挖掘来预测HCV感染糖尿病患者的肝纤维化。

患者与方法

一项回顾性多中心研究纳入了埃及国家病毒性肝炎控制委员会收集的71806例HCV感染患者的实验室和组织病理学数据。通过数据挖掘分析，我们构建了决策树算法来评估HCV感染糖尿病患者纤维化进展的预测因素。

结果

总体而言，12018例（16.8%）患者被诊断患有糖尿病[6428例：空腹血糖≥126mg/dl（9%），5590例：空腹血糖≥110 - 126mg/dl（7.8%）]。DM与高龄、高体重指数（BMI）和甲胎蛋白（AFP）以及低血小板和血清白蛋白显著相关（P≤0.001）。无论年龄如何，晚期肝纤维化（F3 - F4）与DM显著相关（P≤0.001）。在16个属性中，纤维化的决策树模型显示AFP最为关键，以5.25ng/ml为纤维化起点的临界值。患者中AFP水平高于临界值是第一个重要的分裂属性；年龄和血小板计数是第二个重要的分裂属性。