Biostatistics and Bioinformatics Unit, IMDEA Food, CEI UAM+CSIC, E28049 Madrid, Spain.
Nutrients. 2020 Aug 16;12(8):2466. doi: 10.3390/nu12082466.
The prevalence of childhood and adolescence overweight an obesity is raising at an alarming rate in many countries. This poses a serious threat to the current and near-future health systems, given the association of these conditions with different comorbidities (cardiovascular diseases, type II diabetes, and metabolic syndrome) and even death. In order to design appropriate strategies for its prevention, as well as understand its origins, the development of predictive models for childhood/adolescent overweight/obesity and related outcomes is of extreme value. Obesity has a complex etiology, and in the case of childhood and adolescence obesity, this etiology includes also specific factors like (pre)-gestational ones; weaning; and the huge anthropometric, metabolic, and hormonal changes that during this period the body suffers. In this way, Machine Learning models are becoming extremely useful tools in this area, given their excellent predictive power; ability to model complex, nonlinear relationships between variables; and capacity to deal with high-dimensional data typical in this area. This is especially important given the recent appearance of large repositories of Electronic Health Records (EHR) that allow the development of models using datasets with many instances and predictor variables, from which Deep Learning variants can generate extremely accurate predictions. In the current work, the area of Machine Learning models to predict childhood and adolescent obesity and related outcomes is comprehensively and critically reviewed, including the latest ones using Deep Learning with EHR. These models are compared with the traditional statistical ones that used mainly logistic regression. The main features and applications appearing from these models are described, and the future opportunities are discussed.
在许多国家,儿童和青少年超重和肥胖的患病率正在以惊人的速度上升。鉴于这些情况与不同的合并症(心血管疾病、II 型糖尿病和代谢综合征)甚至死亡有关,这对当前和近期的卫生系统构成了严重威胁。为了设计适当的预防策略,以及了解其起源,儿童/青少年超重/肥胖和相关结果的预测模型的开发具有极高的价值。肥胖症具有复杂的病因,而在儿童和青少年肥胖症的情况下,病因还包括特定因素,如(预)妊娠因素;断奶;以及在此期间身体经历的巨大的人体测量、代谢和激素变化。在这方面,机器学习模型因其出色的预测能力、对变量之间复杂非线性关系的建模能力以及处理该领域典型的高维数据的能力而成为非常有用的工具。鉴于最近出现了大量电子健康记录 (EHR) 存储库,这一点尤为重要,这些存储库允许使用具有许多实例和预测变量的数据集来开发模型,深度学习变体可以从这些数据集中生成非常准确的预测。在当前的工作中,全面而批判性地回顾了用于预测儿童和青少年肥胖症及相关结果的机器学习模型领域,包括使用 EHR 的最新深度学习模型。将这些模型与主要使用逻辑回归的传统统计模型进行了比较。描述了这些模型出现的主要特征和应用,并讨论了未来的机会。