Legesse Alemayehu
Department of Statistics, College of Natural and Computational Science, Madda Walabu University, Bale Robe, Ethiopia.
Int J Endocrinol. 2022 Jun 27;2022:3994622. doi: 10.1155/2022/3994622. eCollection 2022.
Recovery from type 2 diabetes is frequently recurrent, as a single patient may recover from more than one over time. The goal of this study was to know the recurrent event (time to recovery) and associated factors of type 2 diabetes in Adama General Hospital, Ethiopia, by comparing shared lognormal frailty and Cox-PH models.
A retrospective analysis of 302 type 2 diabetic patients (01, 2011-01, and 2016) was considered. Descriptive statistics were used to summarize the study variables. The standard Cox-proportional hazards model and a shared lognormal frailty model have been compared. The latter model with a 95% significance level was fitted, variables with value < 0.05 were considered significant, and the adjusted hazard ratio has been used to measure the strength of the risk.
About 56.6% of the patients recovered. The average recovery time was 33.53 (standard deviation, 20.404 ) weeks. Gender (adjusted HR = 1.168, 95% CI = (0.93, 1.46), < 0.05), family history (adjusted HR = 0.765, 95% CI = (0.59, 0.99), < 0.05), cholesterol level (adjusted HR = 0.738, 95% CI = (0.57, 0.96), < 0.05), alcohol use (adjusted HR = 0.698, 95% CI = (0.53, 0.92), < 0.05), and smoking cigarette (adjusted HR = 0.674, 95% CI = (0.51, 0.89), < 0.05) were statistically significant. The estimated frailty term's variance was 0.426 ( value=0.028). Also, the author presents a comparison study for the same data by using a model selection criterion and suggests a better model (shared lognormal frailty model).
Finally, the median recovery time was 30 weeks. Female patients had a better chance of recovery than male patients. A shared lognormal frailty model outperformed the Cox-PH model in fitting the data and controlling event interdependence. There was risk heterogeneity among patients. Positive family history, high cholesterol level, alcohol use, and smoking have an inverse relationship with the overall likelihood of the patients' recovery time. Therefore, future improvement measures against type 2 DM recovery should take all events (for example, the first, second, and third recovery in this study) and these identified factors into account.
2型糖尿病的康复经常会复发，因为随着时间推移，单个患者可能会经历不止一次康复。本研究的目的是通过比较共享对数正态脆弱模型和Cox-PH模型，了解埃塞俄比亚阿达马综合医院2型糖尿病的复发事件（康复时间）及相关因素。
对302例2型糖尿病患者（2011年1月至2016年1月）进行回顾性分析。采用描述性统计来总结研究变量。比较了标准Cox比例风险模型和共享对数正态脆弱模型。对后者模型在95%显著性水平下进行拟合，p值<0.05的变量被认为具有显著性，并使用调整后的风险比来衡量风险强度。
约56.6%的患者康复。平均康复时间为33.53周（标准差，20.404）。性别（调整后HR = 1.168，95%CI =（0.93，1.46），p<0.05）、家族史（调整后HR = 0.765，95%CI =（0.59，0.99），p<0.05）、胆固醇水平（调整后HR = 0.738，95%CI =（0.57，0.96），p<0.05）、饮酒（调整后HR = 0.698，95%CI =（0.53，0.92），p<0.05）和吸烟（调整后HR = 0.674，95%CI =（0.51，0.89），p<0.05）具有统计学显著性。估计的脆弱项方差为0.426（p值 = 0.028）。此外，作者通过使用模型选择标准对相同数据进行了比较研究，并提出了一个更好的模型（共享对数正态脆弱模型）。
最后，中位康复时间为30周。女性患者比男性患者有更好的康复机会。在拟合数据和控制事件相关性方面，共享对数正态脆弱模型优于Cox-PH模型。患者之间存在风险异质性。阳性家族史、高胆固醇水平、饮酒和吸烟与患者康复时间的总体可能性呈负相关。因此，未来针对2型糖尿病康复的改进措施应考虑所有事件（例如本研究中的第一次、第二次和第三次康复）以及这些已确定的因素。
