Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, 305-8576, Japan.
Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
Sci Rep. 2022 Jul 13;12(1):11965. doi: 10.1038/s41598-022-15224-4.
We aimed to investigate the status of falls and to identify important risk factors for falls in persons with type 2 diabetes (T2D) including the non-elderly. Participants were 316 persons with T2D who were assessed for medical history, laboratory data and physical capabilities during hospitalization and given a questionnaire on falls one year after discharge. Two different statistical models, logistic regression and random forest classifier, were used to identify the important predictors of falls. The response rate to the survey was 72%; of the 226 respondents, there were 129 males and 97 females (median age 62 years). The fall rate during the first year after discharge was 19%. Logistic regression revealed that knee extension strength, fasting C-peptide (F-CPR) level and dorsiflexion strength were independent predictors of falls. The random forest classifier placed grip strength, F-CPR, knee extension strength, dorsiflexion strength and proliferative diabetic retinopathy among the 5 most important variables for falls. Lower extremity muscle weakness, elevated F-CPR levels and reduced grip strength were shown to be important risk factors for falls in T2D. Analysis by random forest can identify new risk factors for falls in addition to logistic regression.
我们旨在调查 2 型糖尿病（T2D）患者（包括非老年患者）的跌倒状况，并确定重要的跌倒风险因素。研究对象为 316 名 T2D 患者，他们在住院期间接受了病史、实验室数据和身体能力评估，并在出院后一年接受了跌倒问卷调查。我们使用了两种不同的统计模型，逻辑回归和随机森林分类器，来确定跌倒的重要预测因素。该调查的回复率为 72%；在 226 名应答者中，有 129 名男性和 97 名女性（中位数年龄为 62 岁）。出院后第一年的跌倒发生率为 19%。逻辑回归显示，膝关节伸展力量、空腹 C 肽（F-CPR）水平和背屈力量是跌倒的独立预测因素。随机森林分类器将握力、F-CPR、膝关节伸展力量、背屈力量和增殖性糖尿病视网膜病变列为跌倒的 5 个最重要变量之一。下肢肌肉无力、F-CPR 水平升高和握力下降被证明是 T2D 患者跌倒的重要危险因素。与逻辑回归相比，随机森林分析可以识别跌倒的新风险因素。
