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从健康管理角度出发建立并评估老年非酒精性脂肪性肝病患者高血压风险预测模型。

Establishment and evaluation of a risk-prediction model for hypertension in elderly patients with NAFLD from a health management perspective.

机构信息

Department of Health Management, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

Shanghai Collaborative Innovation Center of Traditional Chinese Medicine Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

出版信息

Sci Rep. 2022 Sep 7;12(1):15138. doi: 10.1038/s41598-022-18718-3.

Abstract

Elderly patients with nonalcoholic fatty liver disease are at a higher risk of developing. This study established an effective, individualised, early Hypertension risk-prediction model and proposed health management advice for patients over 60 years of age with NAFLD. Questionnaire surveys, physical examinations, and biochemical tests were conducted in 11,136 participants. The prevalence of NAFLD among 11,136 participants was 52.1%. Risk factors were screened using the least absolute shrinkage and selection operator model and random forest model. A risk-prediction model was established using logistic regression analysis and a dynamic nomogram was drawn. The model was evaluated for discrimination, calibration, and clinical applicability using receiver operating characteristic curves, calibration curves, decision curve analysis, net reclassification index (NRI), and external validation. The results suggested that the model showed moderate predictive ability. The area under curve (AUC) of internal validation was 0.707 (95% CI: 0.688-0.727) and the AUC of external validation was 0.688 (95% CI: 0.672-0.705). The calibration plots showed good calibration, the risk threshold of the decision curve was 30-56%, and the NRI value was 0.109. This Hypertension risk factor model may be used in clinical practice to predict the Hypertension risk in NAFLD patients.

摘要

老年非酒精性脂肪性肝病患者发生高血压的风险较高。本研究建立了一种有效的、个体化的、早期高血压风险预测模型,并为年龄超过 60 岁的非酒精性脂肪性肝病患者提出了健康管理建议。对 11136 名参与者进行了问卷调查、体格检查和生化检查。11136 名参与者中,非酒精性脂肪性肝病的患病率为 52.1%。使用最小绝对收缩和选择算子模型和随机森林模型筛选风险因素。使用逻辑回归分析建立风险预测模型,并绘制动态列线图。使用接收者操作特征曲线、校准曲线、决策曲线分析、净重新分类指数(NRI)和外部验证评估模型的区分度、校准度和临床适用性。结果表明,该模型具有中等的预测能力。内部验证的曲线下面积(AUC)为 0.707(95%CI:0.688-0.727),外部验证的 AUC 为 0.688(95%CI:0.672-0.705)。校准图显示良好的校准度,决策曲线的风险阈值为 30-56%,NRI 值为 0.109。该高血压危险因素模型可用于临床实践,以预测非酒精性脂肪性肝病患者的高血压风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6382/9452675/78996f56a99d/41598_2022_18718_Fig1_HTML.jpg

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