Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu 610044, China.
Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu 610044, China.
Biomolecules. 2022 Dec 12;12(12):1861. doi: 10.3390/biom12121861.
Mild cognitive impairment (MCI) is the prodromal stage and an important risk factor of Alzheimer's disease (AD). Interventions at the MCI stage are significant in reducing the occurrence of AD. However, there are still many obstacles to the screening of MCI, resulting in a large number of patients going undetected. Given the strong correlation between gastrointestinal function and neuropsychiatric disorders, the aim of this study is to develop a risk prediction model for MCI based on gastrointestinal myoelectrical activity. The Mini-Mental State Examination and electrogastroenterography were applied to 886 participants in western China. All participants were randomly assigned to the training and validation sets in a ratio of 7:3. In the training set, risk variables were screened using LASSO regression and logistic regression, and risk prediction models were built based on nomogram and decision curve analysis, then validation was performed. Eight predictors were selected in the training set, including four electrogastroenterography parameters (rhythm disturbance, dominant frequency and dominant power ratio of gastric channel after meal, and time difference of intestinal channel after meal). The area under the ROC curve for the prediction model was 0.74 in the training set and 0.75 in the validation set, both of which exhibited great prediction ability. Furthermore, decision curve analysis displayed that the net benefit was more desirable when the risk thresholds ranged from 15% to 35%, indicating that the nomogram was clinically usable. The model based on gastrointestinal myoelectrical activity has great significance in predicting the risk of MCI and is expected to be an alternative to scales assessment.
轻度认知障碍(MCI)是阿尔茨海默病(AD)的前驱阶段和重要危险因素。在 MCI 阶段进行干预对于降低 AD 的发生具有重要意义。然而,MCI 的筛查仍然存在许多障碍,导致大量患者未被发现。鉴于胃肠道功能与神经精神障碍之间存在很强的相关性,本研究旨在基于胃肠道肌电活动开发 MCI 的风险预测模型。采用简易精神状态检查和胃肠电图对中国西部的 886 名参与者进行了检查。所有参与者均按 7:3 的比例随机分配到训练集和验证集中。在训练集中,使用 LASSO 回归和逻辑回归筛选风险变量,并基于列线图和决策曲线分析构建风险预测模型,然后进行验证。在训练集中选择了 8 个预测因子,包括四个胃肠电图参数(餐后胃通道节律紊乱、主导频率和主导功率比、餐后肠通道时间差)。预测模型在训练集和验证集中的 ROC 曲线下面积分别为 0.74 和 0.75,均具有很好的预测能力。此外,决策曲线分析显示,当风险阈值范围在 15%至 35%之间时,净效益更理想,表明列线图具有临床可用性。基于胃肠道肌电活动的模型对预测 MCI 风险具有重要意义,有望成为量表评估的替代方法。