Real World Evidence and Clinical Outcome Generation, Sanofi, Paris, France.
Division of Endocrinology and Diabetology, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Diabetes Obes Metab. 2023 Jul;25(7):1823-1829. doi: 10.1111/dom.15039. Epub 2023 Apr 16.
To identify predictive factors for diabetic ketoacidosis (DKA) by retrospective analysis of registry data and the use of a subgroup discovery algorithm.
Data from adults and children with type 1 diabetes and more than two diabetes-related visits were analysed from the Diabetes Prospective Follow-up Registry. Q-Finder, a supervised non-parametric proprietary subgroup discovery algorithm, was used to identify subgroups with clinical characteristics associated with increased DKA risk. DKA was defined as pH less than 7.3 during a hospitalization event.
Data for 108 223 adults and children, of whom 5609 (5.2%) had DKA, were studied. Q-Finder analysis identified 11 profiles associated with an increased risk of DKA: low body mass index standard deviation score; DKA at diagnosis; age 6-10 years; age 11-15 years; an HbA1c of 8.87% or higher (≥ 73 mmol/mol); no fast-acting insulin intake; age younger than 15 years and not using a continuous glucose monitoring system; physician diagnosis of nephrotic kidney disease; severe hypoglycaemia; hypoglycaemic coma; and autoimmune thyroiditis. Risk of DKA increased with the number of risk profiles matching patients' characteristics.
Q-Finder confirmed common risk profiles identified by conventional statistical methods and allowed the generation of new profiles that may help predict patients with type 1 diabetes who are at a greater risk of experiencing DKA.
通过回顾性分析登记数据和使用亚组发现算法，确定糖尿病酮症酸中毒（DKA）的预测因素。
从糖尿病前瞻性随访登记处分析了患有 1 型糖尿病且有两次以上糖尿病就诊的成人和儿童的数据。使用 Q-Finder（一种有监督的非参数专有亚组发现算法）来识别与 DKA 风险增加相关的具有临床特征的亚组。DKA 的定义为住院期间 pH 值低于 7.3。
研究了 108223 名成人和儿童的数据，其中 5609 人（5.2%）患有 DKA。Q-Finder 分析确定了与 DKA 风险增加相关的 11 种特征：低体重指数标准差评分；诊断时出现 DKA；年龄 6-10 岁；年龄 11-15 岁；HbA1c 为 8.87%或更高（≥73mmol/mol）；没有使用速效胰岛素；年龄小于 15 岁且未使用连续血糖监测系统；肾病医生诊断；严重低血糖；低血糖昏迷；以及自身免疫性甲状腺炎。与患者特征相匹配的风险特征数量越多，DKA 的风险就越高。
Q-Finder 证实了传统统计方法确定的常见风险特征，并生成了可能有助于预测 1 型糖尿病患者中 DKA 风险更高的新特征。
