Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan.
Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan.
Sci Rep. 2023 Jul 20;13(1):11690. doi: 10.1038/s41598-023-38811-5.
Association rule is a transparent machine learning method expected to share information about risks for chronic kidney disease (CKD) among diabetic patients, but its findings in clinical data are limited. We used the association rule to evaluate the risk for kidney disease in General and Worker diabetic cohorts. The absence of risk factors was examined for association with stable kidney function and worsening kidney function. A confidence value was used as an index of association, and a lift of > 1 was considered significant. Analyses were applied for individuals stratified by KDIGO's (Kidney Disease: Improving Global Outcomes) CKD risk categories. A General cohort of 4935 with a mean age of 66.7 years and a Worker cohort of 2153 with a mean age of 47.8 years were included in the analysis. Good glycemic control was significantly related to stable kidney function in low-risk categories among the General cohort, and in very-high risk categories among the Worker cohort; confidences were 0.82 and 0.77, respectively. Similar results were found with poor glycemic control and worsening kidney function; confidences of HbA1c were 0.41 and 0.27, respectively. Similarly, anemia, obesity, and hypertension showed significant relationships in the low-risk General and very-high risk Worker cohorts. Stratified risk assessment using association rules revealed the importance of the presence or absence of risk factors.
关联规则是一种透明的机器学习方法,有望在糖尿病患者中共享慢性肾脏病(CKD)风险信息,但在临床数据中的发现有限。我们使用关联规则评估一般和工人糖尿病队列中发生肾脏病的风险。我们研究了无风险因素与稳定肾功能和肾功能恶化之间的关联。置信值用作关联的指标,置信值>1 被认为具有显著意义。对按照 KDIGO(肾脏疾病:改善全球结局)CKD 风险类别分层的个体进行了分析。一般队列纳入 4935 人,平均年龄为 66.7 岁,工人队列纳入 2153 人,平均年龄为 47.8 岁。在一般队列的低风险类别和工人队列的极高风险类别中,良好的血糖控制与稳定的肾功能显著相关,置信度分别为 0.82 和 0.77。在血糖控制不佳和肾功能恶化的情况下也发现了类似的结果,HbA1c 的置信度分别为 0.41 和 0.27。同样,贫血、肥胖和高血压在低风险的一般队列和极高风险的工人队列中也显示出显著的关系。使用关联规则进行分层风险评估揭示了存在或不存在风险因素的重要性。