Pu Jincheng, Song Jiamin, Pan Shengnan, Zhuang Shuqi, Gao Ronglin, Liang Yuanyuan, Wu Zhenzhen, Wang Yanqing, Zhang Youwei, Yang Lufei, Han Fang, Wu Huihong, Tang Jianping, Wang Xuan
Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, No.389 Xincun Road, Shanghai 200065, China.
Ther Adv Chronic Dis. 2023 Jul 18;14:20406223231181490. doi: 10.1177/20406223231181490. eCollection 2023.
Patients with primary Sjögren's syndrome (pSS) are at increased risk of cardiovascular morbidity as compared with the general population.
A retrospective study on 349 Chinese patients with pSS was conducted to identify potential risk factors for cardiovascular events and develop a cardiovascular risk nomogram.
This is a retrospective observational study.
The study included 349 patients who were diagnosed with pSS at Tongji Hospital, School of Medicine, Tongji University, China from January 2010 to March 2022. The least absolute shrinkage and selection operator (LASSO) was used to select features for the cardiovascular risk model. The features selected in LASSO were used to build the cardiovascular risk model in a multivariate logistic regression analysis. C-index, receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis were used to assess the predictive model. Internal validation was performed by bootstrapping.
Sex, joint pain as an initial symptom, dry mouth, oral ulcers, dental caries, Raynaud's phenomenon, fatigue, diabetes, elevated thyroid-stimulating hormone (TSH) level, and elevated systolic blood pressure were included in the nomogram for the prediction of cardiovascular risk. Our model had good discrimination (C-index: 0.824, 95% confidence interval: 0.712-0.936) and good calibration (C-index in the interval validation: 0.8). Decision curve analysis indicated that our nomogram demonstrated clinical usefulness for intervention in a cardiovascular disease possibility threshold of 3%.
The cardiovascular risk nomogram incorporating sex, initial joint pain, dry mouth, oral ulcer, dental caries, Raynaud's phenomenon, fatigue, diabetes, elevated TSH, and systolic blood pressure could be used in the prediction of cardiovascular risk in patients with pSS and the guidance of further treatment.
与普通人群相比，原发性干燥综合征（pSS）患者心血管疾病发病风险增加。
对349例中国pSS患者进行回顾性研究，以确定心血管事件的潜在危险因素并建立心血管风险列线图。
这是一项回顾性观察研究。
该研究纳入了2010年1月至2022年3月在中国同济大学医学院附属同济医院被诊断为pSS的349例患者。使用最小绝对收缩和选择算子（LASSO）为心血管风险模型选择特征。LASSO中选择的特征用于多变量逻辑回归分析中建立心血管风险模型。使用C指数、受试者工作特征（ROC）曲线、校准图和决策曲线分析来评估预测模型。通过自抽样法进行内部验证。
性别、以关节疼痛为初始症状、口干、口腔溃疡、龋齿、雷诺现象、疲劳、糖尿病、促甲状腺激素（TSH）水平升高和收缩压升高被纳入预测心血管风险的列线图。我们的模型具有良好的区分度（C指数：0.824，95%置信区间：0.712 - 0.936）和良好的校准度（区间验证中的C指数：0.8）。决策曲线分析表明，我们的列线图在心血管疾病可能性阈值为3%时对干预具有临床实用性。
包含性别、初始关节疼痛、口干、口腔溃疡、龋齿、雷诺现象、疲劳、糖尿病、TSH升高和收缩压的心血管风险列线图可用于预测pSS患者的心血管风险并指导进一步治疗。
