Personalized Drug Therapy Key Laboratory of Sichuan Province, Department of Pharmacy, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China.
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610044, Sichuan, China.
Sci Rep. 2023 Sep 30;13(1):16437. doi: 10.1038/s41598-023-43240-5.
Fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) are key indicators reflecting blood glucose control in type 2 diabetes mellitus (T2DM) patients. The purpose of this study is to establish a predictive model for blood glucose changes in T2DM patients after 3 months of treatment, achieving personalized treatment.A retrospective study was conducted on type 2 diabetes mellitus real-world medical data from 4 cities in Sichuan Province, China from January 2015 to December 2020. After data preprocessing, data inputting, data sampling, and feature screening, 16 kinds of machine learning methods were used to construct prediction models, and 5 prediction models with the best prediction performance were screened respectively. A total of 100,000 cases were included to establish the FBG model, and 2,169 cases were established to establish the HbA1c model. The best prediction model both of FBG and HbA1c finally obtained are realized by ensemble learning and modified random forest inputting, the AUC values are 0.819 and 0.970, respectively. The most important indicators of the FBG and HbA1c prediction model were FBG and HbA1c. Medication compliance, follow-up outcome, dietary habits, BMI, and waist circumference also had a greater impact on FBG levels. The prediction accuracy of the models of the two blood glucose control indicators is high and has certain clinical applicability.HbA1c and FBG are mutually important predictors, and there is a close relationship between them.
空腹血糖(FBG)和糖化血红蛋白(HbA1c)是反映 2 型糖尿病(T2DM)患者血糖控制的关键指标。本研究旨在建立 T2DM 患者治疗 3 个月后血糖变化的预测模型,实现个体化治疗。
对 2015 年 1 月至 2020 年 12 月中国四川省 4 个城市的 2 型糖尿病真实世界医疗数据进行回顾性研究。经过数据预处理、数据输入、数据抽样和特征筛选,构建了 16 种机器学习方法预测模型,并分别筛选出 5 种预测性能最佳的预测模型。共纳入 10 万例患者建立 FBG 模型,纳入 2169 例患者建立 HbA1c 模型。最终通过集成学习和修改后的随机森林输入实现了 FBG 和 HbA1c 最佳预测模型的构建,AUC 值分别为 0.819 和 0.970。FBG 和 HbA1c 预测模型最重要的指标是 FBG 和 HbA1c。药物依从性、随访结果、饮食习惯、BMI 和腰围对 FBG 水平也有较大影响。两种血糖控制指标模型的预测准确性均较高,具有一定的临床适用性。
HbA1c 和 FBG 是相互重要的预测指标,两者之间存在密切关系。