Hu Huan, Nakagawa Tohru, Honda Toru, Yamamoto Shuichiro, Kochi Takeshi, Okazaki Hiroko, Miyamoto Toshiaki, Ogasawara Takayuki, Gommori Naoki, Yamamoto Makoto, Konishi Maki, Inoue Yosuke, Kabe Isamu, Dohi Seitaro, Mizoue Tetsuya
Research Center for Prevention from Radiation Hazards of Workers, National Institute of Occupational Safety and Health.
Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine.
J Atheroscler Thromb. 2025 Mar 1;32(3):334-344. doi: 10.5551/jat.64919. Epub 2024 Sep 19.
This study aimed to develop a cardiovascular disease (CVD) risk model using data from a large occupational cohort.
A risk prediction model was developed using the routine health checkup data of 96,117 Japanese employees (84.0% men) who were 30-64 years of age and had no CVD at baseline. Cox proportional hazards regression models were employed to develop a risk model for assessing the 10-year CVD risk. Measures of discrimination and calibration were used to assess the predictive performance of the model and internal validation was used to examine potential overfitting.
During a mean follow-up period of 6.7 years (range, 0.1-11.0 years), 422 cases of incident CVD were confirmed. The final model, which included predictor variables of age, smoking, diabetes, systolic blood pressure, and low- and high-density lipoprotein cholesterol levels, demonstrated a good predictive ability (Harrell's C-statistic, 0.796; 95% confidence interval, 0.775-0.817) with excellent calibration between observed and predicted values. Internal validation revealed minimal overfitting.
The developed model can accurately predict the 10-year CVD risk. Because it is based on routine health checkup data, the prediction model can be easily implemented in the workplace. Further studies are required to assess the external validity and transferability of the proposed CVD risk model.
本研究旨在利用来自一个大型职业队列的数据开发一种心血管疾病(CVD)风险模型。
使用96117名30 - 64岁且基线时无CVD的日本员工(84.0%为男性)的常规健康体检数据开发风险预测模型。采用Cox比例风险回归模型开发用于评估10年CVD风险的风险模型。使用区分度和校准度测量来评估模型的预测性能,并使用内部验证来检查潜在的过度拟合情况。
在平均6.7年(范围0.1 - 11.0年)的随访期内,确诊422例新发CVD病例。最终模型纳入了年龄、吸烟、糖尿病、收缩压以及低密度和高密度脂蛋白胆固醇水平等预测变量,显示出良好的预测能力(Harrell氏C统计量为0.796;95%置信区间为0.775 - 0.817),观察值与预测值之间校准良好。内部验证显示过度拟合最小。
所开发的模型能够准确预测10年CVD风险。由于该模型基于常规健康体检数据,因此可在工作场所轻松实施。需要进一步研究来评估所提出的CVD风险模型的外部有效性和可转移性。