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中国肥胖成年人抑郁风险预测模型的开发与验证

Development and validation of a predictive model for depression risk in Chinese obese adults.

作者信息

Yu Cong, Cao Jiamin, Chen Wenguang, Hong Ensi

机构信息

Graduate School, Jiangxi University of Chinese Medicine, Nanchang, China.

Nanchang Normal University, Infirmary of the Logistics Support Department, Nanchang, Jiangxi, China.

出版信息

Front Public Health. 2025 May 14;13:1574386. doi: 10.3389/fpubh.2025.1574386. eCollection 2025.

Abstract

OBJECTIVE

To construct a prediction model for the risk of depression in the obese population, aiming to facilitate the early identification of high-risk individuals and guide personalized preventive interventions.

METHODS

This study was based on the data from the China Health and Retirement Longitudinal Study (CHARLS 2015), the Center for Epidemiologic Studies Depression Scale-10 (CES-D10) to assess the depression of obese patients, Lasso regression and multivariable logistic regression were used to select predictors, the construction of a nomogram model, and the use of the random splitting method divided into a training set ( = 974) and a validation set ( = 418) by the 7:3 method, and the model was evaluated by the ROC curves and the AUC, the H-L goodness-of-fit test, the calibration graphs, and the clinical decision-making curve to assess the model.

RESULTS

A total of 1,392 obese patients were finally included, with a prevalence of depression of 32.68%. Age, respiratory function, renal disease, digestive disease, grip strength, rheumatism and arthritis, and sleep duration were selected to construct the predictive nomogram model of depression risk in obese patients, and the AUCs of the training set and validation set were 0.715 (95% CI = 0.681-0.749) and 0.716 (95% CI = 0.665-0.767). This suggests that the model has moderate discriminatory power. Respectively, the H-L test was statistically insignificant ( > 0.05, H-L test;  > 0.05). Goodness of fit, calibration curves showed significant agreement between the model and actual observations, and clinical decision curves indicated good model calibration and net benefit.

CONCLUSION

The model constructed in this study has good efficacy in predicting the occurrence of depression in the obese population and can be used for the early identification of high-risk groups and the adoption of targeted preventive measures to reduce the risk of depression.

摘要

目的

构建肥胖人群抑郁风险预测模型,旨在促进高危个体的早期识别并指导个性化预防干预。

方法

本研究基于中国健康与养老追踪调查(CHARLS 2015)的数据,采用流行病学研究中心抑郁量表10项版(CES-D10)评估肥胖患者的抑郁情况,运用Lasso回归和多变量逻辑回归筛选预测因素,构建列线图模型,并采用随机分割法按7:3比例分为训练集(n = 974)和验证集(n = 418),通过ROC曲线及AUC、H-L拟合优度检验、校准图和临床决策曲线对模型进行评估。

结果

最终纳入1392例肥胖患者,抑郁患病率为32.68%。选取年龄、呼吸功能、肾脏疾病、消化系统疾病、握力、风湿和关节炎以及睡眠时间构建肥胖患者抑郁风险预测列线图模型,训练集和验证集的AUC分别为0.715(95%CI = 0.681 - 0.749)和0.716(95%CI = 0.665 - 0.767)。这表明该模型具有中等区分能力。H-L检验分别无统计学意义(P>0.05,H-L检验;P>0.05)。拟合优度方面,校准曲线显示模型与实际观察结果具有显著一致性,临床决策曲线表明模型校准良好且净效益良好。

结论

本研究构建的模型在预测肥胖人群抑郁发生方面具有良好效果,可用于高危人群的早期识别并采取针对性预防措施以降低抑郁风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/888c/12116313/b9e52f2cb238/fpubh-13-1574386-g001.jpg

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