Establishment and Evaluation of a Nomogram Prediction Model for Rheu-matoid Arthritis Complicated with Interstitial Lung Disease in the Elderly Based on 25-(OH)D and Serological Factors
Establishment and Evaluation of a Nomogram Prediction Model for Rheu-matoid Arthritis Complicated with Interstitial Lung Disease in the Elderly Based on 25-(OH)D and Serological Factors
Objective To establish a nomogram prediction model for rheumatoid arthritis(RA)complicated with in-terstitial lung disease(RA-ILD)in the elderly based on vitamin 25-(OH)D and serological factors,and to evaluate the mod-el.Methods A total of 220 elderly patients with RA treated in our hospital from May 2020 to October 2022 were selected and divided into RA group(n =169)and RA-ILD group(n =51)according to whether they had interstitial lung disease.The general information and laboratory-related indicators[rheumatoid factor(RF),anti cyclic citrulline peptide antibody(anti CCP),anti keratin antibody(AKA),rheumatoid arthritis disease activity score(DAS28)],the levels of vitamin 25-(OH)D,serological factors[interleukin-33(IL-33),interleukin-35(IL-35),lysyl oxidase-like protein-2(LOXL-2),Krebs Von den Lungen-6(KL-6),and matrix metalloproteinase-8(MMP-8)]were compared between the two groups.The correlation between vitamin 25-(OH)D and serological factors was analyzed,to analyze the influencing factors of the occur-rence of RA-ILD.A nomogram prediction model for RA-ILD was constructed based on the influencing factors,vitamin 25-(OH)D and serological factors,and then evaluated.Results There were significant differences in RF and DAS28 scores between RA-ILD group and simple RA group(P＜0.01).Vitamin 25-(OH)D,IL-35 and KL-6 in RA-ILD group were lower than those in simple RA group,while IL-33,LOXL-2 and MMP-8 were higher than those in simple RA group(P＜0.05,P＜0.01).Vitamin 25-(OH)D was positively correlated with IL-35 and KL-6,and negatively correlated with IL-33,LOXL-2 and MMP-8(P＜0.05).Vitamin 25-(OH)D,IL-35,KL-6,IL-33,LOXL-2,MMP-8,RF and DAS28 scores were the influen-tial factors in the occurrence of RA-ILD(P＜0.01).The prediction probability corresponding to the sum of each prediction factor was the risk probability of RA-ILD occurrence in this patient.This model had high predictive efficacy in RA-ILD and good calibration.Conclusion This nomogram model was established based on 25-(OH)D and serological factors to predict the occurrence of RA-ILD in elderly patients with RA,showing high predictive efficacy and good calibration.
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