中国卫生统计2024,Vol.41Issue(1) :23-27.DOI:10.11783/j.issn.1002-3674.2024.01.005

载脂蛋白E联合临床相关指标预测阿尔兹海默病模型的建立与验证

Apolipoprotein ApoE Combined with Clinical Related Indices to Predict and Verify a Model for Alzheimer's Disease

吴天晨 杨卉 梁艳 杨永刚
中国卫生统计2024,Vol.41Issue(1) :23-27.DOI:10.11783/j.issn.1002-3674.2024.01.005

载脂蛋白E联合临床相关指标预测阿尔兹海默病模型的建立与验证

Apolipoprotein ApoE Combined with Clinical Related Indices to Predict and Verify a Model for Alzheimer's Disease

吴天晨 1杨卉 2梁艳 1杨永刚1
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作者信息

  • 1. 南京市中医院(210001)
  • 2. 南京中医药大学
  • 折叠

摘要

目的 以载脂蛋白E(ApoE)为基础,结合阿尔茨海默病发病危险因素及临床常见指标,构建阿尔兹海默病发病风险的临床预测模型.方法 从南京市中医院大数据平台中,检索时间为 2019 年 1 月至 2021 年 1 月两年时间内,阿尔兹海默病患者 61 例,模糊匹配健康体检者 111 例.利用LASSO回归筛选危险因素,构建logistic回归预测模型,10 折交叉进行区分度验证,bootstrap法进行校准度验证,临床决策曲线评判预测模型的临床指导性,最后以列线图可视化呈现临床预测模型.结果 筛选出 12 个变量,最终纳入 4 个危险因素:年龄、游离三碘甲状腺素(FT3)、性别、ApoE.全样本ROC曲线下面积为 0.879,10 折交叉 9 次验证后ROC曲线下平均面积为 0.864;采用Bootstrap法抽样及Hosmer-Lemeshow校准度检验,结果χ2=6.496,P=0.592>0.05.临床决策曲线阈值概率区间为 1%~88.6%.结论 利用年龄、游离三碘甲状腺素、性别、ApoE构建的临床预测模型对患者进行个体化评估,可以预警阿尔兹海默病,开展早期预防干预,减缓该病的发生发展.

Abstract

Objective To construct a clinical prediction model for the risk of Alzheimer's disease based on ApoE,combined with risk factors and common clinical indicators.Methods There were 61 cases of Alzheimer's disease patients and 111 cases of fuzzy matching healthy physical examination from Nanjing Hospital of Chinese Medicine data platform from January 2019 to January 2021.Using LASSO regression screening of risk factors,constructing logistic regression forecasting model,10 fold cross verifies the degree of differentiation,validation the calibration of the bootstrap method.The clinical guidance of the prediction model was evaluated by the clinical decision curve,and finally,the clinical prediction model was visualized by nomogram.Results 12 variables were screened out and four risk factors were included,which are age,free triiodothyroxine(FT3),gender and ApoE.The AUC of ROC of the whole sample was 0.879,and the average AUC of ROC after 10 folded and 9 crossed training sets verification was 0.864.Bootstrap method and Hosmer-Lemeshow were used to test the calibration degree.Results χ2 =6.496,P=0.592>0.05.The threshold probability of clinical decision curve ranged from 1%to 88.6%.Conclusion Individualized evaluation of patients using clinical prediction models constructed by age,FT3,gender and ApoE can provide early warning of Alzheimer's disease,carry out early prevention intervention and slow down the development of the disease.

关键词

痴呆/阿尔兹海默病/预测模型/载脂蛋白E

Key words

Dementia/Alzheimer's disease/Prediction model/Apolipoprotein E

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基金项目

国家自然科学基金(81904112)

江苏省自然科学基金资助项目(BK20190136)

南京市中医药青年人才培养项目(ZYQ20047)

出版年

2024
中国卫生统计
中国卫生信息学会 中国医科大学

中国卫生统计

CSTPCDCSCD北大核心
影响因子:1.172
ISSN:1002-3674
参考文献量20
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