代谢因素与结直肠息肉发病相关性及风险预测模型建立  

Correlation between metabolic factors and colorectal polyps and establishment of risk prediction model

作　　者：陈杰[1] 赵倩茹[1] 董玲 李冰[1] 赵向娅[1] 杨轶[1] 杨胜楠[1] 田蕊[1] 李晓丽[1] CHEN Jie;ZHAO Qianru;DONG Ling;LI Bing;ZHAO Xiangya;YANG Yi;YANG Shengnan;TIAN Rui;LI Xiaoli(Department of Integrated Geriatrics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院老年综合二科,河南郑州450052

出　　处：《肿瘤基础与临床》2022年第6期478-484,共7页journal of basic and clinical oncology

基　　金：河南省医学科技攻关计划省部共建重点项目(SBGJ202002058)。

摘　　要：目的分析代谢相关因素与结直肠息肉(CRP)发病之间的相关性,探讨CRP发病的独立危险因素,并建立风险预测模型。方法选取2020年9月至2022年7月在郑州大学第一附属医院老年病科就诊且首次行消化内镜检查的患者675例,根据内镜下有无CRP分为CRP组380例、非结直肠息肉(NCRP)组295例。单因素分析2组患者之间一般特征资料、代谢相关疾病、代谢相关临床指标间的差异,通过多因素二元Logistic回归确定CRP发病的独立危险因素并构建风险预测模型,受试者工作特征曲线检验该模型预测效能。结果单因素分析结果显示,年龄、性别、体重指数、长期吸烟、长期饮酒、恶性肿瘤家族史、高血压、糖尿病、冠心病、脂肪肝、血脂异常、高尿酸血症、外周动脉粥样硬化、临床实验室指标(谷丙转氨酶、谷氨酰转肽酶、前白蛋白、总胆汁酸、血尿素氮、血肌酐、血尿酸、空腹血糖、糖化血红蛋白、甘油三酯、高密度脂蛋白)在CRP组与NCRP组之间比较差异均有统计学意义(χ^(2)=3.476,P=0.001;χ^(2)=55.927,P<0.001;χ^(2)=13.732,P<0.001;χ^(2)=28.283,P<0.001;χ^(2)=36.936,P<0.001;χ^(2)=7.882,P=0.005;χ^(2)=25.818,P<0.001;χ^(2)=42.334,P<0.001;χ^(2)=17.750,P<0.001;χ^(2)=34.806,P<0.001;χ^(2)=36.732,P<0.001;χ^(2)=36.111,P<0.001;χ^(2)=16.254,P<0.001;Z=2.917,P=0.004;Z=4.508,P<0.001;t=3.771,P<0.001;Z=1.993,P=0.046;Z=2.993,P=0.003;t=4.886,P<0.001;t=4.501,P<0.001;Z=4.376,P<0.001;Z=5.868,P<0.001;Z=4.099,P<0.001;t=2.921,P=0.004)。多因素回归结果显示,年龄≥60岁(OR=2.684,95%CI:1.200~6.001,P=0.016)、男性(OR=1.895,95%CI:1.291~2.782,P=0.001)、长期吸烟(OR=1.585,95%CI:1.039~2.418,P=0.033)、长期饮酒(OR=1.937,95%CI:1.303~2.880,P=0.001)、恶性肿瘤家族史(OR=1.585,95%CI:1.072~2.334,P=0.021)、糖尿病(OR=1.963,95%CI:1.243~3.102,P=0.004)、高尿酸血症(OR=2.297,95%CI:1.424~3.706,P=0.001),血脂异常(OR=1.809,95%CI:1.249~2.620,P=0.002)是结直肠息肉发病的独立�Objective To analyze the correlation between metabolic related factors and colorectal polyp(CRP),and to explore the independent risk factors of CRP and establish a risk prediction model.Methods From September 2020 to July 2022,All the 675 patients who had been hospitalized in the Department of Geriatrics of the First Affiliated Hospital of Zhengzhou University and had undergone digestive endoscopy for the first time were selected.They were divided into the CRP group of 380 patients and the non-colorectal polyp(NCRP)group of 295 patients.Univariate analysis was used to analyze the differences of general characteristics,metabolism related diseases,and metabolism related clinical indicators.The independent risk factors of colorectal polyps were determined by multivariate binary logistic regression,and a risk prediction model was constructed.The prediction efficiency of the model was tested by the subject work characteristic curve.Results The results of univariate analysis showed that age,gender,body mass index,long-term smoking,long-term drinking,family history of malignant tumor,hypertension,diabetes,coronary heart disease,fatty liver,dyslipidemia,hyperuricemia,peripheral atherosclerosis,and clinical laboratory indicators(alanine aminotransferase,glutamyl transpeptidase,prealbumin,total bile acid,blood urea nitrogen,blood creatinine,blood uric acid,fasting blood glucose,glycosylated red egg white,triglyceride,high density lipoprotein)were significantly different between the CRP group and the NCRP group(χ^(2)=3.476,P=0.001;χ^(2)=55.927,P<0.001;χ^(2)=13.732,P<0.001;χ^(2)=28.283,P<0.001;χ^(2)=36.936,P<0.001;χ^(2)=7.882,P=0.005;χ^(2)=25.818,P<0.001;χ^(2)=42.334,P<0.001;χ^(2)=17.750,P<0.001;χ^(2)=34.806,P<0.001;χ^(2)=36.732,P<0.001;χ^(2)=36.111,P<0.001;χ^(2)=16.254,P<0.001;Z=2.917,P=0.004;Z=4.508,P<0.001;t=3.771,P<0.001;Z=1.993,P=0.046;Z=2.993,P=0.003;t=4.886,P<0.001;t=4.501,P<0.001;Z=4.376,P<0.001;Z=5.868,P<0.001;Z=4.099,P<0.001;t=2.921,P=0.004).The results of multivariate binary logistic regression showed

关 键 词：结直肠息肉 代谢 风险预测模型 

分 类 号：R735.3[医药卫生—肿瘤]