Ⅱ型糖尿病患者伴发抑郁危险预测模型的构建及验证  

Construction and validation of the associated depression risk prediction model in patients with typeⅡdiabetes mellitus

作　　者：张艺旋 冯天元[2] 高一飞 ZHANG Yixuan;FENG Tianyuan;GAO Yifei(School of Health Management,Southern Medical University,Guangzhou 510080,P.R.China;Pingshan Medical and Health Group of Southern Medical University,Shenzhen 518118,P.R.China;General Education Department of Southern Medical University,Guangzhou 510080,P.R.China)

机构地区：[1]南方医科大学卫生管理学院,广州510080 [2]南方医科大学坪山医疗健康集团,广东深圳518118 [3]南方医科大学通识教育部,广州510080

出　　处：《中国循证医学杂志》2023年第8期874-879,共6页Chinese Journal of Evidence-based Medicine

基　　金：国家重点研发计划项目(编号:2020YFC2006401);广东省医学科研基金项目(编号:B2023422)。

摘　　要：目的探究社区Ⅱ型糖尿病患者伴发抑郁的危险因素,并构建其危险预测模型。方法选取2021年10月—2022年4月深圳市坪山区两条街道所属三家社区健康服务中心的269例Ⅱ型糖尿病伴发抑郁患者作为抑郁组,217例单纯Ⅱ型糖尿病患者作为对照组,比较两组危险因素差异,构建Logistic回归危险预测模型,采用Hosmer-Lemeshow检验和受试者工作特征曲线(ROC)对模型的拟合优度及预测能力进行检验,最后对模型进行验证。结果Logistic回归分析结果显示,吸烟、糖尿病并发症、生理功能、心理维度、医学应对为面对、医学应对为回避是Ⅱ型糖尿病患者发生抑郁的独立危险因素。建模集Hosmer-Lemeshow检验P=0.345,ROC曲线下面积为0.987,敏感度为95.2%,特异度为98.6%。验证集ROC曲线下面积为0.945,灵敏度为89.8%,特异度为84.8%,正确率为86.8%,模型预测价值较好。结论本研究所构建的Ⅱ型糖尿病患者伴发抑郁危险预测模型有较好的预测能力和鉴别能力。Objective To explore the risk factors for accompanying depression in patients with community typeⅡdiabetes and to construct their risk prediction model.Methods A total of 269 patients with typeⅡdiabetes accompanied with depression and 217 patients with simple typeⅡdiabetes from three community health service centers in two streets of Pingshan District,Shenzhen from October 2021 to April 2022 were included.The risk factors were analyzed and screened out,and a logistic regression risk prediction model was constructed.The goodness of fit and prediction ability of the model were tested by the Hosmer-Lemeshow test and the receiver operating characteristic(ROC)curve.Finally,the model was verified.Results Logistic regression analysis showed that smoking,diabetes complications,physical function,psychological dimension,medical coping for face,and medical coping for avoidance were independent risk factors for depressive disorder in patients with typeⅡdiabetes.Modeling group Hosmer-Lemeshow test P=0.345,the area under the ROC curve was 0.987,sensitivity was 95.2%and specificity was 98.6%.The area under the ROC curve was 0.945,sensitivity was 89.8%,specificity was 84.8%,and accuracy was 86.8%,showing the model predictive value.Conclusion The risk prediction model of typeⅡdiabetes patients with depressive disorder constructed in this study has good predictive and discriminating ability.

关 键 词：Ⅱ型糖尿病 抑郁 危险因素 预测模型 

分 类 号：R587.2[医药卫生—内分泌] R749.4[医药卫生—内科学]