空腹血糖受损患者非酒精性脂肪性肝病风险预测列线图模型的构建  

Construction of nomogram prediction model for the risk of non-alcoholic fatty liver disease in people with impaired fasting glucose

作　　者：梁露 于健[1] 周燕[2] 王彩梅[3] 韦瑾 李禄伟 LIANG Lu;YU Jian;ZHOU Yan(Department of Endocrinology,Affiliated Hospital,Guilin Medical University,Guilin 541001,CHINA)

机构地区：[1]桂林医学院附属医院内分泌科,广西541001 [2]桂林医学院附属医院呼吸内科,广西541001 [3]桂林医学院附属医院检验科,广西541001

出　　处：《江苏医药》2024年第5期468-473,共6页Jiangsu Medical Journal

基　　金：桂林市科学研究与技术开发计划项目(20190218-5-1)。

摘　　要：目的分析空腹血糖受损(IFG)患者发生非酒精性脂肪性肝病(NAFLD)的影响因素,并构建列线图风险预测模型。方法473例IFG患者中,合并NAFLD 212例(病例组),未合并NAFLD 261例(对照组)。采用多因素logistic回归分析IFG患者发生NAFLD的影响因素。构建列线图风险预测模型,使用ROC曲线、校准曲线、决策曲线分析及临床影响曲线评估该模型的准确度及临床实用性。结果多因素logistic回归分析结果显示,BMI和TyG-BMI增加、TG和ALT水平升高是IFG患者发生NAFLD的独立危险因素(P<0.05)。基于上述危险因素构建列线图模型。ROC曲线分析显示,列线图模型预测IFG患者发生NAFLD的AUC为0.753[95%CI(0.712~0.791),P<0.01],对应的灵敏度为78.77%,特异度为60.77%,表明模型区分度良好。校准曲线趋近于理想曲线,提示模型准确度较高。决策曲线分析及临床影响曲线显示该模型具有较好的临床效能。结论本研究构建的列线图模型能够有效评估IFG患者NAFLD的发生风险。Objective To analyze the influencing factors for non-alcoholic fatty liver disease(NAFLD)in the patients with impaired fasting glucose(IFG),and construct a nomogram prediction model.Methods A total of 473 IFG patients were divided into group A(combined with NAFLD,212 cases)and group C(without NAFLD,261 cases).Multivariate logistic regression analysis was applied to analyze the influencing factors for NAFLD in IFG patients,and the nomogram prediction model was constructed.ROC curve,calibration curve,decision curve analysis(DCA)and clinical impact curve(CIC)were used to evaluate the accuracy and clinical practicability of the nomogram model.ResultsThe results of multivariate logistic regression analysis showed that increased BMI,TG,TyG-BMI and ALT were the independent risk factors for NAFLD in IFG patients(P<0.05).The AUC value of predicting NAFLD in IFG patients by the nomogram model was 0.753[95%CI(0.712-0.791),P<0.01],with the sensitivity of 78.77%and the specificity of 60.77%,which indicated a good model differentiation.The calibration curve showed a higher accuracy.The DCA and CIC showed that the nomogram model had better clinical efficiency.Conclusion The nomogram model can effectively evaluate the risk of NAFLD in IFG patients.

关 键 词：空腹血糖受损 非酒精性脂肪性肝病 列线图模型 

分 类 号：R587[医药卫生—内分泌]