列线图预测空腹血糖受损患者2型糖尿病发病风险的研究  

Study of Nomogram in Predicting the Risk of Type 2 Diabetes in Patients with Impaired Fasting Glucose

作　　者：朱丽娟 王琳琳 董松[1] 刘佳[1] 李晓静 杜扬帆 柳洪宙 申义 ZHU Lijuan;WANG Linlin;DONG Song;LIU Jia;LI Xiaojing;DU Yangfan;LIU Hongzhou;SHEN Yi(Department of Endocrinology,Aerospace Center Hospital,Beijing 100049,China;Department of Endocrinology,First Hospital of Handan City,Handan,Hebei 056002,China)

机构地区：[1]航天中心医院内分泌科,北京100049 [2]邯郸市第一医院内分泌科,河北邯郸056002

出　　处：《转化医学杂志》2025年第3期170-175,共6页Translational Medicine Journal

基　　金：河北省医学科学研究课题计划资助(20231924)。

摘　　要：目的构建并验证用于预测中国空腹血糖受损(IFG)人群3年和5年2型糖尿病(T2DM)发病风险的列线图模型。方法本研究采用回顾性队列研究设计,选取瑞慈医疗集团在中国建立的健康检查数据库2010年至2016年期间所有进行健康检查的≥20岁参与者的医疗记录。共纳入7193名IFG人群,分别进行3年和5年随访。采用单因素和多因素Cox回归分析确定T2DM独立危险因素。基于Cox回归分析结果,构建预测IFG患者3年和5年T2DM发病风险的列线图。采用C指数和校准曲线评估列线图在训练集和验证集中的区分度和校准度。结果研究人群被随机分成训练集(5036例)和验证集(2157例)。在训练集中进行多因素Cox回归分析后,发现年龄、身体质量指数、空腹血糖、甘油三酯和谷丙转氨酶是T2DM的独立危险因素,并将其纳入列线图模型。在训练集和验证集中,C指数分别为0.64233(95%CI:0.62534~0.65931)和0.64237(95%CI:0.61586~0.66889)。校准图表明,估计概率与实际观测率之间具有良好的一致性。结论本研究列线图是一个简单可靠的工具,可用于预测中国IFG人群3年和5年T2DM的发病风险。该模型有助于早期识别高危人群,为及时干预提供依据,降低T2DM的发病率。Objective To construct and validate a nomogram model for predicting the 3-year and 5-year risk of type 2 diabetes mellitus(T2DM)in a Chinese population with impaired fasting glucose(IFG).Methods This study adopted a retrospective cohort design.A total of 7193 individuals with IFG were included and followed up for3-year and 5-year periods.Univariate and multivariate Cox regression analyses were performed to identify independent risk factors for T2DM.Based on Cox regression results,a nomogram was constructed to predict the 3-year and 5-year incidence of T2DM in IFG patients.The discrimination and calibration of the nomogram were evaluated using the C-index and calibration curves in both the training and validation sets.Results The study population was randomly divided into a modeling set(n=5036)and a validation set(n=2157).Multivariate Cox regression analysis in the training set identified age,body mass index(BMI),fasting plasma glucose(FPG),triglycerides(TG),and alanine aminotransferase(ALT)as independent risk factors for T2DM,which were incorporated into the nomogram model.In the training and validation sets,the C-indexes were 0.64233(95%CI:0.62534-0.65931)and 0.64237(95%CI:0.61586-0.66889),respectively.The calibration plot showed good agreement between the estimated probabilities and the actual observed rates.Conclusion The nomogram developed in this study is a simple and reliable tool for predicting the 3-year and 5-year risk of T2DM in the Chinese IFG population.It can help identify high-risk individuals early,providing a basis for timely intervention and reducing the incidence of T2DM.

关 键 词：列线图 2型糖尿病 危险因素 C指数 

分 类 号：R587.1[医药卫生—内分泌]