首发未治疗抑郁症合并糖调节受损的危险因素及预警风险模型的建立

Risk factors of first-episode untreated depression with impaired glucose regulation and establishment of early warning model

目的 探讨首发未治疗抑郁症合并糖调节受损的危险因素,并建立首发未治疗抑郁症合并糖调节受损的的列线图模型。方法 选取180例首发未治疗抑郁症患者作为研究对象,采用LASSO分析和Logistic回归分析筛选首发未治疗抑郁症合并糖调节受损的的危险因素,并建立首发未治疗抑郁症患者糖调节受损的列线图模型。结果 糖调节受损组和糖调节正常组年龄、体质量指数、高血压、高血脂、糖尿病史及活动不足方面比较差异均有统计学意义(P<0.05)。Logistic回归分析的结果显示,年龄≥60岁、体质量指数≥24 kg/m^(2)、高血压、高血脂、有糖尿病史及活动不足是首发未治疗抑郁症患者糖调节受损的独立危险因素(P<0.05)。首发未治疗抑郁症患者糖调节受损的列线图模型的预测值和实测值基本一致,C-index指数为0.843(95%CI:0.812~0.875),列线图模型的AUC为0.807,阈值概率在1%~69%范围内时,采用本列线图来预测首发未治疗抑郁症患者糖调节受损的发生风险具有较高的净获益值。结论 年龄、体质量指数、高血压、高血脂、糖尿病史及活动不足等是首发未治疗抑郁症患者糖调节受损的独立危险因素,基于以上六项独立危险因素所建立的列线图有助于预测首发未治疗抑郁症患者糖调节受损的发生风险。

Objective To explore the risk factors and establish a nomogram model for first-episode untreated depression with impaired glucose regulation. Methods A total of 180 patients with first-episode untreated depression were selected as the research subjects. LASSO analysis and logistic regression analysis were used to screen the risk factors of first-episode untreated depression combined with impaired glucose regulation, and to establish a nomogram model for impaired glucose regulation in patients with first-episode untreated depression. Results There existed significant differences in ages, body mass indexes(BMIs), hypertension, hyperlipidemia, history of diabetes and insufficient activity between impaired glucose regulation group and normal glucose regulation group(P<0.05). The results of logistic regression analysis showed that age≥60 years old, BMI≥24 kg/m^(2), hypertension, hyperlipidemia, history of diabetes and insufficient activity were independent risk factors for impaired glucose regulation in patients with first-episode untreated depression(P<0.05). The predicted value of the nomogram model of impaired glucose regulation in first-episode untreated depressive patients was basically consistent with the measured value, and the C-index was 0.843(95%CI: 0.812~0.875). AUC of the nomogram model was 0.807. When the threshold probability ranged from 1% to 69%, using this nomogram to predict the risk of impaired glucose regulation in patients with first-episode untreated depression had a high value of net benefit. Conclusion Age, BMI, hypertension, hyperlipidemia, history of diabetes, and lack of activity are independent risk factors for impaired glucose regulation in patients with first-episode untreated depression. A nomogram based on the above six independent risk factors is helpful to predict the risk of impaired glucose regulation in patients with first-episode untreated depression.