基于维生素K2、IGFBP-3、Omentin-1构建特发性矮小症儿童疗效预测模型的研究

Prediction model of therapeutic effect on children with idiopathic short stature based on vitamin K 2,IGFBP-3 and Omentin-1

目的探讨维生素K_(2)、胰岛素样生长因子结合蛋白3(IGFBP-3)、网膜素(Omentin-1)与特发性矮小症(ISS)儿童疗效的关系,并以此构建预测模型。方法选取2019-2021年济南市第二妇幼保健院收治的242例ISS儿童,均接受重组人生长激素(rhGH)治疗,根据治疗12个月后的疗效分为有效组和无效组。统计两组一般资料及维生素K2、IGFBP-3、Omentin-1水平,采用Logistic回归模型、决策树模型分析ISS儿童治疗疗效的影响因素,采用受试者工作特征(ROC)曲线分析两种模型预测效能。结果两组25-羟维生素D[25(OH)D]、甲状旁腺激素(PTH)、促甲状腺激素(TSH)、维生素K2、IGFBP-3、Omentin-1、rhGH剂量、每周户外运动时间比较,差异有统计学意义(P<0.05);PTH(OR=7.011,95%CI:2.456~20.014)、维生素K2(OR=0.605,95%CI:0.465~0.788)、IGFBP-3(OR=0.458,95%CI:0.321~0.654)、Omentin-1(OR=0.514,95%CI:0.389~0.679)、rhGH剂量(OR=0.563,95%CI:0.445~0.712)是ISS儿童治疗无效的影响因素(P<0.05);决策树模型显示,维生素K2、IGFBP-3、Omentin-1是ISS治疗疗效的影响因素,其中IGFBP-3的影响最为显著;ROC曲线结果显示,决策树模型、Logistic回归模型对预测ISS治疗无效的曲线下面积分别为0.922、0.908,模型分类效果均良好。结论ISS儿童的治疗疗效受维生素K2、IGFBP-3、Omentin-1等因素影响,且IGFBP-3影响最为显著,Logistic回归模型、决策树模型可互为补充,从不同方面为改善ISS儿童治疗疗效提供参考。

Objective To investigate the relationship between vitamin K_(2),insulin-like growth factor binding protein 3(IGFBP-3),Omentin-1 and the therapeutic effect on children with idiopathic short stature(ISS),and to build a prediction model.Methods A total of 242 ISS children in Jinan Second Maternal and Child Health Hospital from 2019 to 2021 were selected.All of them received recombinant human growth hormone(rhGH)treatment and were divided into effective group and ineffective group according to the therapeutic effect after 12 months of treatment.The general data,vitamin K 2,IGFBP-3 and Omentin-1 in the two groups were analyzed.The influencing factors of ISS children′s therapeutic effect were analyzed by Logistic regression model and decision tree model.The predictive performance of two models was analyzed by using receiver operating characteristic(ROC)curve.Results There were statistically significant differences in 25-hydroxy vitamin D[25(OH)D],parathyroid hormone(PTH),thyroid stimulating hormone(TSH),vitamin K 2,IGFBP-3,Omentin-1,rhGH dosage and weekly outdoor exercise time between the two groups(P<0.05).Logistic regression showed that PTH(OR=7.011,95%CI:2.456-20.014),vitamin K 2(OR=0.605,95%CI:0.465-0.788),IGFBP-3(OR=0.458,95%CI:0.321-0.654),Omentin-1(OR=0.514,95%CI:0.389-0.679)and rhGH dose(OR=0.563,95%CI:0.445-0.712)]were the influential factors for treatment ineffectiveness in ISS children(P<0.05).The decision tree model showed that vitamin K 2,IGFBP-3 and Omentin-1 were the factors influencing the therapeutic effect of ISS,and IGFBP-3 had the most significant impact.ROC curve results showed that the area under the curve of decision tree model and Logistic regression model were 0.922 and 0.908,respectively,with good classification effect.Conclusion The therapeutic effect of ISS children is influenced by factors such as vitamin K 2,IGFBP-3,Omentin-1,and so on,and IGFBP-3 has the most significant impact.Logistic regression model and decision tree model could complement each other so as to provide reference for improving the therapeutic effect of ISS children from different aspects.