基于分类树模型的海军飞行人员高尿酸血症危险因素分析

Analysis of Risk Factors of Hyperuricemia Based on Classification Tree Model in Naval Pilots

目的在海军飞行人员中构建高尿酸血症(hyperuricemia,HUA)发病风险的分类树模型,筛选发病危险因素,为HUA的预防及早期干预提供依据。方法选取2019-01/2021-12月于作者单位疗养的717例海军飞行人员作为研究对象,采用横断面研究方法,分析年度体检数据,计算海军飞行人员HUA检出率,了解发病特征。通过分类回归树(classification and regression tree,CART)法建立HUA发病模型,计算灵敏度、特异度、准确率,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价发病模型预测效果。结果717例海军飞行人员中,共检出HUA 195例(27.20%)。HUA发病风险的分类树模型共5层,筛选出9个解释变量,分别为运动情况、体质量指数(body mass index,BMI)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、甘油三酯(triglyceride,TG)、饮食情况、饮酒情况、胆固醇(total cholesterol,TC)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、促甲状腺素(thyroid stimulating hormone,TSH)。其中,运动情况、BMI、LDL-C是HUA发病的主要危险因素。结论海军飞行人员HUA检出率较高,运动情况、BMI、LDL-C、TG、饮食情况、饮酒情况、TC、AST、TSH是HUA的危险因素。在进行健康宣教时,应指导其养成良好的生活习惯,积极控制BMI、LDL-C水平,降低HUA的发病率,从而提高海军飞行人员健康水平。

Objective To develop a classification tree model of the risk of hyperuricemia(HUA)among naval pilots for screening the risk factors,so as to provide basis for the prevention and early intervention of HUA.Methods A total of 717 navy pilots who underwent recuperation at the author′s unit from January 2019 to December 2021 were selected as the research subjects,the cross-sectional study method was used to analyze their annual physical examination data,calculate the detection rate of HUA among navy pilots and comprehend the pathogenic characteristics of the disease.The incidence model of HUA was established by classification and regression tree(CART),and the sensitivity,specificity and accuracy were calculated and the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive effects of the onset model.Results Of the 717 naval pilots,195 were detected as HUA(27.20%).The classification tree model of HUA incidence risk contained 5 layers,and 9 explanatory variables were screened out,including exercise situation,body mass index(BMI),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),diet consumption,alcohol consumption,total cholesterol(TC),aspartate aminotransferase(AST)and thyroid stimulating hormone(TSH).Among them,exercise situation,BMI and LDL-C were the main risk factors for HUA.Conclusion The detection rate of HUA in naval pilots was high;exercise situation,BMI,LDL-C,TG,diet consumption,alcohol consumption,TC,AST and TSH were risk factors of HUA.When conducting health education,the pilots should be guided to form good living habits to actively control their BMI and LDL-C levels,so as to reduce the incidence rate of HUA and to improve their health level.