老年2型糖尿病患者发生口腔衰弱风险的列线图预测模型构建

Construction of nomogram prediction model for the risk of oral frailty in elderly patients with type 2 diabetes mellitus

目的分析老年2型糖尿病患者发生口腔衰弱的影响因素,并构建列线图预测模型。方法选取370例老年2型糖尿病患者作为研究对象,其中建模组纳入284例,验证组纳入86例。采用(OF-8)量表进行口腔衰弱筛查,得分≥4分为口腔衰弱筛查阳性。通过自制调查问卷收集2组患者一般资料。采用多因素Logistic回归分析法分析2型糖尿病患者发生口腔衰弱的影响因素,并构建预测模型。采用Homser-Lemeshow拟合优度检验和受试者工作特征(ROC)曲线验证模型的拟合优度及预测效能。结果老年2型糖尿病患者中口腔衰弱的发生率为45.4%(129/284)。年龄、体质量指数(BMI)、四肢骨骼肌质量指数(ASMI)、吸烟、月收入、主观咀嚼困难是老年糖尿病患者发生口腔衰弱的影响因素(P<0.05)。内部、外部验证的ROC曲线下面积分别为0.887(95%CI:0.847~0.925)、0.839(95%CI:0.755~0.923)。Homser-Lemeshow检验显示χ^(2)=4.852,P=0.773,列线图模型的拟合优度良好。结论年龄、ASMI、BMI、吸烟、月收入、主观咀嚼困难是老年糖尿病患者发生口腔衰弱的影响因素,基于上述影响因素构建的列线图预测模型的效能较好。

Objective To analyze the influencing factors of oral frailty in elderly patients with type 2 diabetes and construct a nomogram prediction model.Methods A total of 370 elderly patients with type 2 diabetes were selected as the research subjects,including 284 patients in the modeling group and 86 patients in the validation group.The Oral Frailty Index-8(OF-8)Scale was used for oral frailty screening,and a score of≥4 was considered positive for oral frailty.General information of the two groups was collected through a self-made questionnaire.Multivariate Logistic regression analysis was used to analyze the influencing factors of oral frailty in patients with type 2 diabetes,and nomogram model was constructed.The goodness-of-fit and predictive performance of the model were verified using the Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic curve(ROC).Results The incidence of oral frailty among elderly patients with type 2 diabetes was 45.4%(129/284).Age,body mass index(BMI),appendicular skeletal muscle mass index(ASMI),smoking,monthly income and subjective chewing difficulty were identified as influencing factors for oral frailty in elderly diabetic patients(P<0.05).The areas under the ROC for internal and external validation were 0.887(95%CI,0.847 to 0.925)and 0.839(95%CI,0.755 to 0.923),respectively.The Hosmer-Lemeshow test showed thatχ^(2)=4.852,P=0.773,indicating good goodness-of-fit for the nomogram model.Conclusion Age,ASMI,BMI,smoking,monthly income and subjective chewing difficulty are influencing factors for oral frailty in elderly diabetic patients.The nomogram prediction model constructed based on these influencing factors demonstrates good performance.