基于LASSO回归探讨皮肌炎病人合并间质性肺炎的危险因素及预测模型构建

    Exploration of risk factors and construction of a predictive model for dermatomyositis patients with interstitial lung disease based on LASSO regression

    • 摘要:
      目的: 探讨皮肌炎(DM)合并间质性肺炎(ILD)的危险因素,构建相关预测模型,并进行验证。
      方法: 回顾性分析2022年8月至2024年5月收治的100例皮肌炎病人,收集病人的所有资料。采用LASSO回归对DM合并ILD的危险因素进行筛选,LASSO回归中的调节参数λ采用10折交叉验证方法进行验证,选择λ不为0的变量纳入多因素logistic回归模型,建立DM合并ILD影响因素预测模型。根据预测模型结果,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,并计算曲线下面积(area under the curve,AUC)。利用Bootstrap重复取样(1000次)对该模型进行内部验证,计算可获得一致性指数(consistency index,C-index)。
      结果: 共纳入100例DM病人中,合并ILD病人33例,未合并ILD病人67例。单因素分析提示了8个显著差异的指标,使用LASSO回归降维处理,提示了5项最佳建模指标,并将其进行logistic回归分析,最终得到了4项指标为危险因素:Gottron丘疹、抗Jo-1抗体阳性、抗MDA5抗体阳性和血清铁蛋白水平升高(P < 0.05~P < 0.01),并构建危险因素模型:Logi(P) = 2.312 + 1.235 * Gottron丘疹 + 0.331 * 抗Jo-1抗体 + 0.514 * 抗MDA5抗体 + 0.219 * 血清铁蛋白,评估显示该模型的C-index为0.916,AUC为0.903,95%CI为0.837~0.942,提示模型预测能力较好。
      结论: 本研究基于LASSO-logistic建立了DM合并ILD危险因素的预测模型,且预测能力良好,临床中具有较好的应用价值。

       

      Abstract:
      Objective To investigate the risk factors of dermatomyositis (DM) complicated with interstitial lung disease (ILD), and to establish and validate a prediction model.
      Methods One hundred patients with DM treated from August 2022 to May 2024 were retrospectively analyzed, and all the data of the patients were collected. LASSO regression was used to screen the risk factors of DM complicated with ILD. The adjustment parameter λ in LASSO regression was verified by 10-fold cross-validation method. Variables with λ not equal to 0 were selected and included into multivariate logistic regression model to establish the prediction model for the influencing factors of DM complicated with ILD. According to the results of the prediction model, the receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated. Bootstrap repeated sampling (1 000 times) was used to verify the model internally, and the consistency index (C-index) was obtained.
      Results A total of 100 patients with DM were included, including 33 patients with ILD and 67 patients without ILD. Univariate analysis identified 8 indicators with significant differences. LASSO regression was used to reduce dimensionality, and 5 optimal modeling indicators were selected. Subsequent logistic regression analysis confirmed 4 independent risk factors: Gottron papule, positive anti-Jo-1 antibody, positive anti-MDA5 antibody, and elevated level of serum ferritin (P < 0.05 to P < 0.01). The risk prediction model was constructed as follows: Logit(P) = 2.312 + 1.235 * Gottron papule + 0.331 * anti-JO-1 antibody + 0.514 * anti-MDA5 antibody + 0.219 * serum ferritin. Model evaluation demonstrated a C-index of 0.916 and an AUC of 0.903 (95%CI: 0.837–0.942), indicating excellent predictive performance.
      Conclusions Based on the LASSO-logistic analysis, the established prediction model for risk factors of DM complicated with ILD demonstrates good predictive performance and had good clinical application value.

       

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