老年糖尿病病人衰弱风险预测模型的建立与验证

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Establishment and validation of a frailty risk prediction model for elderly patients with diabetes mellitus

Abstract  Objective：To explore the status and influencing factors of frailty in elderly patients with diabetes mellitus， and to construct a risk prediction model for frailty.Methods：A total of 566 patients with diabetes mellitus who were hospitalized in the department of endocrinology of a tertiary Grade A hospital in Xinjiang from August 2020 to June 2021 were selected and divided into a training set（n=351） and a validation set（n=215） according to the order of admission by 6∶4.The general data and laboratory examination results of the research objects were collected.The receiver operating characteristic（ROC） curve and calibration curve were used to evaluate the discrimination and calibration of the prediction model.The clinical decision curve （DCA） was used to evaluate the clinical effectiveness of the prediction model.Results：Six predictive variables including age，duration of disease，HbA1c，times of hypoglycemia， diabetic foot and marriage were screened out by LASSO regression.Logistic regression results showed that age，HbA1c，course of disease，frequency of hypoglycemia， diabetic foot and marriage were the influencing factors of frailty in diabetic patients （P<0.05）.ROC curve analysis showed that the AUC of the prediction model was 0.790（95%CI 0.742， 0.838） in the training set and 0.703［95%CI（0.628， 0.778）］ in the validation set. The goodness of fit test showed that the model had a good fit，and DCA showed that the net return rate of the prediction model was high.Conclusion：The prediction model based on age， duration of diabetes， HbA1c，frequency of hypoglycemia， diabetic foot， and marriage can be used to predict the risk of frailty in elderly diabetic patients.

Keywords     diabetes mellitus； frailty； influencing factors； prediction model； investigation and research

摘要  目的：探讨糖尿病病人的衰弱现状及影响因素，并构建老年糖尿病病人衰弱风险预测模型。（剩余9977字）