Development and validation of a risk prediction model for osteoporosis in elderly patients with type 2 diabetes mellitus: a retrospective and multicenter study

作者全名："Tan, Juntao; Zhang, Zhengyu; He, Yuxin; Xu, Xiaomei; Yang, Yanzhi; Xu, Qian; Yuan, Yuan; Wu, Xin; Niu, Jianhua; Tang, Songjia; Wu, Xiaoxin; Hu, Yongjun"

作者地址："[Tan, Juntao] Chongqing Med Univ, Affiliated Banan Hosp, Operat Management Off, Chongqing 401320, Peoples R China; [Zhang, Zhengyu] Zhejiang Univ, Affiliated Hosp 1, Coll Med, Med Records Dept, Hangzhou 310003, Peoples R China; [He, Yuxin] Chongqing Med Univ, Affiliated Banan Hosp, Dept Med Adm, Chongqing 401320, Peoples R China; [Xu, Xiaomei] Chengdu Fifth Peoples Hosp, Dept Infect Dis, Chengdu 611130, Peoples R China; [Yang, Yanzhi] Chengdu First Peoples Hosp, Dept Endocrinol & Metab, Chengdu 610041, Peoples R China; [Xu, Qian] Chongqing Med Univ, Coll Med Informat, Chongqing 400016, Peoples R China; [Xu, Qian] Chongqing Med Univ, Med Data Sci Acad, Chongqing 400016, Peoples R China; [Xu, Qian] Chongqing Med Univ, Lib, Chongqing 400016, Peoples R China; [Yuan, Yuan] Chongqing Med Univ, Med Records Dept, Women & Childrens Hosp, Chongqing 401147, Peoples R China; [Wu, Xin] Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 3, Chongqing 401120, Peoples R China; [Niu, Jianhua] Zhejiang Univ, Affiliated Hosp 1, Dept Crit Care, Sch Med, 79 Qing Chun Rd, Hangzhou 310003, Zhejiang, Peoples R China; [Tang, Songjia] Zhejiang Univ, Affiliated Hangzhou Peoples Hosp 1, Plast & Aesthet Surg Dept, Sch Med, Hangzhou 310000, Zhejiang, Peoples R China; [Wu, Xiaoxin] Zhejiang Univ, Affiliated Hosp 1, State Key Lab Diag & Treatment Infect Dis, Natl Clin Res Ctr Infect Dis,Sch Med, 79 Qing Chun Rd, Hangzhou 310003, Zhejiang, Peoples R China; [Hu, Yongjun] Chongqing Med Univ, Dept Orthoped, Affiliated Banan Hosp, Chongqing 401320, Peoples R China"

通信作者："Tang, SJ (通讯作者)，Zhejiang Univ, Affiliated Hangzhou Peoples Hosp 1, Plast & Aesthet Surg Dept, Sch Med, Hangzhou 310000, Zhejiang, Peoples R China.; Wu, XX (通讯作者)，Zhejiang Univ, Affiliated Hosp 1, State Key Lab Diag & Treatment Infect Dis, Natl Clin Res Ctr Infect Dis,Sch Med, 79 Qing Chun Rd, Hangzhou 310003, Zhejiang, Peoples R China.; Hu, YJ (通讯作者)，Chongqing Med Univ, Dept Orthoped, Affiliated Banan Hosp, Chongqing 401320, Peoples R China."

来源：BMC GERIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001091398300001

JCR分区：Q2

影响因子：3.4

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Type 2 diabetes mellitus; Osteoporosis; Elderly patients; Prediction model

摘要："BackgroundThis study aimed to construct a risk prediction model to estimate the odds of osteoporosis (OP) in elderly patients with type 2 diabetes mellitus (T2DM) and evaluate its prediction efficiency.MethodsThis study included 21,070 elderly patients with T2DM who were hospitalized at six tertiary hospitals in Southwest China between 2012 and 2022. Univariate logistic regression analysis was used to screen for potential influencing factors of OP and least absolute shrinkage. Further, selection operator regression (LASSO) and multivariate logistic regression analyses were performed to select variables for developing a novel predictive model. The area under the receiver operating characteristic curve (AUROC), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) were used to evaluate the performance and clinical utility of the model.ResultsThe incidence of OP in elderly patients with T2DM was 7.01% (1,476/21,070). Age, sex, hypertension, coronary heart disease, cerebral infarction, hyperlipidemia, and surgical history were the influencing factors. The seven-variable model displayed an AUROC of 0.713 (95% confidence interval [CI]:0.697-0.730) in the training set, 0.716 (95% CI: 0.691-0.740) in the internal validation set, and 0.694 (95% CI: 0.653-0.735) in the external validation set. The optimal decision probability cut-off value was 0.075. The calibration curve (bootstrap = 1,000) showed good calibration. In addition, the DCA and CIC demonstrated good clinical practicality. An operating interface on a webpage (https://juntaotan.shinyapps.io/osteoporosis/) was developed to provide convenient access for users.ConclusionsThis study constructed a highly accurate model to predict OP in elderly patients with T2DM. This model incorporates demographic characteristics and clinical risk factors and may be easily used to facilitate individualized prediction."

基金机构：Project of Banan District Science and Technology Bureau of Chongqing Municipality [KY202208137032001]; Natural Science Foundation of Zhejiang Province [LQ21H190004]

基金资助正文：This study was funded by Project of Banan District Science and Technology Bureau of Chongqing Municipality (grant number KY202208137032001) and the Natural Science Foundation of Zhejiang Province (grant number LQ21H190004). The funding sources had no role in the study design; in the writing of the report; or in the decision to submit the paper for publication.