Development and validation of a scoring system for prediction of insulin requirement for optimal control of blood glucose during glucocorticoid treatments.
Development and validation of a scoring system for prediction of insulin requirement for optimal control of blood glucose during glucocorticoid treatments.
复制标题
开发和验证评分系统，用于预测糖皮质激素治疗期间血糖最佳控制的胰岛素需求。
DOI：
10.1016/j.diabres.2018.03.043
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Morita H.
中科院分区：
文献类型：
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作者：
Kawashima M;Taguchi K;Kitada Y;Yamauchi M;Ikeda T;Kajita K;Murakami D;Okada H;Uno Y;Mori I;Ishizuka T;Morita H.
AimsWe已经开发并验证了一种新的评分系统，预测胰岛素的需求，最佳控制血糖糖皮质激素（GC）治疗期间，GC treatment.MethodsThree的临床参数的回顾性分析百三成人（开发集）进行第一次治疗的泼尼松龙（PSL）被分为两组，根据治疗或不胰岛素。两组间单因素分析后，采用逐步logistic回归分析确定胰岛素需求的独立危险因素。我们构建了一个由几个类别组成的加分评分系统，每个危险因素的系数来自另一个logistic回归分析。我们验证了它的两个验证集，A和B。结果男性，空腹血糖（FPG），HbA 1c，血清肌酐（CRE）和较高的初始剂量的PSL水平被确定为危险因素。敏感性、特异性和准确性分别为90.0%、88.1%和88.4%，87.5%、66.7%和70.5%;开发组、验证组A和验证组B分别为83.3%、76.1%和76.6%，结论该评分系统是一个有效和可靠的工具，以预测胰岛素需求提前在GC治疗。
AimsWe have developed and validated a novel scoring system to predict insulin requirement for optimal control of blood glucose during glucocorticoid (GC) treatments, by retrospective analyses of clinical parameters before GC treatment.MethodsThree hundred-three adults (the Developing set) undergoing their first treatment of prednisolone (PSL) were divided into two groups, depending on treatment with or without insulin. Independent risk factors for insulin requirement were identified by a stepwise logistic regression analysis after univariate analyses between the two groups. We constructed a point-addition scoring system consisting of several categories and their coefficients in each risk factor derived from another logistic regression analysis. We validated it to two validation sets, A and B.ResultsMale, higher levels of fasting plasma glucose (FPG), HbA1c, and serum creatinine (CRE) and a higher initial dose of PSL were identified as the risk factors. The sensitivity, specificity, and accuracy were 90.0%, 88.1%, and 88.4%; 87.5%, 66.7%, and 70.5%; 83.3%, 76.1%, and 76.6% in the Developing set, Validation set A, and Validation set B, respectively, when the scoring system was applied.ConclusionsThe scoring system is a valid and reliable tool to predict insulin requirements in advance during GC treatment.