International journal of surgery (London, England) · 2025
Relationship between glycolipid metabolism and aortic dissection in a hypertensive population: an early diagnostic model with internal training and external validation.
СтатьяМногоцентровое исследованиеВалидационное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Lin Yong, Huang Yi-Ting, Wu Shao-Sheng, He Yi-Na, Lu Hai, Li Wang, Lan Lan, Qin Peng-Yu, Chen Liang-Wan, Zhu Yong-Ping, Chen Mei-Fang
Аннотация
BACKGROUND: The relationship between glycolipid metabolism and acute type A aortic dissection in patients with hypertension remains unknown.
MATERIALS AND METHODS: All patients with hypertension from six centers over the past 5 years were enrolled in this retrospective multi-center study. Participants from the leading institution were classified into the training set and those from the participating institutions were classified into the validation set. Baseline demographic and glycolipid metabolic characteristics were collected to establish an early diagnostic model for acute type A aortic dissection. Internal training and external validation were performed to assess the efficacy of the model.
RESULTS: Younger age, higher body mass index, male sex, absence of diabetes mellitus, lower serum total cholesterol concentration, and higher serum lipoprotein(a) concentration were identified as risk factors for acute type A aortic dissection in individuals with hypertension. Incorporating these variables into the clinical early diagnostic model yielded receiver operating characteristic values of 0.789 (0.758-0.820) for the training set and 0.744 (0.689-0.789) for the validation set. The positive predictive value was 0.893 (0.871-0.916) for the training set and 0.835 (0.788-0.883) for the validation set, while the negative predictive values were 0.448 (0.401-0.496) and 0.448 (0.366-0.529) for the two sets respectively. Decision curve analysis for the training set showed that the model provided greater net benefit than the two extreme strategies for threshold values between 0.05 and 0.72. The same was true for the validation set when the threshold value was between 0.09 and 0.71. The Hosmer-Lemeshow test confirmed that the P values for the calibration curves of the training and validation sets were higher than 0.05, indicating good calibration.
CONCLUSION: The model based on demographic characteristics and serum lipid levels was validated to have a good predictive value for acute type A aortic dissection among hypertensive individuals.
MATERIALS AND METHODS: All patients with hypertension from six centers over the past 5 years were enrolled in this retrospective multi-center study. Participants from the leading institution were classified into the training set and those from the participating institutions were classified into the validation set. Baseline demographic and glycolipid metabolic characteristics were collected to establish an early diagnostic model for acute type A aortic dissection. Internal training and external validation were performed to assess the efficacy of the model.
RESULTS: Younger age, higher body mass index, male sex, absence of diabetes mellitus, lower serum total cholesterol concentration, and higher serum lipoprotein(a) concentration were identified as risk factors for acute type A aortic dissection in individuals with hypertension. Incorporating these variables into the clinical early diagnostic model yielded receiver operating characteristic values of 0.789 (0.758-0.820) for the training set and 0.744 (0.689-0.789) for the validation set. The positive predictive value was 0.893 (0.871-0.916) for the training set and 0.835 (0.788-0.883) for the validation set, while the negative predictive values were 0.448 (0.401-0.496) and 0.448 (0.366-0.529) for the two sets respectively. Decision curve analysis for the training set showed that the model provided greater net benefit than the two extreme strategies for threshold values between 0.05 and 0.72. The same was true for the validation set when the threshold value was between 0.09 and 0.71. The Hosmer-Lemeshow test confirmed that the P values for the calibration curves of the training and validation sets were higher than 0.05, indicating good calibration.
CONCLUSION: The model based on demographic characteristics and serum lipid levels was validated to have a good predictive value for acute type A aortic dissection among hypertensive individuals.