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银屑病患者的慢性药物性肝损伤风险:基于NHANES 2009−2014年调查数据

Risk of chronic drug-induced liver injury in patients with psoriasis: based on NHANES 2009–2014

  • 摘要: 目的:本研究旨在利用2009年至2014年美国国家健康与营养调查(NHANES)的数据,探究银屑病患者发生慢性药物性肝损伤(DILI)的风险,并通过机器学习建立起一种风险预测模型。方法:共选取了6303名参与者,他们均回答了有关银屑病和药物使用情况的问题。慢性药物性肝损伤的诊断依据是血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)和总胆红素(TBIL)水平的持续异常。在不同模型中采用多元逻辑回归等方法,探究银屑病与慢性药物性肝损伤之间的关系。对潜在的混杂因素(年龄、性别、种族、家庭收入、受教育程度、饮酒情况、吸烟情况和身体质量指数(BMI))进行了控制。结果:在控制了潜在的混杂因素后,结果显示银屑病与慢性药物性肝损伤之间存在显著的正相关关系,并基于糖尿病和BMI生成最佳预测模型。结论:银屑病患者发生慢性药物性肝损伤的风险似乎更高。需要更多的前瞻性研究来证实这一临床关联。

     

    Abstract: Objective: This study aims to utilize data from the National Health and Nutrition Examination Survey (NHANES), which was conducted in the United States from 2009 to 2014, to investigate the risk of chronic drug-induced liver injury (DILI) in patients with psoriasis and to establish a risk prediction model via machine learning. Methods: A total of 6,303 participants were selected, all of whom answered questions regarding psoriasis and drug use. Chronic DILI was diagnosed on the basis of persistent abnormalities in the serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL) levels. Multiple logistic regression and other methods have been employed in different models to explore the relationship between psoriasis and chronic DILI. Potential confounding factors (age, sex, ethnicity, household income, education, alcohol consumption, smoking, and body mass index (BMI)) were controlled. Results: After controlling for potential confounding factors, the results revealed a significant positive correlation between psoriasis and chronic DILI, and an optimal predictive model was generated on the basis of diabetes status and BMI. Conclusion: Patients with psoriasis appear to be at increased risk of chronic DILI. More prospective studies are needed to confirm this clinical correlation.

     

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