In this paper, we first evaluated the distribution of blood pressure (BP) using a dataset containing 113,979 measurements in 48,022 individuals with the cooperation of one health insurance society in Japan from April,...In this paper, we first evaluated the distribution of blood pressure (BP) using a dataset containing 113,979 measurements in 48,022 individuals with the cooperation of one health insurance society in Japan from April, 2013 to March, 2016. The means of the systolic BP (SBP) and diastolic BP (DBP) were 125.4 and 77.6 mmHg with standard deviations of 16.5 and 11.7 mmHg, respectively. Under the 140/90 criterion, 21.6% of the measurements showed hypertension. According to the World Health Organization/International Society of Hypertension criterion, 16.4%, 4.2% and 0.96% were classified as grades 1, 2 and 3, respectively. The factors affecting BP were evaluated by a regression analysis and were found to include age, gender, some eating habits, daily activities, smoking, drinking alcohol, sleeping and wages. Age was a very important factor, and the age cohorts from the previous study might be revised based on these findings. Among factors that individuals can control, the influence of drinking alcohol is very large. Comparing to an individual who does not drink, SBP and DBP of a heavy drinker are more than 5.0 mmHg higher on the average.展开更多
Background: Many people take medicines to control high blood pressure (BP), or hypertension. Randomized clinical trials (RCT) are usually used for the evaluation of effects of medicines. However, RCT have some serious...Background: Many people take medicines to control high blood pressure (BP), or hypertension. Randomized clinical trials (RCT) are usually used for the evaluation of effects of medicines. However, RCT have some serious problems. Data and Methods: We evaluated the effects of BP medicines in Japan using a dataset containing 113,979 cases. We employed four statistical methods in the analysis. First, we simply compared the systolic blood pressure (SBP) of individuals with and without BP medicines. We then used a regression model with a dummy variable, representing taking medicines or not. We replaced the dummy variable by its expected value, and estimated the regression model again. Finally, we selected individuals who had both taken and not taken medicines at different times. The effect of sample selection was also considered in the estimation. Results: For the simple comparison, SBP with BP medicines was 11 mmHg higher than without medicines. In the next regression analysis, SBP with BP medicines was still 5 mmHg higher. When the dummy variable was replaced by its expected value, SBP with medicines decreased by 7 mmHg. For individuals taking medicines at some times and not at others, SBP decreased by 9 and 8 mmHg in models with and without a sample bias correction, respectively. Conclusion: The methods eliminated some problems of RCT and might be attractive. However, we obtained contradictory conclusions depending on the statistical methods employed, despite using the identical dataset. Statistical methods must be selected carefully to obtain a reliable evaluation. Limitations: The dataset was observatory, and the sample period was only 3 years.展开更多
Background: The cost and economic burden of diabetes are a serious worldwide issue. In this study, we evaluated medical payments for persons diagnosed with diabetes and the factors that led to a person having diabetes...Background: The cost and economic burden of diabetes are a serious worldwide issue. In this study, we evaluated medical payments for persons diagnosed with diabetes and the factors that led to a person having diabetes to reduce its prevalence. Methods: A dataset containing 113,979 medical checkups and 3,671,783 monthly medical, dental, care-giving and pharmacy payment records of one health insurance society was used. The dataset contains information of normal and healthy persons. The sample period ran from April, 2013 to March, 2016. The medical payments for persons diagnosed with diabetes were calculated. The regression analysis was used to remove the effects of age and gender. The probit analysis was used to analyze the factors that led to a person having diabetes. Results: In 2.9% of cases, the person undergoing the checkup was diagnosed with diabetes, and the medical payments for these patients were 2.7 times as much as the average medical payment per person. This result did not change significantly even if age and gender were considered. The results of the probit analysis suggested that body mass index, high systolic blood pressure, low diastolic blood pressure, eating habits, physical activities, smoking, drinking alcohol and sleeping were important factors for diabetes. Conclusion: The diabetes might be a costlier disease than previously thought in Japan. By the estimation, 8% of all medical payments were made for these persons with diabetes, which is much higher than the result shown by national survey data. However, overall prevalence could be recused by efforts such as prevention of overweight and obesity.展开更多
Objective:To appraise the effectiveness of HbA_(1c) and fasting plasma glucose(FPG) on screening diabetes in health check-up.Methods:A total of 1 337 individuals(male 850,female 487),aged 27 to 91 years with HbA_(1c) ...Objective:To appraise the effectiveness of HbA_(1c) and fasting plasma glucose(FPG) on screening diabetes in health check-up.Methods:A total of 1 337 individuals(male 850,female 487),aged 27 to 91 years with HbA_(1c) test were included.Participates with HbA_(1c)≥6.0%or FPG≥6.1 mmol/ L underwent oral glucose tolerance test(OGTT).Diabetes mellitus was diagnosed according to the criteria of WHO in 1999,FPG≥7.0 mmol/L and/or OGTT 2 h-postload plasm glucose(2 h-PG)≥11.1 mmol/L.The sensitivity and specificity of HbA_(1c) thresholds and FPG or combination test on screening of diabetes were analyzed.Results:A total of 842 subjects had HbA_(1c)<6.0%,in which 32 had isolated FPG≥6.1 mmol/L,of 495 had HbA_(1c)≥6.0%.Subjects with HbA_(1c)≥6.0% had significant increased disorder indexes than those with HbA_(1c)<6.0%.527 subjects who had HbA_(1c)≥6.0%or FPG≥6.1 mmol/L underwent OGTT.A total of 234 subjects were newly diagnosed diabetes,including 123(123/234,52.56%) with FPG≥7.0 mmol/L,and 111 subjects(111/234, 47.43%) with isolated 2 h-PG≥11.1 mmol/L.Among 234 new diabetes,91.88%(215 subjects) had HbA_(1c)≥6.3%,and 77.40%(181 subjects) had HbA_(1c)≥6.5%.HbA_(1c)≥6.3%combined FPG≥7.0 mmol/L increased the positive rate of newly diagnosed diabetes from 91.88%to 96.58%. Conclusions:HbA_(1c) is a practical and convenient tool for screening undiagnosed diabetes in routine health check-up of a large population.Combined use of HbA_(1c)≥6.3%and/or FPG≥7.0 mmol/L is efficient for early detection of diabetes.展开更多
AIM: To identify associated factors of diabetic retinopathy(DR) screening and ey e check-up practice among diabetes mellitus(DM) patients attending Felege Hiwot Specialized Hospital.METHODS: An institution-based cross...AIM: To identify associated factors of diabetic retinopathy(DR) screening and ey e check-up practice among diabetes mellitus(DM) patients attending Felege Hiwot Specialized Hospital.METHODS: An institution-based cross-sectional study was applied from October 4, 2019 to January 12, 2020 at Felege Hiwot Specialized Hospital. A systematic random sampling technique was used to recruit participants and an interviewer-administered questionnaire was employed to collect the data. The collected data were entered into Epi Info version 7 and transposed to SPSS version 24 for statistical analysis. Descriptive statistics were executed and associated factors were identified using binary logistic regression. The strength of association between the independent and the outcome variable was determined using an adjusted odds ratio(AOR) with 95% confidence interval(CI). RESULTS: Four hundred and six participants partake with a response rate of 95.7% and a mean age of 47±11.5y. The magnitude of DR screening was 308(75.9%, 95%CI: 71.5%, 79.8%). Higher educational level(AOR=3.25;95%CI: 1.40, 8.78), good knowledge of DR(AOR=2.50;95%CI: 1.55, 4.46), and family history of DM(AOR=2.15;95%CI: 1.41,3.85) were significantly associated with DR screening. On the other side, rural residence [AOR=3.11(1.89, 5.02)] and undesirable attitudes toward DR [AOR=5.65(3.14, 8.76)] were significantly associated with poor regular eye checkup practice.CONCLUSION: Most of the participants are screened for DR. Higher education, family history, and good knowledge are associated with DR screening. In addition, rural residence and undesirable attitudes toward DR are associated with regular eye checkup practice.展开更多
Background: Caries detection in school oral examinations insufficient accuracy. Objective: To evaluate advantages of introducing quantitative light-induced fluorescence-digital (QLF-D) in school oral examinations. Met...Background: Caries detection in school oral examinations insufficient accuracy. Objective: To evaluate advantages of introducing quantitative light-induced fluorescence-digital (QLF-D) in school oral examinations. Methods: Experiment No. 1. Early demineralized lesions in the upper and lower incisors and canines were visually inspected by three dentists and by QLF-D. The numbers of tooth planes with early demineralized lesions were compared between the methods. Experiment No. 2. Approximal demineralized lesions in molars were assessed by visual inspection, x-ray imaging, and QLF-D. The numbers of tooth planes with demineralized lesions were compared among the methods. Experiment No. 3. Plaque distribution was evaluated by QLF-D and a traditional staining method. The ratio of the diameter of plaque to tooth crown in the tooth axis direction in each method was calculated. The results were evaluated by Pearson’s correlation coefficient analysis and Bland-Altman plot. Results: Experiment No. 1. The three dentists found 0.67 tooth planes on average. QLF-D found 22 tooth planes with early demineralized lesions in the same samples. Experiment No. 2. Fourteen approximal tooth planes of molars were found to have demineralized lesions by x-ray imaging. QLF-D detected 71.4% of the tooth planes out of the 14, whereas visual inspection found 7.1%. Experiment No. 3. The Pearson’s correlation coefficient for the evaluations of plaque distribution between the QLF-D and traditional staining methods was 0.77 (P Conclusion: The results support introduction of QLF-D for use in school dental examinations.展开更多
To prevent the development of metabolic syndrome among adult members of the community, improving the participation rate in the specific medical checkup (a medical examination focused on factors associated with metabol...To prevent the development of metabolic syndrome among adult members of the community, improving the participation rate in the specific medical checkup (a medical examination focused on factors associated with metabolic syndrome prior to the onset of lifestyle-related disease) is an important public health issue. This study used claim data and health checkup data and aimed to detect those community-dwelling adults who were least likely to participate in the specific medical checkup. Analysis included the medical and health checkup chart data of 61,753 adults aged 60 - 69 years (as of April 2011) who lived in Fukui prefecture, Japan. The chi-squared interaction was used to analyze data. If a person did not participate in the specific medical checkup, individual was categorized as “absent.” Between April 2012 and March 2013, 66.3% of subjects were absent from the specific medical checkup. Those most likely to be absent included those who were also absent at the previous year’s checkup, those who were men, and those who did not have an examination for hypertension;87.9% of patients who met all of these criteria were absent. Among women who were absent at the previous year’s checkup, the absentee rate differed by about 10.0% between those whose municipalities did (74.8%) or did not (84.2%) have a free checkup program. Our findings may help public health professionals detect those who require intervention and to effectively and efficiently improve participation in the specific medical checkup.展开更多
<strong>Background: </strong>The high blood pressure (BP) or hypertension is a widely prevalent disease and its costs are very high, and many studies about the relationships between BP and health condition...<strong>Background: </strong>The high blood pressure (BP) or hypertension is a widely prevalent disease and its costs are very high, and many studies about the relationships between BP and health conditions have been done. We need to know the precise distributions of BP and factors affecting BP. <strong>Data and Methods</strong><strong>:</strong> The distributions of BP are analyzed using 12,877,653 observations obtained from the JMDC Claims Database. The factors that may affect the BP are analyzed by the regression models using 4,615,346 observations. <strong>Results:</strong> The averages of systolic BP (SBP) and diastolic BP (DBP) are 120.4 and 74.2 mmHg with standard deviations of 15.9 and 11.3 mmHg, respectively. Among the nonmodifiable factors, age and gender are important factors. Among the modifiable factors, variables related to obesity are important risk factors. Taking antihypertensive drugs makes SBP and DBP 13.4 mmHg and 7.8 mmHg lower. <strong>Conclusion:</strong> The criteria of BP should be carefully determined considering age and gender. The effects of age may be a little different for SBP and DBP. It is necessary to use the proper model to evaluate the effect of antihypertensive drugs correctly. <strong>Limitations:</strong> The dataset is observatory. Although there are various types of treatment methods and antihypertension drugs, their effects are not evaluated.展开更多
目的调查成都地区成年健康体检女性生殖道HPV感染情况,并构建风险预测模型。方法选择2022年3月至2023年3月在成都市三家医院进行健康体检的女性作为研究对象,收集生殖道HPV感染的相关因素,以7∶3比例将研究对象分为训练集、验证集,并根...目的调查成都地区成年健康体检女性生殖道HPV感染情况,并构建风险预测模型。方法选择2022年3月至2023年3月在成都市三家医院进行健康体检的女性作为研究对象,收集生殖道HPV感染的相关因素,以7∶3比例将研究对象分为训练集、验证集,并根据有无HPV感染将研究对象分为感染组与非感染组。使用LASSO回归筛选潜在因素,采用Logistic回归分析构建HPV感染风险预测模型并绘制列线图。采用受试者工作特征(receiver operating characteristic,ROC)曲线及其曲线下面积(area under curve,AUC)、校准曲线和决策曲线评估风险预测模型的区分度、校准度和临床适用性。结果共纳入2318例健康体检女性,HPV感染481例(20.75%),其中单一感染316例(65.70%)、多重感染165例(34.30%)。训练集1622例,验证集696例;训练集中感染组341例,非感染组1281例。LASSO回归及Logistic回归结果显示,年龄[OR=0.955,95%CI(0.912,0.999)]、产次[OR=4.392,95%CI(1.420,13.583)]、初次性交年龄[OR=0.870,95%CI(0.774,0.979)]、安全套使用情况[OR=0.314,95%CI(0.109,0.905)]、性伴侣人数[OR=6.068,95%CI(1.825,20.177)]、性伴侣包皮过长[OR=3.218,95%CI(1.042,9.936)]、性传播疾病患病情况[OR=3.476,95%CI(1.071,11.277)]、生殖道炎症[OR=3.526,95%CI(1.185,10.494)]、宫颈柱状上皮异位情况[OR=4.375,95%CI(1.374,13.934)]为健康体检女性HPV感染的影响因素(P<0.05)。ROC曲线结果显示,训练集和验证集中预测模型的AUC分别为0.913[95%CI(0.866,0.960)]、0.880[95%CI(0.818,0.941)]。训练集和验证集中预测模型的H-L拟合优度检验结果均无统计学意义(P>0.05)。校准曲线结果显示,训练集和验证集中预测曲线与标准曲线基本拟合。决策曲线结果显示,训练集和验证集中模型风险概率阈值分别为0.05~0.90、0.05~0.78时,患者获益。结论成都地区健康体检女性生殖道HPV感染率为20.75%,其主要受年龄、产次、初次性交年龄、安全套使用情况、性伴侣人数、性伴侣包皮过长、性传播疾病患病情况、生殖道炎症、宫颈柱状上皮异位情况的影响,根据上述因素构建的女性生殖道HPV感染风险预测模型具有一定的临床使用价值。展开更多
文摘In this paper, we first evaluated the distribution of blood pressure (BP) using a dataset containing 113,979 measurements in 48,022 individuals with the cooperation of one health insurance society in Japan from April, 2013 to March, 2016. The means of the systolic BP (SBP) and diastolic BP (DBP) were 125.4 and 77.6 mmHg with standard deviations of 16.5 and 11.7 mmHg, respectively. Under the 140/90 criterion, 21.6% of the measurements showed hypertension. According to the World Health Organization/International Society of Hypertension criterion, 16.4%, 4.2% and 0.96% were classified as grades 1, 2 and 3, respectively. The factors affecting BP were evaluated by a regression analysis and were found to include age, gender, some eating habits, daily activities, smoking, drinking alcohol, sleeping and wages. Age was a very important factor, and the age cohorts from the previous study might be revised based on these findings. Among factors that individuals can control, the influence of drinking alcohol is very large. Comparing to an individual who does not drink, SBP and DBP of a heavy drinker are more than 5.0 mmHg higher on the average.
文摘Background: Many people take medicines to control high blood pressure (BP), or hypertension. Randomized clinical trials (RCT) are usually used for the evaluation of effects of medicines. However, RCT have some serious problems. Data and Methods: We evaluated the effects of BP medicines in Japan using a dataset containing 113,979 cases. We employed four statistical methods in the analysis. First, we simply compared the systolic blood pressure (SBP) of individuals with and without BP medicines. We then used a regression model with a dummy variable, representing taking medicines or not. We replaced the dummy variable by its expected value, and estimated the regression model again. Finally, we selected individuals who had both taken and not taken medicines at different times. The effect of sample selection was also considered in the estimation. Results: For the simple comparison, SBP with BP medicines was 11 mmHg higher than without medicines. In the next regression analysis, SBP with BP medicines was still 5 mmHg higher. When the dummy variable was replaced by its expected value, SBP with medicines decreased by 7 mmHg. For individuals taking medicines at some times and not at others, SBP decreased by 9 and 8 mmHg in models with and without a sample bias correction, respectively. Conclusion: The methods eliminated some problems of RCT and might be attractive. However, we obtained contradictory conclusions depending on the statistical methods employed, despite using the identical dataset. Statistical methods must be selected carefully to obtain a reliable evaluation. Limitations: The dataset was observatory, and the sample period was only 3 years.
文摘Background: The cost and economic burden of diabetes are a serious worldwide issue. In this study, we evaluated medical payments for persons diagnosed with diabetes and the factors that led to a person having diabetes to reduce its prevalence. Methods: A dataset containing 113,979 medical checkups and 3,671,783 monthly medical, dental, care-giving and pharmacy payment records of one health insurance society was used. The dataset contains information of normal and healthy persons. The sample period ran from April, 2013 to March, 2016. The medical payments for persons diagnosed with diabetes were calculated. The regression analysis was used to remove the effects of age and gender. The probit analysis was used to analyze the factors that led to a person having diabetes. Results: In 2.9% of cases, the person undergoing the checkup was diagnosed with diabetes, and the medical payments for these patients were 2.7 times as much as the average medical payment per person. This result did not change significantly even if age and gender were considered. The results of the probit analysis suggested that body mass index, high systolic blood pressure, low diastolic blood pressure, eating habits, physical activities, smoking, drinking alcohol and sleeping were important factors for diabetes. Conclusion: The diabetes might be a costlier disease than previously thought in Japan. By the estimation, 8% of all medical payments were made for these persons with diabetes, which is much higher than the result shown by national survey data. However, overall prevalence could be recused by efforts such as prevention of overweight and obesity.
文摘Objective:To appraise the effectiveness of HbA_(1c) and fasting plasma glucose(FPG) on screening diabetes in health check-up.Methods:A total of 1 337 individuals(male 850,female 487),aged 27 to 91 years with HbA_(1c) test were included.Participates with HbA_(1c)≥6.0%or FPG≥6.1 mmol/ L underwent oral glucose tolerance test(OGTT).Diabetes mellitus was diagnosed according to the criteria of WHO in 1999,FPG≥7.0 mmol/L and/or OGTT 2 h-postload plasm glucose(2 h-PG)≥11.1 mmol/L.The sensitivity and specificity of HbA_(1c) thresholds and FPG or combination test on screening of diabetes were analyzed.Results:A total of 842 subjects had HbA_(1c)<6.0%,in which 32 had isolated FPG≥6.1 mmol/L,of 495 had HbA_(1c)≥6.0%.Subjects with HbA_(1c)≥6.0% had significant increased disorder indexes than those with HbA_(1c)<6.0%.527 subjects who had HbA_(1c)≥6.0%or FPG≥6.1 mmol/L underwent OGTT.A total of 234 subjects were newly diagnosed diabetes,including 123(123/234,52.56%) with FPG≥7.0 mmol/L,and 111 subjects(111/234, 47.43%) with isolated 2 h-PG≥11.1 mmol/L.Among 234 new diabetes,91.88%(215 subjects) had HbA_(1c)≥6.3%,and 77.40%(181 subjects) had HbA_(1c)≥6.5%.HbA_(1c)≥6.3%combined FPG≥7.0 mmol/L increased the positive rate of newly diagnosed diabetes from 91.88%to 96.58%. Conclusions:HbA_(1c) is a practical and convenient tool for screening undiagnosed diabetes in routine health check-up of a large population.Combined use of HbA_(1c)≥6.3%and/or FPG≥7.0 mmol/L is efficient for early detection of diabetes.
文摘AIM: To identify associated factors of diabetic retinopathy(DR) screening and ey e check-up practice among diabetes mellitus(DM) patients attending Felege Hiwot Specialized Hospital.METHODS: An institution-based cross-sectional study was applied from October 4, 2019 to January 12, 2020 at Felege Hiwot Specialized Hospital. A systematic random sampling technique was used to recruit participants and an interviewer-administered questionnaire was employed to collect the data. The collected data were entered into Epi Info version 7 and transposed to SPSS version 24 for statistical analysis. Descriptive statistics were executed and associated factors were identified using binary logistic regression. The strength of association between the independent and the outcome variable was determined using an adjusted odds ratio(AOR) with 95% confidence interval(CI). RESULTS: Four hundred and six participants partake with a response rate of 95.7% and a mean age of 47±11.5y. The magnitude of DR screening was 308(75.9%, 95%CI: 71.5%, 79.8%). Higher educational level(AOR=3.25;95%CI: 1.40, 8.78), good knowledge of DR(AOR=2.50;95%CI: 1.55, 4.46), and family history of DM(AOR=2.15;95%CI: 1.41,3.85) were significantly associated with DR screening. On the other side, rural residence [AOR=3.11(1.89, 5.02)] and undesirable attitudes toward DR [AOR=5.65(3.14, 8.76)] were significantly associated with poor regular eye checkup practice.CONCLUSION: Most of the participants are screened for DR. Higher education, family history, and good knowledge are associated with DR screening. In addition, rural residence and undesirable attitudes toward DR are associated with regular eye checkup practice.
文摘Background: Caries detection in school oral examinations insufficient accuracy. Objective: To evaluate advantages of introducing quantitative light-induced fluorescence-digital (QLF-D) in school oral examinations. Methods: Experiment No. 1. Early demineralized lesions in the upper and lower incisors and canines were visually inspected by three dentists and by QLF-D. The numbers of tooth planes with early demineralized lesions were compared between the methods. Experiment No. 2. Approximal demineralized lesions in molars were assessed by visual inspection, x-ray imaging, and QLF-D. The numbers of tooth planes with demineralized lesions were compared among the methods. Experiment No. 3. Plaque distribution was evaluated by QLF-D and a traditional staining method. The ratio of the diameter of plaque to tooth crown in the tooth axis direction in each method was calculated. The results were evaluated by Pearson’s correlation coefficient analysis and Bland-Altman plot. Results: Experiment No. 1. The three dentists found 0.67 tooth planes on average. QLF-D found 22 tooth planes with early demineralized lesions in the same samples. Experiment No. 2. Fourteen approximal tooth planes of molars were found to have demineralized lesions by x-ray imaging. QLF-D detected 71.4% of the tooth planes out of the 14, whereas visual inspection found 7.1%. Experiment No. 3. The Pearson’s correlation coefficient for the evaluations of plaque distribution between the QLF-D and traditional staining methods was 0.77 (P Conclusion: The results support introduction of QLF-D for use in school dental examinations.
文摘To prevent the development of metabolic syndrome among adult members of the community, improving the participation rate in the specific medical checkup (a medical examination focused on factors associated with metabolic syndrome prior to the onset of lifestyle-related disease) is an important public health issue. This study used claim data and health checkup data and aimed to detect those community-dwelling adults who were least likely to participate in the specific medical checkup. Analysis included the medical and health checkup chart data of 61,753 adults aged 60 - 69 years (as of April 2011) who lived in Fukui prefecture, Japan. The chi-squared interaction was used to analyze data. If a person did not participate in the specific medical checkup, individual was categorized as “absent.” Between April 2012 and March 2013, 66.3% of subjects were absent from the specific medical checkup. Those most likely to be absent included those who were also absent at the previous year’s checkup, those who were men, and those who did not have an examination for hypertension;87.9% of patients who met all of these criteria were absent. Among women who were absent at the previous year’s checkup, the absentee rate differed by about 10.0% between those whose municipalities did (74.8%) or did not (84.2%) have a free checkup program. Our findings may help public health professionals detect those who require intervention and to effectively and efficiently improve participation in the specific medical checkup.
文摘<strong>Background: </strong>The high blood pressure (BP) or hypertension is a widely prevalent disease and its costs are very high, and many studies about the relationships between BP and health conditions have been done. We need to know the precise distributions of BP and factors affecting BP. <strong>Data and Methods</strong><strong>:</strong> The distributions of BP are analyzed using 12,877,653 observations obtained from the JMDC Claims Database. The factors that may affect the BP are analyzed by the regression models using 4,615,346 observations. <strong>Results:</strong> The averages of systolic BP (SBP) and diastolic BP (DBP) are 120.4 and 74.2 mmHg with standard deviations of 15.9 and 11.3 mmHg, respectively. Among the nonmodifiable factors, age and gender are important factors. Among the modifiable factors, variables related to obesity are important risk factors. Taking antihypertensive drugs makes SBP and DBP 13.4 mmHg and 7.8 mmHg lower. <strong>Conclusion:</strong> The criteria of BP should be carefully determined considering age and gender. The effects of age may be a little different for SBP and DBP. It is necessary to use the proper model to evaluate the effect of antihypertensive drugs correctly. <strong>Limitations:</strong> The dataset is observatory. Although there are various types of treatment methods and antihypertension drugs, their effects are not evaluated.
文摘目的调查成都地区成年健康体检女性生殖道HPV感染情况,并构建风险预测模型。方法选择2022年3月至2023年3月在成都市三家医院进行健康体检的女性作为研究对象,收集生殖道HPV感染的相关因素,以7∶3比例将研究对象分为训练集、验证集,并根据有无HPV感染将研究对象分为感染组与非感染组。使用LASSO回归筛选潜在因素,采用Logistic回归分析构建HPV感染风险预测模型并绘制列线图。采用受试者工作特征(receiver operating characteristic,ROC)曲线及其曲线下面积(area under curve,AUC)、校准曲线和决策曲线评估风险预测模型的区分度、校准度和临床适用性。结果共纳入2318例健康体检女性,HPV感染481例(20.75%),其中单一感染316例(65.70%)、多重感染165例(34.30%)。训练集1622例,验证集696例;训练集中感染组341例,非感染组1281例。LASSO回归及Logistic回归结果显示,年龄[OR=0.955,95%CI(0.912,0.999)]、产次[OR=4.392,95%CI(1.420,13.583)]、初次性交年龄[OR=0.870,95%CI(0.774,0.979)]、安全套使用情况[OR=0.314,95%CI(0.109,0.905)]、性伴侣人数[OR=6.068,95%CI(1.825,20.177)]、性伴侣包皮过长[OR=3.218,95%CI(1.042,9.936)]、性传播疾病患病情况[OR=3.476,95%CI(1.071,11.277)]、生殖道炎症[OR=3.526,95%CI(1.185,10.494)]、宫颈柱状上皮异位情况[OR=4.375,95%CI(1.374,13.934)]为健康体检女性HPV感染的影响因素(P<0.05)。ROC曲线结果显示,训练集和验证集中预测模型的AUC分别为0.913[95%CI(0.866,0.960)]、0.880[95%CI(0.818,0.941)]。训练集和验证集中预测模型的H-L拟合优度检验结果均无统计学意义(P>0.05)。校准曲线结果显示,训练集和验证集中预测曲线与标准曲线基本拟合。决策曲线结果显示,训练集和验证集中模型风险概率阈值分别为0.05~0.90、0.05~0.78时,患者获益。结论成都地区健康体检女性生殖道HPV感染率为20.75%,其主要受年龄、产次、初次性交年龄、安全套使用情况、性伴侣人数、性伴侣包皮过长、性传播疾病患病情况、生殖道炎症、宫颈柱状上皮异位情况的影响,根据上述因素构建的女性生殖道HPV感染风险预测模型具有一定的临床使用价值。
