1.Development and Validation of a Nomogram Prediction Model for Endometrial Malignancy in Patients with Abnormal Uterine Bleeding
Hengchao RUAN ; Suhan CHEN ; Jingyi LI ; Linjuan MA ; Jie LUO ; Yizhou HUANG ; Qian YING ; Jianhong ZHOU
Yonsei Medical Journal 2023;64(3):197-203
Purpose:
This study aimed to identify the risk factors and sonographic variables that could be integrated into a predictive model for endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) in women with abnormal uterine bleeding (AUB).
Materials and Methods:
This retrospective study included 1837 patients who presented with AUB and underwent endometrial sampling. Multivariable logistic regression was developed based on clinical and sonographic covariates [endometrial thickness (ET), resistance index (RI) of the endometrial vasculature] assessed for their association with EC/AEH in the development group (n=1369), and a predictive nomogram was proposed. The model was validated in 468 patients.
Results:
Histological examination revealed 167 patients (12.2%) with EC or AEH in the development group. Using multivariable logistic regression, the following variables were incorporated in the prediction of endometrial malignancy: metabolic diseases [odds ratio (OR)=7.764, 95% confidence intervals (CI) 5.042–11.955], family history (OR=3.555, 95% CI 1.055–11.971), age ≥40 years (OR=3.195, 95% CI 1.878–5.435), RI ≤0.5 (OR=8.733, 95% CI 4.311–17.692), and ET ≥10 mm (OR=8.479, 95% CI 5.440–13.216). :A nomogram was created using these five variables with an area under the curve of 0.837 (95% CI 0.800–0.874). The calibration curve showed good agreement between the observed and predicted occurrences. For the validation group, the model provided acceptable discrimination and calibration.
Conclusion
The proposed nomogram model showed moderate prediction accuracy in the differentiation between benign and malignant endometrial lesions among women with AUB.
2.The relationship between dietary fiber intake and hypertension:an analysis based on the NHANES data from 2015-2016 in the United States
Linjuan LI ; Jiaoyan LI ; Xiaoqin LUO
Chinese Journal of Clinical Medicine 2024;31(5):734-741
Objective To explore the relationship between dietary fiber intake and hypertension in different populations.Methods Dietary fiber intake was calculated using the data from 2015-2016 National Health and Nutrition Examination Survey(NHANES)database by combining dietary data collected by the 24-hour dietary recall method with the USDA Food and Nutritional Database.Hypertension was defined based on blood pressure values obtained through questionnaires and mobile center measurements.Logistic regression models were used to analyze the relationship between dietary fiber intake and hypertension in individuals aged≥18 years.Generalized additive model(GAM)and smoothed curve fitting were used to analyze the dose-response relationship between them.Results Compared with the low dietary fiber intake(<17.75 g/d)group,in the total population,the prevalence risk of hypertension was 18% lower in the high dietary fiber intake(≥18.85 g/d)group(OR=0.82,95% CI 0.68-0.98).In the male population,the risk of hypertension in the high dietary fiber intake group decreased by 23% (OR=0.77,95% CI 0.60-0.98).In the female population,when dietary fiber intake was>28.05 g/d,the risk of hypertension decreased by 6% (OR=0.94,95% CI 0.89-0.99)for 1 g/d increase in dietary fiber intake.In the population aged>60 years,the risk of hypertension decreased by 31% in the high dietary fiber intake group(OR=0.69,95% CI 0.48-0.99).In the population aged≤45 years,the risk of hypertension decreased by 6% (OR=0.94,95% CI 0.88-0.99)for 1 g/d increase when dietary fiber intake>34.5 g/d.Conclusions High dietary fiber intake is associated with a decreased risk of developing hypertension,and a reasonable increase in dietary fiber intake can help reduce the incidence of hypertension.
3.Neutrophil-lymphocyte and platelet-lymphocyte ratios for assessing disease activity in patients with rheumatoid arthritis receiving tofacitinib treatment.
Juan TANG ; Juan CHEN ; Guoxin LIN ; Hao ZHANG ; Ming GUI ; Nannan LI ; Yihong GU ; Linjuan LUO ; Jian SUN
Journal of Southern Medical University 2023;43(10):1651-1656
OBJECTIVE:
To evaluate the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for assessing disease activity in patients with rheumatoid arthritis (RA) treated with tofacitinib.
METHODS:
This retrospective study was conducted among 98 RA patients in active stage treated with tofacitinib in Third Xiangya Hospital and 100 healthy control subjects from the Health Management Center of the hospital from 2019 to 2021. We collected blood samples from all the participants for measurement of erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and other blood parameters 1 month before and 6 months after tofacitinib treatment. We further evaluated PLR and NLR before and after tofacitinib treatment in the RA patients, and analyzed their correlations with RA disease activity.
RESULTS:
PLR and NLR increased significantly in RA patients as compared with the healthy controls. In the RA patients, PLR and NLR were positively correlated with the levels of hs- CRP, ESR, IL- 6, Disease Activity Score of 28 joints-ESR (DAS28-ESR), anti-cyclic citrullinated peptide (CCP), and rheumatoid factor (RF) before and after tofacitinib treatment. Tofacitinib treatment for 6 months significantly decreased hs-CRP, ESR, IL-6, CCP, RF and DAS28-ESR levels in the RA patients.
CONCLUSION
NLR and PLR can be useful biomarkers for assessing disease activity in RA patients treated with tofacitinib.
Humans
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Neutrophils
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Retrospective Studies
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C-Reactive Protein/analysis*
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Interleukin-6/metabolism*
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Arthritis, Rheumatoid
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Lymphocytes