Differential diagnosis model of systemic lupus erythematosus based on LASSO-logistic regression
10.16781/j.CN31-2187/R.20240520
- VernacularTitle:基于LASSO-logistic回归建立系统性红斑狼疮的鉴别诊断模型
- Author:
Linlin ZHANG
1
;
Jiaqiang WANG
;
Jiong ZHANG
;
Jinglu QIU
;
Min LIANG
;
Yan LIANG
Author Information
1. 四川省医学科学院·四川省人民医院(电子科技大学附属医院)临床医学检验中心及人类疾病基因研究四川省重点实验室,成都 610072
- Keywords:
systemic lupus erythematosus;
least absolute shrinkage and selection operator regression;
differential diagnosis;
nomogram
- From:
Academic Journal of Naval Medical University
2025;46(10):1322-1328
- CountryChina
- Language:Chinese
-
Abstract:
Objective To construct a differential diagnosis model for systemic lupus erythematosus(SLE)from other autoimmune diseases based on the conventional test indicators in clinical laboratory,so as to improve the diagnostic efficacy of the existing test indicators.Methods The data of 178 SLE patients(SLE group)and 196 patients with other autoimmune diseases(control group)diagnosed in Sichuan Provincial People's Hospital from Apr.2022 to Mar.2023 were retrospectively analyzed.The differences in the levels of 19 clinical routine indicators between the 2 groups were analyzed.The least absolute shrinkage and selection operator(LASSO)regression was used to screen for test indicators with non-zero coefficients.These indicators were then used in logistic regression to construct a Nomogram model for SLE differential diagnosis.Model performance was assessed using receiver operating characteristic(ROC)curves and decision curve analysis.Results The levels of anti-cardiolipin antibody immunoglobulin(Ig)G,anti-cardiolipin antibody IgA,high-sensitivity C reactive protein(hs-CRP),D-dimer,and thrombin time(TT)in the SLE group were significantly higher than those in the control group(all P＜0.05),while the levels of IgM,complement 3(C3),complement 4(C4),prothrombin time(PT),and activated partial thromboplastin time(APTT)in the SLE group were significantly lower than those in the control group(all P＜0.05).Through LASSO regression,IgM,C3 and C4 were selected as the most likely indicators with non-zero coefficients.Multivariate logistic regression analysis showed that the differential diagnosis model was Logit P=4.18-1.34 × IgM-1.70 × C3-6.61 × C4.The area under the curve of this model was 0.80(95％confidence interval 0.76-0.85),with a sensitivity of 0.77 and a specificity of 0.74.Decision curve analysis demonstrated favourable clinical utility within a threshold probability range of 0.2-0.9.Conclusion The present model,constructed using the clinical routine indicators,such as IgM,C3 and C4,is helpful for the differential diagnosis of SLE from other autoimmune diseases and has good clinical application value.
