[Construction of a diagnostic model and scoring system for central precocious puberty in girls, with external validation].

Q3 Medicine

中国当代儿科杂志 Pub Date : 2024-12-15 DOI:10.7499/j.issn.1008-8830.2405079

Shi-Chao Qiu, Zhi-Hua Wang, Na Song, Ting Zhao, Yi-Hua Lian, Jia Yu, Ma-Li Li, Chao Liu

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引用次数: 0

Abstract

Objectives: To establish an efficient and clinically applicable predictive model and scoring system for central precocious puberty (CPP) in girls, and to develop a diagnostic prediction application.

Methods: A total of 342 girls aged 4 to 9 years with precocious puberty were included, comprising 216 cases of CPP and 126 cases of isolated premature thelarche. Lasso regression was used to screen for predictive factors, and logistic regression was employed to establish the predictive model. Additionally, a scoring system was constructed using the evidence weight binning method. Data from 129 girls aged 4 to 9 years with precocious puberty were collected for external validation of the scoring system.

Results: The logistic regression model incorporated five predictive factors: age, insulin-like growth factor-1 (IGF-1), serum follicle-stimulating hormone (FSH), the luteinizing hormone (LH)/FSH baseline ratio, and uterine thickness. The calculation formula was: ln(P/1-P)=-8.439 + 0.216 × age (years) + 0.008 × IGF-1 (ng/mL) + 0.159 × FSH (mIU/mL) + 9.779 × LH/FSH baseline ratio + 0.284 × uterine thickness (mm). This model demonstrated good discriminative ability (area under the curve=0.892) and calibration (Hosmer-Lemeshow test P>0.05). The scoring system based on this logistic regression model showed good discrimination in both the prediction model and external validation datasets, with areas under the curve of 0.895 and 0.805, respectively. Based on scoring system scores, the population was stratified into three risk levels: high, medium, and low. In the high-risk group, the prevalence of CPP exceeded 90%, while the proportion was lower in the medium and low-risk groups.

Conclusions: The CPP diagnostic predictive model established for girls aged 4 to 9 years exhibits good diagnostic performance. The scoring system can effectively and rapidly stratify the risk of CPP, providing valuable reference for clinical decision-making.

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[女童中枢性性早熟诊断模型及评分体系构建，外部验证]。

目的：建立一种高效、临床适用的女童中枢性性早熟（CPP）预测模型及评分系统，并开展诊断预测应用。方法：选取4 ~ 9岁性早熟女童342例，其中CPP 216例，孤立性早熟126例。采用Lasso回归筛选预测因素，采用logistic回归建立预测模型。此外，采用证据权分组法构建了评分系统。收集了129名4 - 9岁性早熟女孩的数据，对评分系统进行外部验证。结果：logistic回归模型纳入年龄、胰岛素样生长因子-1 （IGF-1）、血清促卵泡激素（FSH）、促黄体生成素(LH)/FSH基线比值、子宫厚度5个预测因素。计算公式为：ln(P/1-P)=-8.439 + 0.216 ×年龄（岁）+ 0.008 × IGF-1 (ng/mL) + 0.159 × FSH (mIU/mL) + 9.779 × LH/FSH基线比+ 0.284 ×子宫厚度（mm）。该模型具有较好的判别能力（曲线下面积=0.892）和校正能力（Hosmer-Lemeshow检验P < 0.05）。基于该逻辑回归模型的评分系统在预测模型和外部验证数据集上均具有较好的判别性，曲线下面积分别为0.895和0.805。根据评分系统得分，将人群分为三个风险水平：高、中、低。高危组CPP患病率超过90%，中、低危组比例较低。结论：建立的CPP诊断预测模型对4 ~ 9岁女童具有较好的诊断效果。该评分系统能有效、快速地对CPP的风险进行分层，为临床决策提供有价值的参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

中国当代儿科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

1.50

自引率

0.00%

发文量

5006

期刊介绍： The Chinese Journal of Contemporary Pediatrics (CJCP) is a peer-reviewed open access periodical in the field of pediatrics that is sponsored by the Central South University/Xiangya Hospital of Central South University and under the auspices of the Ministry of Education of China. It is cited as a source in the scientific and technological papers of Chinese journals, the Chinese Science Citation Database (CSCD), and is one of the core Chinese periodicals in the Peking University Library. CJCP has been indexed by MEDLINE/PubMed/PMC of the American National Library, American Chemical Abstracts (CA), Holland Medical Abstracts (EM), Western Pacific Region Index Medicus (WPRIM), Scopus and EBSCO. It is a monthly periodical published on the 15th of every month, and is distributed both at home and overseas. The Chinese series publication number is CN 43-1301/R；ISSN 1008-8830. The tenet of CJCP is to “reflect the latest advances and be open to the world”. The periodical reports the most recent advances in the contemporary pediatric field. The majority of the readership is pediatric doctors and researchers.