中国内脏肥胖指数与肾结石发病风险的相关性研究及综合预测模型构建

A study on the correlation between the Chinese visceral adiposity index and the risk of kidney stone development, and the construction of a comprehensive predictive model

摘要

目的 探讨中国内脏肥胖指数（CVAI）与肾结石发病风险的相关性并构建相关综合预测模型。方法 回顾性收集2024年10月-2025年10月石河子大学附属第一医院泌尿外科收治的397例患者的临床资料，利用logistic回归对肾结石的危险因素进行逐步回归分析和筛选，并根据这些危险因素构建临床预测模型和列线图。利用受试者工作特征（ROC）曲线、校准曲线和临床决策曲线（DCA），对预测模型的区分能力、校准效果和临床实用性进行综合评价。结果 在logistic逐步回归分析后，CVAI、内脏肥胖指数（VAI）、血肌酐和年龄被确定为肾结石发生风险的独立危险因素（P＜0.05）。基于筛选出的危险因素构建预测模型，该预测模型在训练集和验证集中的曲线下面积（AUC）分别为0.860（95%CI:0.817～0.903）与0.815（95%CI:0.740～0.890），并且校准曲线及 DCA 均显示出良好的区分能力与临床应用潜力。结论 年龄、血肌酐、VAI及 CVAI均为肾结石发生的独立危险因素，基于这些因素构建的列线图模型在预测肾结石发生风险方面具有较高的准确性，优于任一单一指标，且展现出良好的临床决策能力，为肾结石的预防和诊断提供依据。

Abstract

Objective To investigate the association between the Chinese visceral adiposity index (CVAI) and the risk of kidney stones and the construction of a predictive model. Methods A retrospectively analysis was conducted on the clinical data of 397 adult patients treated in our hospital during Oct.2024 and Oct.2025. The risk factors for kidney stones were identified with logistic stepwise regression analysis. Based on these factors, a nomogram predictive model was constructed. The model's discriminatory ability, calibration, and clinical utility were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). Results Logistic stepwise regression analysis identified CVAI, visceral adiposity index (VAI), creatinine, and age as the independent risk factors for kidney stones (all P＜0.05). The predictive model demonstrated area under the ROC curve (AUC) of 0.860 (95%CI: 0.817-0.903) in the training set and 0.815 (95%CI: 0.740-0.890) in the validation set. Both of the calibration curve and DCA indicated good discriminatory ability and strong potential for clinical application. Conclusion Age, creatinine, VAI and CVAI are independent risk factors for kidney stones. The model based on these factors exhibits high accuracy in predicting occurrence, outperforms single indicators, and demonstrates promising clinical decision-making capability.

关键词

肾结石 / 肥胖 / 中国内脏肥胖指数 / 风险预测 / 列线图

Key words

kidney stones / obesity / Chinese visceral adiposity index / risk prediction / nomogram

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基金资助

新疆生产建设兵团科技计划项目(2024ZD043)

新疆生产建设兵团英才人才发展专项项目(CZ000821)