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Abstract
Post-acute pancreatitis diabetes mellitus (PPDM-A) is the main component of pancreatic exocrine diabetes mellitus. Timely diagnosis of PPDM-A improves patient outcomes and the mitigation of burdens and costs. We aimed to determine risk factors prospectively and predictors of PPDM-A in China, focusing on giving personalized treatment recommendations. Here, we identify and evaluate the best set of predictors of PPDM-A prospectively using retrospective data from 820 patients with acute pancreatitis at four centers by machine learning approaches. We used the L1 regularized logistic regression model to diagnose early PPDM-A via nine clinical variables identified as the best predictors. The model performed well, obtaining the best AUC = 0.819 and F1 = 0.357 in the test set. We interpreted and personalized the model through nomograms and Shapley values. Our model can accurately predict the occurrence of PPDM-A based on just nine clinical pieces of information and allows for early intervention in potential PPDM-A patients through personalized analysis. Future retrospective and prospective studies with multicentre, large sample populations are needed to assess the actual clinical value of the model.
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1 Southeast University, Department of Endocrinology, Zhongda Hospital, School of Medicine, Nanjing, China (GRID:grid.263826.b) (ISNI:0000 0004 1761 0489); Southeast University, Institute of Glucose and Lipid Metabolism, Nanjing, China (GRID:grid.263826.b) (ISNI:0000 0004 1761 0489)
2 First Affiliated Hospital of Xinjiang Medical University, Department of Endocrinology, Changji Branch, Xinjiang, China (GRID:grid.412631.3)
3 First Affiliated Hospital of Hunan Normal University, Department of Endocrinology, Hunan Provincial People’s Hospital, Changsha, China (GRID:grid.411427.5) (ISNI:0000 0001 0089 3695)
4 Yixing Second People’s Hospital, Department of Endocrinology, Wuxi, China (GRID:grid.411427.5)
5 Southeast University, Department of Endocrinology, Zhongda Hospital, School of Medicine, Nanjing, China (GRID:grid.263826.b) (ISNI:0000 0004 1761 0489); Southeast University, Institute of Glucose and Lipid Metabolism, Nanjing, China (GRID:grid.263826.b) (ISNI:0000 0004 1761 0489); Southeast University, Department of Endocrinology, Zhongda Hospital, School of Medicine, Institute of Pancreas, Nanjing, China (GRID:grid.263826.b) (ISNI:0000 0004 1761 0489)