基于CHG指数和临床指标的军事飞行人员5年高血压发病风险预测模型OA

Objective To develop a nomogram model based on the cholesterol-high-density lipoprotein-glucose(CHG)index and clinical indicators to predict the 5-year risk of hypertension onset in military aircrew,thereby providing a predictive tool for early identification and intervention.Methods A total of 1051 normotensive male military aircrew who underwent physical examinations or clinical diagnosis and treatment at the Air Force Medical Center between January 2016 and June 2020 were retrospectively enrolled.They were randomly divided into a training set(n=736)and a validation set(n=315)and followed up until July 30,2025.Kaplan-Meier analysis and Cox proportional hazards models were used to analyze the effects of CHG index levels and other clinical indicators on hypertension incidence.A nomogram prediction model incorporating CHG index was constructed.The receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA)were applied to evaluate the model's discrimination,calibration ability,and clinical utility.Internal validation of the model's predictive performance was performed in the validation set.Results After a median follow-up of 69(interquartile range,54-71)months,a total of 290 new-onset hypertension cases(27.6%)were identified among the cohort.Kaplan-Meier survival curves and multivariable Cox regression analysis indicated that the CHG index,age,body mass index,diastolic blood pressure,family history of hypertension,smoking status,atherosclerosis,uric acid,and low-density lipoprotein cholesterol(LDL-C)were all independent predictors of new-onset hypertension(P<0.05).The nomogram model constructed with the above predictors predicted that the areas under the ROC curve of 5-year new-onset hypertension in military aircrew in the training set and the validation set were 0.872 and 0.849,respectively.The results of decision curve analysis showed favorable clinical benefit.Conclusions The CHG index is an independent predictor of hypertension incidence risk in military aircrew.The nomogram model integrating the CHG index and other clinical indicators can be used for the early identification of hypertension risk.