基于舌象色彩空间参数的糖尿病肾病诊断模型与剂量-反应关系研究OA

Objective The objectification of tongue diagnosis has developed continuously with the improvement of tongue diagnosis instrument precision.Multiple studies have adopted color space models to conduct in-depth research on objective tongue manifestation quantification.This study aims to explore the characteristics of objective tongue parameters in patients with Diabetic Kidney Disease(DKD),as well as the correlation and dose-response relationship between these objective quantitative parameters and the risk of DKD.Methods This cross-sectional study enrolled patients with type 2 diabetes mellitus(T2DM)and diabetic kidney disease(DKD).Baseline information and tongue images were collected from 1531 T2DM patients and 684 DKD patients.RGB color parameters were extracted from the tongue images and converted into CIELAB color space values.Propensity score matching(PSM)and stratified analyses were performed to eliminate the confounding effects of disease duration and age.Unconditional logistic regression and least absolute shrinkage and selection operator(LASSO)regression were applied to screen objective tongue parameters associated with DKD,and receiver operating characteristic(ROC)curves were constructed to evaluate the discriminative ability of the models.Restricted cubic spline(RCS)regression was used to analyze the dose-response relationship between the selected parameters and DKD risk.Results Significant inter-group differences were observed in each objective tongue manifestation parameter.Logistic regression identified 28 objective tongue parameters significantly associated with DKD,and LASSO regression identified 26 parameters.Stratified analyses by age and disease duration revealed no systematic effect modification across strata.The ROC curves indicated good discriminative ability of the models for distinguishing DKD from T2DM.Dose-response relationships were observed between the tongue parameters and DKD risk.Conclusion This study reveals characteristic objective tongue parameters in DKD patients and demonstrates significant dose-response associations between these parameters and DKD risk,providing a preliminary basis for future diagnostic test studies on tongue-image-assisted DKD screening.