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国际临床研究杂志

International Journal of Clinical Research

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International Journal of Clinical Research. 2025; 9: (9) ; 10.12208/j.ijcr.20250416 .

Analysis of serum IL-6, IL-1β and PICP expression levels in elderly AF patients and construction of nomogram model: A case-control study
老年房颤患者血清IL-6、IL-1β和PICP表达水平的分析及列线图模型的构建

作者： 吕福强1,2, 石世林1,2, 李龙1,2, 迪力拜尔·玉素甫4, 刘克坚1,3 *

1 石河子大学第一附属医院心内科 新疆石河子

2 石河子大学医学院临床医学系 新疆石河子

3 国家卫生健康委员会中亚高发病防治重点实验室 新疆石河子

4 第三师图木舒克市总医院检验科 新疆图木舒克

*通讯作者： 刘克坚,单位： 石河子大学第一附属医院心内科 新疆石河子 国家卫生健康委员会中亚高发病防治重点实验室 新疆石河子；

引用本文: 吕福强, 石世林, 李龙, 迪力拜尔·玉素甫, 刘克坚 老年房颤患者血清IL-6、IL-1β和PICP表达水平的分析及列线图模型的构建[J]. 国际临床研究杂志, 2025; 9: (9) : 16-22.
Published: 2025/9/21 10:15:18

摘要

目的 探讨老年房颤（AF）患者血清白细胞介素6（IL-6）、白细胞介素1β（IL-1β）、I型前胶原羧基端前肽（PICP）的表达特征，并构建基于多维度指标的列线图预测模型。方法 采用病例对照研究设计，纳入2023年12月至2024年10月住院治疗的老年AF患者116例（病例组）及同期年龄、性别匹配的体检人群120例（对照组）。通过酶联免疫吸附试验定量检测血清IL-6、IL-1β及PICP水平。采用Logistic回归筛选变量并构建列线图模型，最终纳入多因素分析中P<0.05的左心房直径（LAD）、IL-6、IL-1β和PICP作为预测变量。通过受试者工作特征曲线（ROC）、校准曲线及决策曲线分析（DCA）评估模型效能。结果 AF组血清IL-6、IL-1β水平高于对照组（P＜0.001），血清PICP水平低于对照组（P＜0.001）。多因素Logistic回归分析显示，IL-6（OR：1.090，95%CI：1.029-1.154）、IL-1β（OR：1.009，95%CI：1.004-1.014）、左心房直径（OR：1.253，95%CI：1.142-1.375）是老年AF的危险因素，而PICP（OR：0.887，95%CI：0.834-0.943）则为保护因素。基于上述指标构建的列线图模型展现出良好的老年AF预测效能（AUC=0.948，95%CI：0.922-0.974）。校准曲线表明模型预测概率与实际观察概率高度一致（Hosmer-Lemeshow检验P=0.795；平均绝对误差=0.022）。DCA显示在0.07-1.00风险阈值范围内具有显著净获益。结论 IL-6升高、IL-1β升高、PICP降低及左心房扩大是老年AF的危险因素，构建的列线图模型具有良好预测价值，为个体化风险评估提供可视化工具。

关键词： 老年房颤；白细胞介素6；白细胞介素1β；I型前胶原羧基端前肽；列线图

Abstract

Objective To explore the expression characteristics of serum interleukin-6 (IL-6), interleukin-1β (IL-1β), and type I procollagen carboxy-terminal propeptide (PICP) in elderly patients with atrial fibrillation (AF), and to construct a nomogram prediction model based on multi-dimensional indicators.
Methods A case-control study design was adopted, including 116 elderly AF patients hospitalized from December 2023 to October 2024 (case group) and 120 age- and gender-matched healthy individuals undergoing physical examinations during the same period (control group). The levels of serum IL-6, IL-1β and PICP were quantitatively detected by enzyme-linked immunosorbent assay. Logistic regression was used to screen variables and construct a nomogram model. Left atrial diameter (LAD), IL-6, IL-1β and PICP with P < 0.05 in the multivariate analysis were finally included as predictive variables. The model performance was evaluated by receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA).
Results Serum levels of IL-6 and IL-1β were higher in the AF group than in the control group (P < 0.001), while serum PICP levels were lower (P < 0.001). Multivariate Logistic regression analysis showed that IL-6 (OR: 1.090, 95% CI: 1.029 - 1.154), IL-1β (OR: 1.009, 95% CI: 1.004 - 1.014), and left atrial diameter (OR: 1.253, 95% CI: 1.142 - 1.375) were risk factors for elderly AF, while PICP (OR: 0.887, 95% CI: 0.834 - 0.943) was a protective factor. The nomogram model constructed based on these indicators demonstrated excellent predictive performance for elderly AF (AUC = 0.948, 95% CI: 0.922 - 0.974). The calibration curve indicated a high consistency between the predicted probability and the observed probability (Hosmer-Lemeshow test P = 0.795; mean absolute error = 0.022). DCA showed significant net benefit within the risk threshold range of 0.07 - 1.00.
Conclusion   Elevated IL-6, elevated IL-1β, decreased PICP, and left atrial enlargement are risk factors for elderly AF. The constructed nomogram model has good predictive value and provides a visual tool for individualized risk assessment.

Key words： Atrial fibrillation in the elderly; Interleukin-6; Interleukin-1β; Type I procollagen carboxy-terminal propeptide; Nomogram

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