Abstract:
Background And Objective: Tic disorder (TD) is a common neuropsychiatric disorder in children and adolescents. Its clinical manifestations are vocal tic and motor tic, and its etiological mechanism is not completely clear. At present, the co-morbidity of TD and allergic diseases continues to rise, especially airway allergic diseases. This study aims to analyze the correlation between TD and airway allergic diseases, explore the risk factors of TD, and construct the nomogram prediction model of TD combined with airway allergic diseases, so as to help clinical better identify patients with TD combined with allergic diseases.
Methods: We retrospectively analyzed the clinical data and pulmonary function of 187 children with TD who attended the pediatrics outpatient clinic of XX Hospital from January 1, 2015 to December 31, 2023. According to whether the children with TD had airway allergic diseases, they were divided into TD group (124 cases) and CON group (63 cases). The basic information, past history, family history, treatment and related lung function data of the two groups were recorded and compared. Basic information, past history, family history, treatment, and relevant pulmonary function data were recorded and compared between the two groups. The differences in 13 indicators, including gender, age, history of respiratory tract infection, family history and lung function, were analyzed by one-way logistic regression analysis, and the statistically significant risk factors selected as predictors were analyzed by multifactorial logistic stepwise regression analysis. Then, based on the results of the multifactorial logistic regression analysis, we constructed a line graph prediction model for TD co-infected with airway allergic diseases and evaluated its predictive efficacy.
Results: Univariate logistic analysis showed that sex, FVC, FEV1, FEV1/FVC, PEF, emotional state, co-morbid ADHD or OCD, family history of Tourette's syndrome, recurrent respiratory infections, and prognosis of anti-allergy treatment were not associated with TD co-morbid airway allergic disease. In contrast, age, changes in small airway function, and having a history of allergy were significantly associated with TD co-morbid airway allergic disease (P<0.05). Further multifactorial logistic stepwise regression analysis also showed that age, changes in small airway function, and a history of allergy were independent risk factors for TD co-morbid airway allergic disease. Further analysis suggested that the model was optimized by retaining the minimum Akaike information criterion (AIC) for the three variables of age, changes in small airway function, and having a history of allergy. We constructed and internally validated a column-line graph for predicting the risk of TD co-morbid airway allergic disease, and the results showed that the C-index was 0.882, and the calibration curve showed that the predicted risk of TD co-morbidity was basically the same as the actual risk of TD co-morbidity.
Conclusion: TD co-morbidity with allergic diseases is associated with, changes in small airway function, and a history of allergy. The TD co-morbid airway allergic disease risk column-line graph prediction model we constructed initially realized the visualization of the research results, which was readable, well calibrated, with a fair degree of differentiation, and has practical application for predicting TD co-morbid airway allergic disease.
Key words: Tic disorder, Airway allergic disease, Lung function, nomogram, children
