AUTHOR=Zhu Lichen , Fu Yu , Zhu Linchao , Yao Yimin , Chen Li 

TITLE=Identification of routine blood derived hematological and lipid indices in ILD through machine learning; a retrospective case-control study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1633713

DOI=10.3389/fmed.2025.1633713

ISSN=2296-858X

ABSTRACT=IntroductionInterstitial lung disease (ILD) comprises various disorders marked by pulmonary inflammation and fibrosis. Early diagnosis and risk prediction are vital for improving patient outcomes.MethodsWe retrospectively analyzed 603 patients who had visited the Hubin Campus between January 2022 and April 2025, employing a 1:2 case-control design with age- and gender-matched groups. We collected clinical information, complete blood count data, lipid metabolism indicators, and various derived indices.ConclusionSix key markers were identified through three machine learning algorithms (LassoCV, SVMREFCV, and Boruta): neutrophil percentage, lymphocyte percentage, monocyte percentage, hemoglobin, and two novel ratios - neutrophil-to-HDL-C and lymphocyte-to-HDL-C. The random forest model outperformed seven other machine learning approaches, with AUC values of 0.868 (validation set), 0.885 (test set), and 0.849 (external cohort), demonstrating consistent predictive accuracy.DiscussionBased on these findings, we developed an online prediction tool to assist primary care clinicians in assessing the risk of ILD in suspected cases. Our results indicate that the random forest model exhibits high accuracy and clinical utility for early ILD prediction, providing a novel tool and methodology for early diagnosis and intervention. Future studies will focus on further optimizing the model and validating it in larger multicenter cohorts.