Development and multi-cohort validation of a clinical score for predicting type 2 diabetes mellitus


Autoři: Vanessa Kraege aff001;  Peter Vollenweider aff001;  Gérard Waeber aff001;  Stephen J. Sharp aff002;  Maite Vallejo aff003;  Oscar Infante aff003;  Mohammad Reza Mirjalili aff004;  Fatemeh Ezoddini-Ardakani aff004;  Hassan Mozaffari-Khosravi aff004;  Mohammad Hasan Lotfi aff004;  Masoud Mirzaei aff004;  Marie Méan aff001;  Pedro Marques-Vidal aff001
Působiště autorů: Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland aff001;  MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, England, United Kingdom aff002;  Tlalpan 2020 Study, Department of Socio-Medical Research, National Institute of Cardiology, Ignacio Chávez, Mexico City, Mexico aff003;  Shahid Sadoughi University of Medical Sciences, Yazd, Iran aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0218933

Souhrn

Background and aims

Many countries lack resources to identify patients at risk of developing Type 2 diabetes mellitus (diabetes). We aimed to develop and validate a diabetes risk score based on easily accessible clinical data.

Methods

Prospective study including 5277 participants (55.0% women, 51.8±10.5 years) free of diabetes at baseline. Comparison with two other published diabetes risk scores (Balkau and Kahn clinical, respectively 5 and 8 variables) and validation on three cohorts (Europe, Iran and Mexico) was performed.

Results

After a mean follow-up of 10.9 years, 405 participants (7.7%) developed diabetes. Our score was based on age, gender, waist circumference, diabetes family history, hypertension and physical activity. The area under the curve (AUC) was 0.772 for our score, vs. 0.748 (p<0.001) and 0.774 (p = 0.668) for the other two. Using a 13-point threshold, sensitivity, specificity, positive and negative predictive values (95% CI) of our score were 60.5 (55.5–65.3), 77.1 (75.8–78.2), 18.0 (16.0–20.1) and 95.9 (95.2–96.5) percent, respectively. Our score performed equally well or better than the other two in the Iranian [AUC 0.542 vs. 0.564 (p = 0.476) and 0.513 (p = 0.300)] and Mexican [AUC 0.791 vs. 0.672 (p<0.001) and 0.778 (p = 0.575)] cohorts. In the European cohort, it performed similarly to the Balkau score but worse than the Kahn clinical [AUC 0.788 vs. 0.793 (p = 0.091) and 0.816 (p<0.001)]. Diagnostic capacity of our score was better than the Balkau score and comparable to the Kahn clinical one.

Conclusion

Our clinically-based score shows encouraging results compared to other scores and can be used in populations with differing diabetes prevalence.

Klíčová slova:

Cardiovascular diseases – Diabetes mellitus – HbA1c – Hypertension – Medical risk factors – Mexico – Physical activity – Type 2 diabetes


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PLOS One


2019 Číslo 10

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