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糖尿病风险评分:一种预测2型糖尿病风险的实用工具。

The diabetes risk score: a practical tool to predict type 2 diabetes risk.

作者信息

Lindström Jaana, Tuomilehto Jaakko

机构信息

Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.

出版信息

Diabetes Care. 2003 Mar;26(3):725-31. doi: 10.2337/diacare.26.3.725.

Abstract

OBJECTIVE

Interventions to prevent type 2 diabetes should be directed toward individuals at increased risk for the disease. To identify such individuals without laboratory tests, we developed the Diabetes Risk Score.

RESEARCH DESIGN AND METHODS

A random population sample of 35- to 64-year-old men and women with no antidiabetic drug treatment at baseline were followed for 10 years. New cases of drug-treated type 2 diabetes were ascertained from the National Drug Registry. Multivariate logistic regression model coefficients were used to assign each variable category a score. The Diabetes Risk Score was composed as the sum of these individual scores. The validity of the score was tested in an independent population survey performed in 1992 with prospective follow-up for 5 years.

RESULTS

Age, BMI, waist circumference, history of antihypertensive drug treatment and high blood glucose, physical activity, and daily consumption of fruits, berries, or vegetables were selected as categorical variables. Complete baseline risk data were found in 4435 subjects with 182 incident cases of diabetes. The Diabetes Risk Score value varied from 0 to 20. To predict drug-treated diabetes, the score value >or=9 had sensitivity of 0.78 and 0.81, specificity of 0.77 and 0.76, and positive predictive value of 0.13 and 0.05 in the 1987 and 1992 cohorts, respectively.

CONCLUSIONS

The Diabetes Risk Score is a simple, fast, inexpensive, noninvasive, and reliable tool to identify individuals at high risk for type 2 diabetes.

摘要

目的

预防2型糖尿病的干预措施应针对该疾病风险增加的个体。为了在不进行实验室检测的情况下识别此类个体,我们开发了糖尿病风险评分。

研究设计与方法

对35至64岁、基线时未接受抗糖尿病药物治疗的男性和女性进行随机抽样,随访10年。从国家药物登记处确定药物治疗的2型糖尿病新病例。使用多变量逻辑回归模型系数为每个变量类别分配一个分数。糖尿病风险评分由这些个体分数的总和组成。该评分的有效性在1992年进行的一项独立人群调查中进行了测试,并进行了5年的前瞻性随访。

结果

年龄、体重指数、腰围、抗高血压药物治疗史和高血糖、身体活动以及水果、浆果或蔬菜的每日摄入量被选为分类变量。在4435名受试者中发现了完整的基线风险数据,其中有182例糖尿病发病病例。糖尿病风险评分值从0到20不等。为了预测药物治疗的糖尿病,在1987年和1992年的队列中,评分值≥9时的敏感性分别为0.78和0.81,特异性分别为0.77和0.76,阳性预测值分别为0.13和0.05。

结论

糖尿病风险评分是一种简单、快速、廉价、无创且可靠的工具,可用于识别2型糖尿病高危个体。

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