Kanaya Alka M, Wassel Fyr Christina L, de Rekeneire Nathalie, Shorr Ronald I, Schwartz Ann V, Goodpaster Bret H, Newman Anne B, Harris Tamara, Barrett-Connor Elizabeth
Department of Medicine and Epidemiology and Biostatics, University of California, San Francisco, California 94115, USA.
Diabetes Care. 2005 Feb;28(2):404-8. doi: 10.2337/diacare.28.2.404.
To create a simple prediction rule that could perform as well as the 2-h postchallenge plasma glucose (PCPG) test to predict those at risk for diabetes. We created a prediction rule in one sample and prospectively validated it for incident diabetes in a separate cohort.
A cross-sectional analysis with data from the Rancho Bernardo Study (age 67 +/- 11 years) to derive a rule predicting abnormal PCPG >/=140 mg/dl, using demographic, clinical, and laboratory data of nondiabetic participants with fasting plasma glucose (FPG) <126 mg/dl. Data from the Health, Aging and Body Composition study (age 74 +/- 3 years) were used to prospectively validate this rule for incident diabetes and compare it with the predictive ability of the PCPG test.
Of 1,549 RBS participants, 514 (33%) had PCPG >/=140 mg/dl. Female sex, age, triglycerides, and FPG were most significantly associated with abnormal PCPG. Based on standardized beta-coefficients, we allotted 1 point for female sex, triglycerides >/=150 mg/dl, or FPG 95-104 mg/dl. Age >/=70 years or FPG 105-115 mg/dl were given 2 points, and FPG 116-125 mg/dl received 3 points. In the validation cohort, this simple prediction rule was as good as the 2-h PCPG test for predicting incident diabetes (C-statistic: 0.71 for both).
Advanced age, female sex, FPG, and triglycerides were able to predict adults at risk for diabetes equally well as the 2-h PCPG test. Using this rule, clinicians may better identify older persons who should receive intensive lifestyle intervention to prevent type 2 diabetes.
创建一个简单的预测规则，其预测糖尿病风险的能力与口服葡萄糖耐量试验2小时后血浆葡萄糖（PCPG）检测相当。我们在一个样本中创建了一个预测规则，并在另一个队列中对其预测新发糖尿病的能力进行了前瞻性验证。
采用来自兰乔贝纳多研究（年龄67±11岁）的数据进行横断面分析，以得出预测PCPG异常（≥140mg/dl）的规则，使用空腹血糖（FPG）<126mg/dl的非糖尿病参与者的人口统计学、临床和实验室数据。健康、衰老与身体成分研究（年龄74±3岁）的数据用于前瞻性验证该规则对新发糖尿病的预测能力，并将其与PCPG检测的预测能力进行比较。
在1549名兰乔贝纳多研究参与者中，514名（33%）PCPG≥140mg/dl。女性、年龄、甘油三酯和FPG与PCPG异常最显著相关。根据标准化β系数，女性、甘油三酯≥150mg/dl或FPG 95-104mg/dl得1分。年龄≥70岁或FPG 105-115mg/dl得2分，FPG 116-125mg/dl得3分。在验证队列中，这个简单的预测规则在预测新发糖尿病方面与2小时PCPG检测效果相当（C统计量：两者均为0.71）。
高龄、女性、FPG和甘油三酯预测糖尿病风险的能力与2小时PCPG检测相当。使用该规则，临床医生可以更好地识别那些应接受强化生活方式干预以预防2型糖尿病的老年人。
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