Schwarz P E H, Li J, Lindstrom J, Tuomilehto J
Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany.
Horm Metab Res. 2009 Feb;41(2):86-97. doi: 10.1055/s-0028-1087203. Epub 2008 Nov 19.
The discussion about the diagnosis and treatment of type 2 diabetes - and, more generally, dysglycaemia - should be framed in terms of a continuum of risk. A variety of tools have been developed to identify individuals with an increased risk of developing type 2 diabetes and to quantify the probability of type 2 diabetes either cross-sectionally or prospectively. Such scores are based on traditional risk factors for diabetes, such as age, body mass index (BMI), and family history, while others also evaluate metabolic risk factors such as lipid levels. The performance of a diabetes risk-prediction tool is generally assessed by measuring its accuracy, availability, practicability, and costs. This review discusses the validity and use of today's available major risk-prediction tools for clinical practice, and assesses the scope and cost-effectiveness of available tools. Among these prediction tools, American Diabetes Association (ADA) Risk Tools, Finnish Diabetes Risk Score (FINDRISC), National Health and Nutrition Examination Survey (NHANES) Risk Score, and Study to Prevent Non-Insulin Dependents Diabetes Mellitus (STOP-NIDDM) Risk Score were of our concern. We conclude that the FINDRISC tool is currently the best available tool for use in clinical practice in Caucasian populations, but modifications may be required if applied to other ethnic groups.
关于2型糖尿病以及更广泛的血糖异常的诊断和治疗的讨论，应以风险连续体的角度来进行阐述。已经开发了多种工具来识别患2型糖尿病风险增加的个体，并从横断面或前瞻性角度量化患2型糖尿病的概率。此类评分基于糖尿病的传统风险因素，如年龄、体重指数（BMI）和家族史，而其他一些评分还会评估代谢风险因素，如血脂水平。糖尿病风险预测工具的性能通常通过衡量其准确性、可用性、实用性和成本来评估。本综述讨论了当今临床实践中可用的主要风险预测工具的有效性和用途，并评估了现有工具的范围和成本效益。在这些预测工具中，美国糖尿病协会（ADA）风险工具、芬兰糖尿病风险评分（FINDRISC）、美国国家健康与营养检查调查（NHANES）风险评分以及预防非胰岛素依赖型糖尿病研究（STOP-NIDDM）风险评分是我们关注的对象。我们得出结论，FINDRISC工具目前是白种人群临床实践中可用的最佳工具，但如果应用于其他种族群体，可能需要进行修改。
