Department of Medicine, University of Kuopio and Kuopio University Hospital, 70210 Kuopio, Finland.
J Clin Endocrinol Metab. 2010 Aug;95(8):3858-62. doi: 10.1210/jc.2010-0012. Epub 2010 May 12.
The Finnish Diabetes Risk Score (FINDRISC) is a well established method to evaluate the risk of type 2 diabetes. However, it is unknown whether biochemical markers or confirmed type 2 diabetes risk genes improve the risk evaluation beyond the FINDRISC.
We investigated the role of biochemical markers and type 2 diabetes risk loci in the identification of previously undiagnosed diabetic subjects beyond the FINDRISC in a cross-sectional study.
A random sample of 7232 Finnish men aged 45-74 yr (including 518 men with new type 2 diabetes) participated in the study. Insulin sensitivity and insulin secretion were evaluated by oral glucose tolerance test-derived indices. Total triglycerides, high-density lipoprotein cholesterol, adiponectin, and alanine transaminase were measured. Nineteen type 2 diabetes risk single-nucleotide polymorphisms were genotyped.
FINDRISC was the best single indicator of prevalent undiagnosed diabetes among all variables tested and strongly associated with insulin resistance. It was also more strongly associated with insulin secretion compared with the type 2 risk alleles. The receiver operating characteristics area under the curve based on logistic regression models for the identification of previously undiagnosed type 2 diabetic subjects with the FINDRISC alone was 0.727, and 0.772 after adding total triglycerides, high-density lipoprotein cholesterol, adiponectin, and alanine transaminase in the model. Adding type 2 risk alleles did not further improve the model (0.772).
Biochemical markers, but not genetic markers, improve the identification of previously undiagnosed type 2 diabetes beyond the FINDRISC alone.
芬兰糖尿病风险评分（FINDRISC）是一种评估 2 型糖尿病风险的成熟方法。然而，尚不清楚生物化学标志物或已确认的 2 型糖尿病风险基因是否可以在 FINDRISC 之外改善风险评估。
我们通过横断面研究，调查生物化学标志物和 2 型糖尿病风险基因在 FINDRISC 之外对未确诊的糖尿病患者的识别作用。
从年龄在 45-74 岁的芬兰男性中随机抽取 7232 名（包括 518 名新诊断的 2 型糖尿病患者）参加研究。通过口服葡萄糖耐量试验衍生的指数评估胰岛素敏感性和胰岛素分泌。测量总甘油三酯、高密度脂蛋白胆固醇、脂联素和丙氨酸转氨酶。检测了 19 个 2 型糖尿病风险单核苷酸多态性。
在所有测试的变量中，FINDRISC 是现患未确诊糖尿病的最佳单一指标，与胰岛素抵抗密切相关。与 2 型风险等位基因相比，它与胰岛素分泌的相关性更强。基于逻辑回归模型的用于识别先前未确诊的 2 型糖尿病患者的 FINDRISC 曲线下面积为 0.727，在模型中加入总甘油三酯、高密度脂蛋白胆固醇、脂联素和丙氨酸转氨酶后为 0.772。添加 2 型风险等位基因并不能进一步改善模型（0.772）。
生物化学标志物而非遗传标志物可在 FINDRISC 之外改善对先前未确诊的 2 型糖尿病的识别。
