Department of Public Health, University of Helsinki, Helsinki, Finland.
Diabet Med. 2010 Mar;27(3):274-81. doi: 10.1111/j.1464-5491.2010.02943.x.
A diabetes risk score for screening undiagnosed diabetes was constructed and validated in Chinese adults.
Two consecutive population-based diabetes surveys among Chinese adults aged 20-74 years were conducted in 2002 (n = 1986) and 2006 (n = 4336). Demographic and anthropometric measures were collected following similar procedures. Standard 2-h 75-g oral glucose tolerance tests (OGTTs) were performed to diagnose diabetes in both surveys. Fasting capillary plasma glucose (FCG) and glycated haemoglobin (HbA(1c)) were also measured together with the OGTTs on the same day of the 2006 survey. Beta coefficients estimated using logistic regression analysis derived from data of the 2002 survey were used to develop the risk assessment algorithm. The performance of the algorithm was validated in the study population of the 2006 survey.
Of all the variables tested, waist circumference, age and family history of diabetes were significant predictors of diabetes and were used to construct the risk assessment score. The score, ranging from 3 to 32, performed well when applied to the study population of the 2006 survey. The area under the receiver operating characteristic curve was 67.3% (95% CI, 64.9-69.7%) for the score, while it was 76.3% (73.5-79.0%) for FCG alone and 67.8% (64.9-70.8%) for HbA(1c) alone. At a cut-off point of 14, the sensitivity and specificity of the risk score were 84.2% (81.0-87.5%) and 39.8% (38.2-41.3%).
The risk score based on age, waist circumference and family history of diabetes is efficient as a layperson-oriented diabetes screening tool for health promotion and for population-based screening programmes.
构建并验证了一种适用于中国成年人的糖尿病风险评分，用于筛查未诊断的糖尿病。
在 2002 年（n=1986）和 2006 年（n=4336），对年龄在 20-74 岁的中国成年人进行了两项连续的基于人群的糖尿病调查。采用相似的程序收集了人口统计学和人体测量学的测量数据。在这两项调查中，都采用标准的 2 小时 75 克口服葡萄糖耐量试验（OGTT）来诊断糖尿病。在 2006 年的调查中，还同时测量了空腹毛细血管血浆葡萄糖（FCG）和糖化血红蛋白（HbA(1c)）。使用来自 2002 年调查数据的逻辑回归分析估算的β系数，用于开发风险评估算法。该算法在 2006 年调查的研究人群中进行了验证。
在所测试的所有变量中，腰围、年龄和糖尿病家族史是糖尿病的显著预测因素，用于构建风险评估评分。该评分范围为 3 至 32，在 2006 年调查的研究人群中表现良好。该评分的受试者工作特征曲线下面积为 67.3%（95%CI，64.9-69.7%），而 FCG 单独的曲线下面积为 76.3%（73.5-79.0%），HbA(1c) 单独的曲线下面积为 67.8%（64.9-70.8%）。在 14 分的截断点处，风险评分的灵敏度和特异性分别为 84.2%（81.0-87.5%）和 39.8%（38.2-41.3%）。
基于年龄、腰围和糖尿病家族史的风险评分，作为一种面向非专业人士的糖尿病筛查工具，在健康促进和基于人群的筛查计划中具有较高的效率。
