Tethys Bioscience, Inc., Emeryville, CA 94608, USA.
Diabetes Metab Res Rev. 2012 Sep;28(6):519-26. doi: 10.1002/dmrr.2305.
This study compares a previously developed Diabetes Risk Score to commonly used clinical tools for type 2 diabetes risk evaluation in the Insulin Resistance Atherosclerosis Study (IRAS) cohort, a multi-ethnic US cohort. Available as a clinical test, the PreDx® Diabetes Risk Score uses fasting concentrations of adiponectin, C-reactive protein, ferritin, interleukin-2 receptor alpha, HbA(1c) , glucose and insulin, plus age and gender to predict 5-year risk of diabetes. It was developed in a Northern European population.
The Diabetes Risk Score was measured using archived fasting plasma specimens from 722 non-diabetic IRAS participants, 17.6% of whom developed diabetes during 5.2 years median follow-up (inter-quartile range: 5.1-5.4 years). The study included non-Hispanic whites (41.8%), Hispanics (34.5%) and African Americans (23.7%). Performance of the algorithm was evaluated by area under the receiver operating characteristic curve (AROC) and risk reclassification against other tools.
The Diabetes Risk Score discriminates participants who developed diabetes from those who did not significantly better than fasting glucose (AROC = 0.763 versus 0.710, p = 0.003). The Diabetes Risk Score performed equally well in subpopulations defined by race/ethnicity or gender. The Diabetes Risk Score provided a significant net reclassification improvement of 0.24 (p = 0.01) when comparing predefined low/moderate/high Diabetes Risk Score categories to metabolic syndrome risk factor counting. The Diabetes Risk Score complemented the use of the oral glucose tolerance test by identifying high risk patients with impaired fasting glucose but normal glucose tolerance, 33% of whom converted.
Measuring the Diabetes Risk Score of elevated-risk US patients could help physicians decide which patients warrant more intensive intervention. The Diabetes Risk Score performed equally well across the ethnic subpopulations present in this cohort.
本研究比较了先前开发的糖尿病风险评分与胰岛素抵抗动脉粥样硬化研究（IRAS）队列中常用的 2 型糖尿病风险评估临床工具，该队列是一个多民族的美国队列。可作为临床检测，PreDx®糖尿病风险评分使用空腹浓度的脂联素、C 反应蛋白、铁蛋白、白细胞介素-2 受体α、糖化血红蛋白（HbA1c）、葡萄糖和胰岛素，加上年龄和性别来预测 5 年糖尿病风险。它是在北欧人群中开发的。
使用来自 722 名非糖尿病 IRAS 参与者的存档空腹血浆标本测量糖尿病风险评分，其中 17.6%的参与者在 5.2 年的中位随访期间（四分位距：5.1-5.4 年）患上了糖尿病。该研究包括非西班牙裔白人（41.8%）、西班牙裔（34.5%）和非裔美国人（23.7%）。通过接受者操作特征曲线下面积（AROC）和与其他工具的风险再分类来评估算法的性能。
糖尿病风险评分能够更好地区分发生糖尿病的参与者和未发生糖尿病的参与者，优于空腹血糖（AROC=0.763 与 0.710，p=0.003）。糖尿病风险评分在按种族/民族或性别定义的亚组中表现相同。与代谢综合征危险因素计数相比，糖尿病风险评分在将预先设定的低/中/高糖尿病风险评分类别进行比较时，提供了 0.24 的显著净再分类改善（p=0.01）。糖尿病风险评分通过识别空腹血糖受损但葡萄糖耐量正常的高风险患者补充了口服葡萄糖耐量试验的使用，其中 33%的患者发生了转换。
测量风险升高的美国患者的糖尿病风险评分可以帮助医生决定哪些患者需要更强化的干预。糖尿病风险评分在本队列中的各个种族亚组中表现相同。
