University of Leicester, Department of Health Sciences, Leicester, UK.
Prim Care Diabetes. 2013 Apr;7(1):11-8. doi: 10.1016/j.pcd.2013.01.003. Epub 2013 Jan 26.
To develop and validate a non-invasive score for detecting undiagnosed impaired fasting glucose (IFG) and type 2 diabetes (T2DM) in a Portuguese population.
We used data from 3,374 individuals aged 18-94 years from a Portuguese cross-sectional study. We developed a logistic regression model for predicting IFG/T2DM (diagnosed using fasting glucose). We externally validated the score using data from two cohorts of the EPI-Porto study, cross-sectional (n = 2,131) and data from the 5 year follow-up (n = 1,304).
The final model included age, sex, BMI and hypertension with an area under the ROC curve of 70.1 (95%CI 68.4, 71.7). Using a cut-point which classifies 50% of the EPI-Porto cross-sectional data as high-risk gave sensitivity 73.2% (95%CI 68.5%, 77.6%), specificity 55.5% (53.1%, 57.8%), positive predictive value (PPV) 27.0% (24.3%, 29.8%) and negative predictive value (NPV) 90.2% (88.3%, 92.0%) for IFG/T2DM. Using the same cut-point on the prospective data classified 45% as high-risk; sensitivity 69.1% (63.4%, 74.4%), specificity 63.3% (60.0%, 66.5%), PPV 38.0% (33.9%, 42.4%), and NPV 86.2% (83.3%, 88.8%).
The Portuguese risk score can be used to identify those at high risk of both prevalent undiagnosed and incident IFG/T2DM.
开发并验证一种非侵入性评分系统，用于检测葡萄牙人群中未诊断的空腹血糖受损（IFG）和 2 型糖尿病（T2DM）。
我们使用了来自葡萄牙一项横断面研究的 3374 名 18-94 岁个体的数据。我们建立了一个预测 IFG/T2DM（根据空腹血糖诊断）的逻辑回归模型。我们使用 EPI-Porto 研究的两个队列的数据（横断面研究，n=2131；5 年随访研究，n=1304）对该评分进行了外部验证。
最终模型纳入了年龄、性别、BMI 和高血压，ROC 曲线下面积为 70.1（95%CI 68.4，71.7）。使用将 EPI-Porto 横断面数据的 50%分类为高危的切点，其敏感性为 73.2%（95%CI 68.5%，77.6%），特异性为 55.5%（53.1%，57.8%），阳性预测值（PPV）为 27.0%（24.3%，29.8%），阴性预测值（NPV）为 90.2%（88.3%，92.0%）。在前瞻性数据中使用相同的切点，将 45%分类为高危；敏感性为 69.1%（63.4%，74.4%），特异性为 63.3%（60.0%，66.5%），PPV 为 38.0%（33.9%，42.4%），NPV 为 86.2%（83.3%，88.8%）。
该葡萄牙风险评分可用于识别那些存在未诊断的空腹血糖受损和新发 2 型糖尿病风险较高的人群。
