Corresponding author: Craig J. Currie,
Diabetes Care. 2014 Feb;37(2):537-45. doi: 10.2337/dc13-1159. Epub 2013 Oct 2.
To evaluate the performance of the UK Prospective Diabetes Study Risk Engine (UKPDS-RE) for predicting the 10-year risk of cardiovascular disease end points in an independent cohort of U.K. patients newly diagnosed with type 2 diabetes.
This was a retrospective cohort study using routine health care data collected between April 1998 and October 2011 from ∼350 U.K. primary care practices contributing to the Clinical Practice Research Datalink (CPRD). Participants comprised 79,966 patients aged between 35 and 85 years (388,269 person-years) with 4,984 cardiovascular events. Four outcomes were evaluated: first diagnosis of coronary heart disease (CHD), stroke, fatal CHD, and fatal stroke.
Accounting for censoring, the observed versus predicted 10-year event rates were as follows: CHD 6.1 vs. 16.5%, fatal CHD 1.9 vs. 10.1%, stroke 7.0 vs. 10.1%, and fatal stroke 1.7 vs. 1.6%, respectively. The UKPDS-RE showed moderate discrimination for all four outcomes, with the concordance index values ranging from 0.65 to 0.78.
The UKPDS stroke equations showed calibration ranging from poor to moderate; however, the CHD equations showed poor calibration and considerably overestimated CHD risk. There is a need for revised risk equations in type 2 diabetes.
评估英国前瞻性糖尿病研究风险引擎（UKPDS-RE）在预测英国新诊断为 2 型糖尿病患者 10 年心血管疾病终点风险方面的性能。
这是一项回顾性队列研究，使用 1998 年 4 月至 2011 年 10 月期间从参与临床实践研究数据链接（CPRD）的约 350 家英国初级保健机构收集的常规医疗保健数据。参与者包括年龄在 35 至 85 岁之间的 79966 名患者（388269 人年），其中有 4984 例心血管事件。评估了以下四个结局：首次诊断为冠心病（CHD）、中风、致命性 CHD 和致命性中风。
考虑到删失，观察到的与预测的 10 年事件发生率如下：CHD 为 6.1%比 16.5%，致命性 CHD 为 1.9%比 10.1%，中风为 7.0%比 10.1%，致命性中风为 1.7%比 1.6%。UKPDS-RE 对所有四个结局均显示出中度区分能力，一致性指数值范围在 0.65 至 0.78 之间。
UKPDS 中风方程的校准范围从差到中等；然而，CHD 方程的校准较差，并且大大高估了 CHD 风险。2 型糖尿病需要修订的风险方程。
