Bozorgmanesh Mohammadreza, Hadaegh Farzad, Azizi Fereidoun
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran 1985717413, Iran.
Endocrine Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran 1985717413, Iran.
ISRN Family Med. 2012 Dec 2;2013:541091. doi: 10.5402/2013/541091. eCollection 2013.
Aims. To provide a yardstick for physicians/patients to efficiently communicate/measure incident diabetes risk. Methods. We included data on 5,960 (3,438 women) diabetes-free adults, aged ≥20 years at baseline who either developed diabetes during two consecutive examinations or completed the followup. Age, systolic blood pressure, family history of diabetes, waist-to-height ratio (WHtR), triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDLD-C), and fasting plasma glucose (FPG) were introduced into an accelerated failure time regression model. Results. Annual diabetes incidence rate was 0.85/1000-person (95% CIs 0.77-0.94). Point-score-system incorporated age (1 point for >65 years), family history of diabetes (4 points), systolic blood pressure (-1 to 3 points), WHtR (-4 to 6 points), TG/HDL-C (1 point for ≥1.5), and FPG (0 to 27 points). Harrell's C statistic = 0.830 (95% CIs 0.808-0.852) and Hosmer-Lemeshow χ (2) = 9.7 (P for lack of fitness = 0.462) indicated good discrimination and calibration. We defined beta-cell age as chronological age of a person with the same predicted risk but all risk factors at the normal levels (i.e., WHtR 0.50, no family history of diabetes, Ln (TG/HDL-C) = 0.531, and FPG = 4.9 (mmol·L(-1))). Conclusion. Hereby, we have made it also possible to estimate wide ranges of "beta-cell age" for most chronological ages to assist clinician with risk communication.
目的。为医生/患者提供一个用于有效沟通/衡量糖尿病发病风险的标准。方法。我们纳入了5960名（3438名女性）无糖尿病的成年人的数据，这些人在基线时年龄≥20岁，他们在连续两次检查期间要么患上糖尿病，要么完成随访。将年龄、收缩压、糖尿病家族史、腰高比（WHtR）、甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）以及空腹血糖（FPG）纳入加速失效时间回归模型。结果。糖尿病年发病率为0.85/1000人（95%置信区间0.77 - 0.94）。积分系统纳入年龄（>65岁得1分）、糖尿病家族史（4分）、收缩压（-1至3分）、WHtR（-4至6分）、TG/HDL-C（≥1.5得1分）以及FPG（0至27分）。Harrell's C统计量 = 0.830（95%置信区间0.808 - 0.852）以及Hosmer-Lemeshow χ² = 9.7（拟合不足的P值 = 0.462）表明具有良好的区分度和校准度。我们将β细胞年龄定义为具有相同预测风险但所有风险因素处于正常水平（即WHtR 0.50、无糖尿病家族史、Ln(TG/HDL-C) = 0.531以及FPG = 4.9(mmol·L⁻¹)）的人的实际年龄。结论。据此，我们还能够为大多数实际年龄估计广泛范围的“β细胞年龄”，以协助临床医生进行风险沟通。
