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在资源有限环境下未诊断2型糖尿病简易风险评分的开发与验证

Development and Validation of a Simple Risk Score for Undiagnosed Type 2 Diabetes in a Resource-Constrained Setting.

作者信息

Bernabe-Ortiz Antonio, Smeeth Liam, Gilman Robert H, Sanchez-Abanto Jose R, Checkley William, Miranda J Jaime, Study Group Cronicas Cohort

机构信息

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

出版信息

J Diabetes Res. 2016;2016:8790235. doi: 10.1155/2016/8790235. Epub 2016 Sep 4.

Abstract

. To develop and validate a risk score for detecting cases of undiagnosed diabetes in a resource-constrained country. . Two population-based studies in Peruvian population aged ≥35 years were used in the analysis: the ENINBSC survey ( = 2,472) and the CRONICAS Cohort Study ( = 2,945). Fasting plasma glucose ≥7.0 mmol/L was used to diagnose diabetes in both studies. Coefficients for risk score were derived from the ENINBSC data and then the performance was validated using both baseline and follow-up data of the CRONICAS Cohort Study. . The prevalence of undiagnosed diabetes was 2.0% in the ENINBSC survey and 2.9% in the CRONICAS Cohort Study. Predictors of undiagnosed diabetes were age, diabetes in first-degree relatives, and waist circumference. Score values ranged from 0 to 4, with an optimal cutoff ≥2 and had a moderate performance when applied in the CRONICAS baseline data (AUC = 0.68; 95% CI: 0.62-0.73; sensitivity 70%; specificity 59%). When predicting incident cases, the AUC was 0.66 (95% CI: 0.61-0.71), with a sensitivity of 69% and specificity of 59%. . A simple nonblood based risk score based on age, diabetes in first-degree relatives, and waist circumference can be used as a simple screening tool for undiagnosed and incident cases of diabetes in Peru.

摘要

在资源有限的国家开发并验证用于检测未诊断糖尿病病例的风险评分。在分析中使用了两项针对秘鲁≥35岁人群的基于人群的研究:ENINBSC调查(n = 2472)和CRONICAS队列研究(n = 2945)。两项研究均使用空腹血糖≥7.0 mmol/L来诊断糖尿病。风险评分的系数源自ENINBSC数据,然后使用CRONICAS队列研究的基线和随访数据对其性能进行验证。在ENINBSC调查中未诊断糖尿病的患病率为2.0%,在CRONICAS队列研究中为2.9%。未诊断糖尿病的预测因素为年龄、一级亲属患糖尿病情况和腰围。评分值范围为0至4,最佳临界值≥2,应用于CRONICAS基线数据时表现中等(AUC = 0.68;95% CI:0.62 - 0.73;敏感性70%;特异性59%)。预测新发病例时,AUC为0.66(95% CI:0.61 - 0.71),敏感性为69%,特异性为59%。基于年龄、一级亲属患糖尿病情况和腰围的简单非血液风险评分可作为秘鲁未诊断和新发糖尿病病例的简单筛查工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bd0/5027039/563a67ff1819/JDR2016-8790235.001.jpg

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