Public Health Agency of Canada, Ottawa, Ontario, Canada.
University of Ottawa, Ottawa, Ontario, Canada.
Health Promot Chronic Dis Prev Can. 2017 Apr;37(4):114-122. doi: 10.24095/hpcdp.37.4.02.
The Public Health Agency of Canada adapted a Finnish diabetes screening tool (FINDRISC) to create a tool (CANRISK) tailored to Canada's multi-ethnic population. CANRISK was developed using data collected in seven Canadian provinces. In an effort to extend the applicability of CANRISK to northern territorial populations, we completed a study with the mainly Inuit population in the Kitikmeot region of Nunavut.
We obtained CANRISK questionnaires, physical measures and blood samples from participants in five Nunavut communities in Kitikmeot. We used logistic regression to test model fit using the original CANRISK risk factors for dysglycemia (prediabetes and diabetes). Dysglycemia was assessed using fasting plasma glucose (FPG) alone and/or oral glucose tolerance test. We generated participants' CANRISK scores to test the functioning of this tool in the Inuit population.
A total of 303 individuals participated in the study. Half were aged less than 45 years, two-thirds were female and 84% were Inuit. A total of 18% had prediabetes, and an additional 4% had undiagnosed diabetes. The odds of having dysglycemia rose exponentially with age, while the relationship with BMI was U-shaped. Compared with lab test results, using a cut-off point of 32 the CANRISK tool achieved a sensitivity of 61%, a specificity of 66%, a positive predictive value of 34% and an accuracy rate of 65%.
The CANRISK tool achieved a similar accuracy in detecting dysglycemia in this mainly Inuit population as it did in a multi-ethnic sample of Canadians. We found the CANRISK tool to be adaptable to the Kitikmeot region, and more generally to Nunavut.
加拿大公共卫生局对芬兰的糖尿病筛查工具（FINDRISC）进行了改编，创建了一个针对加拿大多民族人口的工具（CANRISK）。CANRISK 是使用加拿大七个省份收集的数据开发的。为了将 CANRISK 的适用性扩展到北部地区，我们在努纳武特基蒂克美奥特地区的主要因纽特人群中进行了一项研究。
我们从基蒂克美奥特地区的五个努纳武特社区的参与者那里获得了 CANRISK 问卷、身体测量和血液样本。我们使用逻辑回归测试了使用原始 CANRISK 进行血糖异常（糖尿病前期和糖尿病）的风险因素的模型拟合。使用空腹血糖（FPG）单独和/或口服葡萄糖耐量试验评估血糖异常。我们生成了参与者的 CANRISK 评分，以测试该工具在因纽特人群中的功能。
共有 303 人参加了这项研究。其中一半年龄小于 45 岁，三分之二为女性，84%为因纽特人。共有 18%的人患有糖尿病前期，另有 4%的人患有未确诊的糖尿病。血糖异常的几率随年龄呈指数增长，而与 BMI 的关系呈 U 型。与实验室检测结果相比，使用 32 的截断值，CANRISK 工具的灵敏度为 61%，特异性为 66%，阳性预测值为 34%，准确率为 65%。
CANRISK 工具在检测这个主要因纽特人群中的血糖异常方面与在加拿大多民族样本中的准确性相当。我们发现 CANRISK 工具适用于基蒂克美奥特地区，更普遍地适用于努纳武特。
