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在“PREVIEW:新西兰队列研究”中评估芬兰糖尿病风险评分(FINDRISC)作为超重成年人2型糖尿病筛查工具的效果。

Evaluating FINDRISC as a screening tool for type 2 diabetes among overweight adults in the PREVIEW:NZ cohort.

作者信息

Silvestre Marta Paulino, Jiang Yannan, Volkova Katya, Chisholm Hannah, Lee Wonjoo, Poppitt Sally Diana

机构信息

Human Nutrition Unit, University of Auckland, Auckland, New Zealand; School of Biological Sciences, University of Auckland, Auckland, New Zealand.

Department of Statistics, University of Auckland, Auckland, New Zealand.

出版信息

Prim Care Diabetes. 2017 Dec;11(6):561-569. doi: 10.1016/j.pcd.2017.07.003. Epub 2017 Aug 8.

Abstract

AIMS

This study aimed to evaluate the efficacy of a high (≥12) Finnish diabetes risk (FINDRISC) score in identifying undiagnosed prediabetes and type 2 diabetes (T2D) in an New Zealand population of overweight and obese individuals, across a variety of ethnic groups.

METHODS

We estimated the efficacy of elevated FINDRISC scores in predicting prediabetes and T2D in 424 overweight adults with no prior diagnosis recruited for the PREVention of diabetes through lifestyle Interventions in Europe and Worldwide (PREVIEW) study. All participants who completed the FINDRISC questionnaire during a pre-screening phase with a score of ≥12 were then screened using a 2h oral glucose tolerance test (2h-OGTT) to identify undiagnosed dysglycaemia.

RESULTS

Of the 424 participants, 65% (n=280) were pre-diabetic and 7% (n=32) had undiagnosed T2D. A higher FINDRISC score was significantly associated with prediabetes and T2D (P=0.02). There was a significant association between ethnicity and glycaemic status (normal vs prediabetes/T2D, P=0.02). Increasing the FINDRISC cut-off to ≥15 resulted in a non-significant increase in the proportion of participants correctly classified with dysglycaemia. ROC-AUC=0.6 with sensitivity=0.6026 (95% CI: 0.5459-0.6573) and specificity=0.5536 (95% CI: 0.4567-0.6476). Isolated impaired fasting glucose (IFG) was more efficient in predicting dysglycaemia than isolated impaired glucose tolerance (IGT).

CONCLUSIONS

The FINDRISC questionnaire is a useful and efficacious screening tool to identify unknown prediabetes and T2D in overweight New Zealanders, particularly in Maori individuals.

摘要

目的

本研究旨在评估高(≥12)芬兰糖尿病风险(FINDRISC)评分在新西兰超重和肥胖个体的不同种族群体中识别未诊断的糖尿病前期和2型糖尿病(T2D)的有效性。

方法

我们在欧洲和全球通过生活方式干预预防糖尿病(PREVIEW)研究中招募的424名未预先诊断的超重成年人中,评估升高的FINDRISC评分预测糖尿病前期和T2D的有效性。然后,对在预筛查阶段完成FINDRISC问卷且得分≥12的所有参与者,使用2小时口服葡萄糖耐量试验(2h-OGTT)进行筛查,以识别未诊断的血糖异常。

结果

在424名参与者中,65%(n = 280)为糖尿病前期,7%(n = 32)患有未诊断的T2D。较高的FINDRISC评分与糖尿病前期和T2D显著相关(P = 0.02)。种族与血糖状态(正常与糖尿病前期/T2D)之间存在显著关联(P = 0.02)。将FINDRISC临界值提高到≥15会使正确分类为血糖异常的参与者比例无显著增加。受试者工作特征曲线下面积(ROC-AUC)= 0.6,敏感性= 0.6026(95%置信区间:0.5459 - 0.6573),特异性= 0.5536(95%置信区间:0.4567 - 0.6476)。单纯空腹血糖受损(IFG)在预测血糖异常方面比单纯糖耐量受损(IGT)更有效。

结论

FINDRISC问卷是一种有用且有效的筛查工具,可用于识别新西兰超重人群中未知的糖尿病前期和T2D,尤其是在毛利人群体中。

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