Heltberg Andreas, Andersen John Sahl, Sandholdt Håkon, Siersma Volkert, Kragstrup Jakob, Ellervik Christina
Section of General Practice, Department of Public Health and Research Unit for General Practice, University of Copenhagen, Denmark.
Section of General Practice, Department of Public Health and Research Unit for General Practice, University of Copenhagen, Denmark.
Prim Care Diabetes. 2018 Feb;12(1):13-22. doi: 10.1016/j.pcd.2017.08.005. Epub 2017 Sep 28.
To investigate how self-reported risk factors (including socioeconomic status) predict undiagnosed, prevalent type 2 diabetes mellitus (T2DM). To externally validate Leicester Risk Assessment Score (LRAS), Finnish Diabetes Risk Score (FINDRISC) and Danish Diabetes Risk Score (DDRS), and to investigate how these predict a European Heart SCORE≥5% in a Danish population study.
We included 21,205 adults from the Danish General Suburban Population Study. We used relative importance calculations of self-reported variables in prediction of undiagnosed T2DM. We externally validated established prediction models reporting ROC-curves for undiagnosed T2DM, pre-diabetes and SCORE.
More than 20% of people with T2DM were undiagnosed. The 7 most important self-rated predictors in sequential order were high BMI, antihypertensive-therapy, age, cardiovascular disease, waist-circumference, fitness compared to peers and family disposition for T2DM. The Area Under the Curve for prediction of undiagnosed T2DM was 77.1 for LRAS; 75.4 for DDRS and 67.9 for FINDRISC. AUCs for SCORE was 75.1 for LRAS; 62.3 for DDRS and 54.3 for FINDRISC.
BMI and self-reported cardiovascular disease are important risk factors for undiagnosed T2DM. LRAS performed better than DDRS and FINDRISC in prediction of undiagnosed T2DM and SCORE≥5%. SCORE performed best in predicting pre-diabetes.
研究自我报告的风险因素（包括社会经济地位）如何预测未诊断出的、普遍存在的2型糖尿病（T2DM）。对外验证莱斯特风险评估评分（LRAS）、芬兰糖尿病风险评分（FINDRISC）和丹麦糖尿病风险评分（DDRS），并在一项丹麦人群研究中研究这些评分如何预测欧洲心脏风险评分（SCORE）≥5%。
我们纳入了来自丹麦一般郊区人群研究的21205名成年人。我们使用自我报告变量的相对重要性计算来预测未诊断出的T2DM。我们对外验证已建立的预测模型，报告未诊断出的T2DM、糖尿病前期和SCORE的ROC曲线。
超过20%的T2DM患者未被诊断出来。按顺序排列的7个最重要的自我评估预测因素是高体重指数、抗高血压治疗、年龄、心血管疾病、腰围、与同龄人相比的健康状况以及T2DM的家族倾向。LRAS预测未诊断出的T2DM的曲线下面积为77.1；DDRS为75.4，FINDRISC为67.9。LRAS预测SCORE的AUC为75.1；DDRS为62.3，FINDRISC为54.3。
体重指数和自我报告的心血管疾病是未诊断出的T2DM的重要风险因素。在预测未诊断出的T2DM和SCORE≥5%方面，LRAS的表现优于DDRS和FINDRISC。SCORE在预测糖尿病前期方面表现最佳。
