Lowe Julia, Ke Calvin, Singh Kavita, Gobin Reeta, Lebovic Gerald, Ostrow Brian
Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Canada.
Chronic Diseases Unit, Ministry of Public Health, Lot 1 Brickdam St., Georgetown, Guyana.
Diabetes Ther. 2020 Apr;11(4):873-883. doi: 10.1007/s13300-020-00775-4. Epub 2020 Feb 18.
We present a new diabetes risk score developed and validated in a multi-ethnic population in Guyana, South America. Measurement of in-country diabetes prevalence is a vital epidemiologic tool to combat the pandemic. It is believed that for every person diagnosed with type 2 diabetes there is another undiagnosed. The International Diabetes Federation (IDF) recommends a two-step detection programme using a risk score questionnaire to identify high-risk individuals followed by glycaemic measure.
Data on 798 persons from the 2016 STEPwise Approach to Chronic Disease Risk Factor Surveillance (STEPS) were used to correlate responses to 36 questions with glycated haemoglobin (HbA1C) and fasting plasma glucose (FPG) results. Bootstrapping was used to internally validate the derived seven-variable model. This model with the addition of family history questions was tested in a convenience sample of 659 Guyanese adults and externally validated in a cohort of another 528.
An 8-item Guyana Diabetes Risk Score (GDRS) was derived. The final model performed with an area under the curve (AUC) of 0.812 CONCLUSIONS: The validated eight-item Guyana Diabetes Risk Score will be extremely useful in identifying individuals at high risk of having diabetes in Caribbean, Black or East Indian populations.
我们展示了一种新的糖尿病风险评分,该评分在南美洲圭亚那的多民族人群中开发并得到验证。测量国内糖尿病患病率是抗击这一流行病的重要流行病学工具。据信,每有一名被诊断出患有2型糖尿病的患者,就有另一名未被诊断出的患者。国际糖尿病联合会(IDF)建议采用两步检测方案,使用风险评分问卷来识别高危个体,随后进行血糖测量。
利用2016年慢性病危险因素监测逐步方法(STEPS)中798人的数据,将对36个问题的回答与糖化血红蛋白(HbA1C)和空腹血糖(FPG)结果进行关联。采用自举法对推导得出的七变量模型进行内部验证。在659名圭亚那成年人的便利样本中测试了这个添加了家族史问题的模型,并在另外528人的队列中进行了外部验证。
得出了一个8项的圭亚那糖尿病风险评分(GDRS)。最终模型的曲线下面积(AUC)为0.812。结论:经过验证的8项圭亚那糖尿病风险评分在识别加勒比、黑人或东印度人群中糖尿病高危个体方面将非常有用。