芬兰糖尿病风险评分（FINDRISC）和改良亚洲 FINDRISC（ModAsian FINDRISC）在初级保健中筛查未诊断的 2 型糖尿病和糖调节受损的性能。
Performance of the Finnish Diabetes Risk Score (FINDRISC) and Modified Asian FINDRISC (ModAsian FINDRISC) for screening of undiagnosed type 2 diabetes mellitus and dysglycaemia in primary care.
机构信息
Department of Primary Care Medicine, University Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia.
Department of Primary Care Medicine, University Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia; Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Selangor, Malaysia.
出版信息
Prim Care Diabetes. 2020 Oct;14(5):494-500. doi: 10.1016/j.pcd.2020.02.008. Epub 2020 Mar 7.
AIMS
To evaluate the performance of FINDRISC and ModAsian FINDRISC for the screening of undiagnosed diabetes and dysglycaemia in primary care. To compare the performance of FINDRISC with the recommendations of the American Diabetes Association (ADA) and US Preventive Services Task Force (USPSTF) guidelines.
METHODS
This cross-sectional study was carried out on 293 patients without a prior history of diabetes at a primary care clinic in Malaysia. Questions on body mass index and waist circumference were modified based on the Asian standard in ModAsian FINDRISC. Haemoglobin A1c of ≥6.5% (48 mmol/mol) was used to diagnose diabetes. Areas under the receiver operating curve (ROC-AUC) for FINDRISC and ModAsian FINDRISC were analyzed.
RESULTS
The prevalence of undiagnosed diabetes was 7.5% and prediabetes was 32.8%. The ROC-AUC of FINDRISC was 0.76 (undiagnosed diabetes) and 0.79 (dysglycaemia). There was no statistical difference between FINDRISC and ModAsian FINDRISC. The recommended optimal FINDRISC cut-off point for undiagnosed diabetes was ≥11 (Sensitivity 86.4%, Specificity 48.7%). FINDRISC ≥11 point has higher sensitivity compared to USPSTF criteria (72.7%) and higher specificity compared to the ADA (9.6%).
CONCLUSIONS
FINDRISC is a useful diabetes screening tool to identify those at risk of diabetes in primary care in Malaysia.
目的
评估 FINDRISC 和 ModAsian FINDRISC 在初级保健中筛查未确诊糖尿病和糖调节受损的性能。比较 FINDRISC 的性能与美国糖尿病协会（ADA）和美国预防服务工作组（USPSTF）指南的建议。
方法
本横断面研究在马来西亚一家初级保健诊所对 293 名无糖尿病既往史的患者进行了研究。基于 ModAsian FINDRISC 中的亚洲标准，对体重指数和腰围的问题进行了修改。血红蛋白 A1c 为≥6.5%（48mmol/mol）用于诊断糖尿病。分析 FINDRISC 和 ModAsian FINDRISC 的受试者工作特征曲线（ROC-AUC）下面积。
结果
未确诊糖尿病的患病率为 7.5%，前期糖尿病的患病率为 32.8%。FINDRISC 的 ROC-AUC 为 0.76（未确诊糖尿病）和 0.79（糖调节受损）。FINDRISC 和 ModAsian FINDRISC 之间没有统计学差异。推荐的 FINDRISC 最佳截断值为≥11 用于诊断未确诊糖尿病（敏感性 86.4%，特异性 48.7%）。与 USPSTF 标准（72.7%）相比，FINDRISC≥11 点具有更高的敏感性，与 ADA（9.6%）相比具有更高的特异性。
结论
FINDRISC 是一种在马来西亚初级保健中识别糖尿病高危人群的有用的糖尿病筛查工具。
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