[芬兰糖尿病风险评分问卷对成人胰岛素抵抗的诊断效能]
[Diagnostic performance of the FINDRISC questionnaire to identify insulin resistance in adults].
作者信息
Varela-Vega Yuline, Roy-García Ivonne Analí, Pérez-Rodríguez Marcela, Velázquez-López Lubia
机构信息
Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 28, Servicio de Consulta Externa. Ciudad de México, México.
Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Coordinación de Investigación en Salud, División de Investigación Clínica. Ciudad de México, México.
出版信息
Rev Med Inst Mex Seguro Soc. 2023 Jan 2;61(1):33-41.
BACKGROUND
Insulin resistance (IR) is a state prior to the development of type 2 diabetes (T2D) and it is reversible with lifestyle modification. However, it is underdiagnosed due to the difficulty in its measurement.
OBJECTIVE
To evaluate the diagnostic performance of the FINDRISC questionnaire to identify IR.
MATERIAL AND METHODS
An analytical cross-sectional study was performed in adults aged 20 to 60 years without previous diagnosis of T2D. Those using steroids and pregnant women were excluded. IR was diagnosed through the Triglycerides/glucose index. A ROC curve was used to establish the cut-off point for the diagnosis of IR. Sensitivity, specificity, predictive values and likelihood ratios were calculated. Risk measurement for IR was performed with the FINDRISC instrument.
RESULTS
A total of 253 participants were included, with a prevalence of IR of 60.8%. The area under the curve of the FINDRISC instrument was 0.813 (95% confidence interval [95% CI] 0.759-0.865), with a cut-off point of 8. Sensitivity was 94.8% and specificity was 48.5%, positive predictive value was 74% and negative 86%, with a positive likelihood ratio of 1.84 and a negative of 0.11.
CONCLUSIONS
The FINDRISC instrument is a useful screening tool to identify subjects with IR at the first level of care. A score ≥ 8 identifies subjects with IR.
背景
胰岛素抵抗（IR）是2型糖尿病（T2D）发生之前的一种状态，可通过生活方式改变而逆转。然而，由于其测量困难，目前诊断不足。
目的
评估芬兰糖尿病风险评分（FINDRISC）问卷识别胰岛素抵抗的诊断性能。
材料与方法
对20至60岁、既往未诊断为T2D的成年人进行了一项分析性横断面研究。排除使用类固醇的患者和孕妇。通过甘油三酯/血糖指数诊断胰岛素抵抗。采用ROC曲线确定胰岛素抵抗诊断的切点。计算敏感性、特异性、预测值和似然比。使用FINDRISC工具进行胰岛素抵抗的风险评估。
结果
共纳入253名参与者，胰岛素抵抗患病率为60.8%。FINDRISC工具的曲线下面积为0.813（95%置信区间[95%CI]0.759 - 0.865），切点为8。敏感性为94.8%，特异性为48.5%，阳性预测值为74%，阴性预测值为86%，阳性似然比为1.84，阴性似然比为0.11。
结论
FINDRISC工具是在一级护理中识别胰岛素抵抗患者的有用筛查工具。评分≥8可识别胰岛素抵抗患者。
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