在老年人中使用印度糖尿病风险评分进行糖尿病风险评估：来自印度纵向老龄化研究的二次分析

Risk assessment of diabetes using the Indian Diabetes Risk Score among older adults: Secondary analysis from the Longitudinal Ageing Study in India.

作者信息

Basu Saurav, Maheshwari Vansh, Roy Debolina, Saiyed Mahira, Gokalani Rutul

机构信息

Indian Institute of Public Health - Delhi, Public Health Foundation of India, India.

出版信息

Diabetes Metab Syndr. 2024 May;18(5):103040. doi: 10.1016/j.dsx.2024.103040. Epub 2024 May 16.

DOI:10.1016/j.dsx.2024.103040

PMID:38761608

Abstract

BACKGROUND

The Indian Diabetes Risk Score (IDRS) is a simple tool to assess the probability of an individual having type 2 diabetes (T2DM) but its applicability in community-dwelling older adults is lacking. This study aimed to estimate the risk of T2DM and its determinants among older adults without prior diabetes (DM) using the IDRS, while also assessing its sensitivity and specificity in individuals with a history of diabetes.

METHODS

We analyzed cross-sectional data from the Longitudinal Ageing Study in India (LASI) wave-1 (2017-18). IDRS was calculated amongst individuals aged ≥45 years considering waist circumference, physical activity, age and family history of DM. Risk was categorized as high (≥60), moderate (30-50), and low (<30).

RESULTS

Among 64541 individuals, 7.27 % (95 % CI: 6.78, 7.80) were at low risk, 61.80 % (95 % CI: 60.99, 62.61) at moderate risk, and 30.93 % (95 % CI: 30.19, 31.67) at high risk for T2DM. Adjusted analysis showed higher risk of T2DM among men, widowed/divorced, urban residents, minority religions, overweight, obese, and individuals with hypertension. ROC curve yielded an AUC of 0.67 (95 % CI: 0.66, 0.67, P < 0.001). The IDRS cutoff ≥50 had 73.69 % sensitivity and 51.40 % specificity for T2DM detection.

CONCLUSION

More than 9 in 10 older adults in India without history of DM have high-moderate risk of T2DM when assessed with the IDRS risk-prediction tool. However, the low specificity and moderate sensitivity of IDRS in existing DM cases constraints its practical utility as a decision tool for screening.

摘要

背景

印度糖尿病风险评分（IDRS）是一种评估个体患2型糖尿病（T2DM）概率的简单工具，但缺乏其在社区居住的老年人中的适用性研究。本研究旨在使用IDRS估计无糖尿病（DM）病史的老年人患T2DM的风险及其决定因素，同时评估其在有糖尿病病史个体中的敏感性和特异性。

方法

我们分析了印度纵向老龄化研究（LASI）第1波（2017 - 18年）的横断面数据。在年龄≥45岁的个体中，根据腰围、身体活动、年龄和糖尿病家族史计算IDRS。风险分为高风险（≥60）、中度风险（30 - 50）和低风险（<30）。

结果

在64541名个体中，7.27%（95%CI：6.78，7.80）为低风险，61.80%（95%CI：60.99，62.61）为中度风险，30.93%（95%CI：30.19，31.67）为高风险患T2DM。校正分析显示，男性、丧偶/离婚者、城市居民、少数宗教群体、超重、肥胖以及患有高血压的个体患T2DM的风险更高。ROC曲线得出的AUC为0.67（95%CI：0.66，0.67，P < 0.001）。IDRS临界值≥50时，检测T2DM的敏感性为73.69%，特异性为51.40%。