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Published in: Journal of Endocrinological Investigation 10/2017

01-10-2017 | Original Article

Risk score model of type 2 diabetes prediction for rural Chinese adults: the Rural Deqing Cohort Study

Authors: X. Chen, Z. Wu, Y. Chen, X. Wang, J. Zhu, N. Wang, Q. Jiang, C. Fu

Published in: Journal of Endocrinological Investigation | Issue 10/2017

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Abstract

Objective

Risk score (RS) model is a cost-effective tool to identify adults who are at high risk for diabetes. This study was to develop an RS model of type 2 diabetes (T2DM) prediction specifically for rural Chinese adults.

Methods

A prospective whole cohort study (n = 28,251) and a sub-cohort study (n = 3043) were conducted from 2006–2014 and 2006–2008 to 2015 in rural Deqing, China. All participants were free of T2DM at baseline. Incident T2DM cases were identified through electronic health records, self-reported and fasting plasma glucose testing for the sub-cohort, respectively. RS models were constructed with coefficients (β) of Cox regression. Receiver-operating characteristic curves were plotted and the area under the curve (AUC) reflected the discriminating accuracy of an RS model.

Results

By 2015, the incidence of T2DM was 3.3 and 7.7 per 1000 person-years in the whole cohort and the sub-cohort, respectively. Based on data from the whole cohort, the non-invasive RS model included age (4 points), overweight (2 points), obesity (4 points), family history of T2DM (3 points), meat diet (3 points), and hypertension (2 points). The plus-fasting plasma glucose (FPG) model added impaired fasting glucose (4 points). The AUC was 0.705 with a positive predictive value of 2.5% for the non-invasive model, and for the plus-FPG model the AUC was 0.754 with a positive predictive value of 2.5%. These models performed better as compared with 12 existing RS models for the study population.

Conclusions

Our non-invasive RS model can be used to identify individuals who are at high risk of T2DM as a simple, fast, and cost-effective tool for rural Chinese adults.
Literature
2.
go back to reference Chinese Diabetes Society (2014) China guideline for type 2 diabetes. Chin J Diabetes 22(8):2–42 Chinese Diabetes Society (2014) China guideline for type 2 diabetes. Chin J Diabetes 22(8):2–42
4.
go back to reference Xu Y, Wang L, He J, Bi Y, Li M, Wang T, Wang L, Jiang Y, Dai M, Lu J, Xu M, Li Y, Hu N, Li J, Mi S, Chen CS, Li G, Mu Y, Zhao J, Kong L, Chen J, Lai S, Wang W, Zhao W, Ning G, 2010 China Noncommunicable Disease Surveillance Group (2013) Prevalence and control of diabetes in Chinese adults. JAMA 310(9):948–959. doi:10.1001/jama.2013.168118 CrossRefPubMed Xu Y, Wang L, He J, Bi Y, Li M, Wang T, Wang L, Jiang Y, Dai M, Lu J, Xu M, Li Y, Hu N, Li J, Mi S, Chen CS, Li G, Mu Y, Zhao J, Kong L, Chen J, Lai S, Wang W, Zhao W, Ning G, 2010 China Noncommunicable Disease Surveillance Group (2013) Prevalence and control of diabetes in Chinese adults. JAMA 310(9):948–959. doi:10.​1001/​jama.​2013.​168118 CrossRefPubMed
5.
go back to reference Turner RC, Cull CA, Frighi V, Holman RR (1999) Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. JAMA 281(21):2005–2012CrossRefPubMed Turner RC, Cull CA, Frighi V, Holman RR (1999) Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. JAMA 281(21):2005–2012CrossRefPubMed
6.
go back to reference Gong Q, Gregg EW, Wang J, An Y, Zhang P, Yang W, Li H, Li H, Jiang Y, Shuai Y, Zhang B, Zhang J, Gerzoff RB, Roglic G, Hu Y, Li G, Bennett PH (2011) Long-term effects of a randomised trial of a 6-year lifestyle intervention in impaired glucose tolerance on diabetes-related microvascular complications: the China Da Qing Diabetes Prevention Outcome Study. Diabetologia 54(2):300–307. doi:10.1007/s00125-010-1948-9 CrossRefPubMed Gong Q, Gregg EW, Wang J, An Y, Zhang P, Yang W, Li H, Li H, Jiang Y, Shuai Y, Zhang B, Zhang J, Gerzoff RB, Roglic G, Hu Y, Li G, Bennett PH (2011) Long-term effects of a randomised trial of a 6-year lifestyle intervention in impaired glucose tolerance on diabetes-related microvascular complications: the China Da Qing Diabetes Prevention Outcome Study. Diabetologia 54(2):300–307. doi:10.​1007/​s00125-010-1948-9 CrossRefPubMed
7.
go back to reference Baan CA, Ruige JB, Stolk RP, Witteman JC, Dekker JM, Heine RJ, Feskens EJ (1999) Performance of a predictive model to identify undiagnosed diabetes in a health care setting. Diabetes Care 22(2):213–219CrossRefPubMed Baan CA, Ruige JB, Stolk RP, Witteman JC, Dekker JM, Heine RJ, Feskens EJ (1999) Performance of a predictive model to identify undiagnosed diabetes in a health care setting. Diabetes Care 22(2):213–219CrossRefPubMed
8.
go back to reference Lindstrom J, Tuomilehto J (2003) The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care 26(3):725–731CrossRefPubMed Lindstrom J, Tuomilehto J (2003) The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care 26(3):725–731CrossRefPubMed
9.
go back to reference Park PJ, Griffin SJ, Sargeant L, Wareham NJ (2002) The performance of a risk score in predicting undiagnosed hyperglycemia. Diabetes Care 25(6):984–988CrossRefPubMed Park PJ, Griffin SJ, Sargeant L, Wareham NJ (2002) The performance of a risk score in predicting undiagnosed hyperglycemia. Diabetes Care 25(6):984–988CrossRefPubMed
10.
go back to reference Wilson PW, Meigs JB, Sullivan L, Fox CS, Nathan DM, D’Agostino RB Sr (2007) Prediction of incident diabetes mellitus in middle-aged adults: the Framingham Offspring Study. Arch Intern Med 167(10):1068–1074CrossRefPubMed Wilson PW, Meigs JB, Sullivan L, Fox CS, Nathan DM, D’Agostino RB Sr (2007) Prediction of incident diabetes mellitus in middle-aged adults: the Framingham Offspring Study. Arch Intern Med 167(10):1068–1074CrossRefPubMed
11.
go back to reference Chen L, Magliano DJ, Balkau B, Colagiuri S, Zimmet PZ, Tonkin AM, Mitchell P, Phillips PJ, Shaw JE (2010) AUSDRISK: an Australian Type 2 Diabetes Risk Assessment Tool based on demographic, lifestyle and simple anthropometric measures. Med J Aust 192(4):197–202PubMed Chen L, Magliano DJ, Balkau B, Colagiuri S, Zimmet PZ, Tonkin AM, Mitchell P, Phillips PJ, Shaw JE (2010) AUSDRISK: an Australian Type 2 Diabetes Risk Assessment Tool based on demographic, lifestyle and simple anthropometric measures. Med J Aust 192(4):197–202PubMed
14.
go back to reference Fu CW, Chen Y, Wang F, Wang XC, Wang WB, Zhao GM, Jiang QW (2012) Chronic diseases in adults living in rural communities of China. World Congress on Public Health World Health Organization Fu CW, Chen Y, Wang F, Wang XC, Wang WB, Zhao GM, Jiang QW (2012) Chronic diseases in adults living in rural communities of China. World Congress on Public Health World Health Organization
15.
go back to reference Herman WH, Smith PJ, Thompson TJ, Engelgau MM, Aubert RE (1995) A new and simple questionnaire to identify people at increased risk for undiagnosed diabetes. Diabetes Care 18(3):382–387CrossRefPubMed Herman WH, Smith PJ, Thompson TJ, Engelgau MM, Aubert RE (1995) A new and simple questionnaire to identify people at increased risk for undiagnosed diabetes. Diabetes Care 18(3):382–387CrossRefPubMed
20.
go back to reference Zhou X, Qiao Q, Ji L, Ning F, Yang W, Weng J, Shan Z, Tian H, Ji Q, Lin L, Li Q, Xiao J, Gao W, Pang Z, Sun J (2013) Nonlaboratory-based risk assessment algorithm for undiagnosed type 2 diabetes developed on a nation-wide diabetes survey. Diabetes Care 36(12):3944–3952. doi:10.2337/dc13-0593 CrossRefPubMedPubMedCentral Zhou X, Qiao Q, Ji L, Ning F, Yang W, Weng J, Shan Z, Tian H, Ji Q, Lin L, Li Q, Xiao J, Gao W, Pang Z, Sun J (2013) Nonlaboratory-based risk assessment algorithm for undiagnosed type 2 diabetes developed on a nation-wide diabetes survey. Diabetes Care 36(12):3944–3952. doi:10.​2337/​dc13-0593 CrossRefPubMedPubMedCentral
24.
go back to reference Aekplakorn W, Bunnag P, Woodward M, Sritara P, Cheepudomwit S, Yamwong S, Yipintsoi T, Rajatanavin R (2006) A risk score for predicting incident diabetes in the Thai population. Diabetes Care 29(8):1872–1877CrossRefPubMed Aekplakorn W, Bunnag P, Woodward M, Sritara P, Cheepudomwit S, Yamwong S, Yipintsoi T, Rajatanavin R (2006) A risk score for predicting incident diabetes in the Thai population. Diabetes Care 29(8):1872–1877CrossRefPubMed
25.
go back to reference Glumer C, Vistisen D, Borch-Johnsen K, Colagiuri S, DETECT-2 Collaboration (2006) Risk scores for type 2 diabetes can be applied in some populations but not all. Diabetes Care 29(2):410–414CrossRefPubMed Glumer C, Vistisen D, Borch-Johnsen K, Colagiuri S, DETECT-2 Collaboration (2006) Risk scores for type 2 diabetes can be applied in some populations but not all. Diabetes Care 29(2):410–414CrossRefPubMed
26.
go back to reference Schmidt MI, Duncan BB, Bang H, Pankow JS, Ballantyne CM, Golden SH, Folsom AR, Chambless LE, Atherosclerosis Risk in Communities Investigators (2005) Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study. Diabetes Care 28(8):2013–2018CrossRefPubMed Schmidt MI, Duncan BB, Bang H, Pankow JS, Ballantyne CM, Golden SH, Folsom AR, Chambless LE, Atherosclerosis Risk in Communities Investigators (2005) Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study. Diabetes Care 28(8):2013–2018CrossRefPubMed
27.
go back to reference Nelson KM, Boyko EJ, Third National Health Nutrition Examination Survey (2003) Predicting impaired glucose tolerance using common clinical information: data from the Third National Health and Nutrition Examination Survey. Diabetes Care 26(7):2058–2062CrossRefPubMed Nelson KM, Boyko EJ, Third National Health Nutrition Examination Survey (2003) Predicting impaired glucose tolerance using common clinical information: data from the Third National Health and Nutrition Examination Survey. Diabetes Care 26(7):2058–2062CrossRefPubMed
28.
go back to reference Schulze MB, Hoffmann K, Boeing H, Linseisen J, Rohrmann S, Möhlig M, Pfeiffer AF, Spranger J, Thamer C, Häring HU, Fritsche A, Joost HG (2007) An accurate risk score based on anthropometric, dietary, and lifestyle factors to predict the development of type 2 diabetes. Diabetes Care 30(3):510–515CrossRefPubMed Schulze MB, Hoffmann K, Boeing H, Linseisen J, Rohrmann S, Möhlig M, Pfeiffer AF, Spranger J, Thamer C, Häring HU, Fritsche A, Joost HG (2007) An accurate risk score based on anthropometric, dietary, and lifestyle factors to predict the development of type 2 diabetes. Diabetes Care 30(3):510–515CrossRefPubMed
30.
go back to reference Mohan V, Deepa R, Deepa M, Somannavar S, Datta M (2005) A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India 53:759–763PubMed Mohan V, Deepa R, Deepa M, Somannavar S, Datta M (2005) A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India 53:759–763PubMed
31.
go back to reference Al-Lawati JA, Tuomilehto J (2007) Diabetes risk score in Oman: a tool to identify prevalent type 2 diabetes among Arabs of the Middle East. Diabetes Res Clin Pract 77(3):438–444CrossRefPubMed Al-Lawati JA, Tuomilehto J (2007) Diabetes risk score in Oman: a tool to identify prevalent type 2 diabetes among Arabs of the Middle East. Diabetes Res Clin Pract 77(3):438–444CrossRefPubMed
32.
go back to reference Shai I, Jiang R, Manson JE, Stanpfer MJ, Willett WC, Colditz GA, Hu FB (2006) Ethnicity, obesity, and risk of type 2 diabetes in women: a 20-year follow-up study. Diabetes Care 29(7):1585–1590CrossRefPubMed Shai I, Jiang R, Manson JE, Stanpfer MJ, Willett WC, Colditz GA, Hu FB (2006) Ethnicity, obesity, and risk of type 2 diabetes in women: a 20-year follow-up study. Diabetes Care 29(7):1585–1590CrossRefPubMed
33.
go back to reference Khoo CM, Sairazi S, Taslim S, Gardner D, Wu Y, Lee J, van Dam RM, Shyong Tai E (2011) Ethnicity modifies the relationships of insulin resistance, inflammation, and adiponectin with obesity in a multiethnic Asian population. Diabetes Care 34(5):1120–1126. doi:10.2337/dc10-2097 CrossRefPubMedPubMedCentral Khoo CM, Sairazi S, Taslim S, Gardner D, Wu Y, Lee J, van Dam RM, Shyong Tai E (2011) Ethnicity modifies the relationships of insulin resistance, inflammation, and adiponectin with obesity in a multiethnic Asian population. Diabetes Care 34(5):1120–1126. doi:10.​2337/​dc10-2097 CrossRefPubMedPubMedCentral
Metadata
Title
Risk score model of type 2 diabetes prediction for rural Chinese adults: the Rural Deqing Cohort Study
Authors
X. Chen
Z. Wu
Y. Chen
X. Wang
J. Zhu
N. Wang
Q. Jiang
C. Fu
Publication date
01-10-2017
Publisher
Springer International Publishing
Published in
Journal of Endocrinological Investigation / Issue 10/2017
Electronic ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-017-0680-4

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