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. 2007 Sep-Oct;5(5):425-9.
doi: 10.1370/afm.705.

Assessing risk for development of diabetes in young adults

Arch G Mainous 3rd  1 , Vanessa A Diaz, Charles J Everett
Affiliations

Assessing risk for development of diabetes in young adults

Arch G Mainous 3rd et al. Ann Fam Med. 2007 Sep-Oct.

Abstract

Purpose: The prevalence of diabetes is increasing to epidemic levels. A multivariable risk score for the development of diabetes has been shown to be predictive for middle-aged adults; however, it is unclear how well it performs in a younger adult population. The purpose of this study was to evaluate a preexisting multivariable risk score for the development of diabetes in a young adult cohort.

Methods: We analyzed the Coronary Artery Risk Development in Young Adults (CARDIA), a population-based observational study of participants aged 18 to 30 years recruited in 1985-1986. We observed individuals without diabetes at baseline for 10 years for the development of diabetes (n = 2,543). We computed receiver operating characteristic (ROC) curves for a diabetes risk score composed of the following 6 variables: elevated blood pressure, low high-density lipoprotein cholesterol levels, high triglyceride levels, body mass index, large waist circumference, and hyperglycemia.

Results: The area under the ROC curve was .70 in this population, which was less than the .78 previously found among middle-aged adults. BMI alone (.67) was not significantly different from the risk score. Blacks (.72; 95% CI, .69-.74) and whites (.68; 95% CI, .66-.71) do not significantly differ in the area under the ROC curve for the risk score; however, the area under the ROC curve for BMI is significantly larger for blacks (.69; 95% CI, .66-.72) than for whites (.63; 95% CI, .60-.65).

Conclusion: An established risk score for the development of diabetes among middle-aged persons has limited utility in a younger population. Future research needs to focus on identifying novel factors that may improve the risk stratification for diabetes development among young adults.

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