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. 2013;23(4):295-300.
doi: 10.2188/jea.je20120221. Epub 2013 Jun 15.

Validity of diabetes self-reports in the Saku diabetes study

Atsushi Goto  1 , Akemi Morita, Maki Goto, Satoshi Sasaki, Motohiko Miyachi, Naomi Aiba, Masayuki Kato, Yasuo Terauchi, Mitsuhiko Noda, Shaw Watanabe; Saku Cohort Study Group
Affiliations

Validity of diabetes self-reports in the Saku diabetes study

Atsushi Goto et al. J Epidemiol. 2013.

Abstract
in English, Japanese

Background: Diabetes is an important risk factor for cardiovascular disease, certain types of cancer, and death, and self-reports are one of the most convenient methods for ascertaining diabetes status. We evaluated the validity of diabetes self-reports among Japanese who participated in a health checkup.

Methods: Self-reported diabetes was cross-sectionally compared with confirmed diabetes among 2535 participants aged 28 to 85 years in the Saku cohort study. Confirmed diabetes was defined as the presence of at least 1 of the following: fasting plasma glucose (FPG) level of 126 mg/dL or higher, 2-hour post-load glucose (2-hPG) level of 200 mg/dL or higher after a 75-gram oral glucose tolerance test, glycated hemoglobin (HbA1c) level of 6.5% or higher, or treatment with hypoglycemic medication(s).

Results: Of the 251 participants with self-reported diabetes, 121 were taking hypoglycemic medication(s) and an additional 69 were classified as having diabetes. Of the 2284 participants who did not self-report diabetes, 80 were classified as having diabetes. These data yielded a sensitivity of 70.4%, a specificity of 97.3%, a positive predictive value of 75.7%, and a negative predictive value of 96.5%. The frequency of participants with undiagnosed diabetes was 3.0%. Of these, 64.2% had FPG within the normal range and were diagnosed by 2-hPG and/or HbA1c.

Conclusions: Our findings provide additional support for the use of self-reported diabetes as a measure of diabetes in epidemiologic studies performed in similar settings in Japan if biomarker-based diagnosis is difficult.

背景：: 糖尿病は心血管疾患、一部の癌、死亡の重要なリスク因子とされているが、質問票による糖尿病の自己申告は糖尿病を把握する際の簡便な方法の１つである。本研究は、健康診断を受診した日本人を対象に、糖尿病自己申告の妥当性を検討することを目的とした。

方法：: 対象は佐久コホート研究の参加者2535名(28－85歳)で、糖尿病自己申告の妥当性を横断的に検討した。空腹時血糖値 ≥ 126 mg/dL、75gブドウ糖負荷後2時間血糖値 ≥ 200 mg/dL、HbA1c ≥ 6.5%、血糖降下薬の使用、のいずれかの基準を満たす者を糖尿病と判定した。

結果：: 251名が糖尿病を自己申告していた。そのうち、121名が血糖降下薬を使用しており、69名は血糖降下薬を使用していなかったが、空腹時血糖値、75gブドウ糖負荷後2時間血糖値、HbA1c、のいずれかの基準を満たした。糖尿病を自己申告しなかった2284名のうち、80名が空腹時血糖値、75gブドウ糖負荷後2時間血糖値、HbA1c、のいずれかの基準を満たしたため、糖尿病と判定された。その結果、糖尿病自己申告による感度は70.4%、特異度は97.3%であり、陽性反応的中率は75.7%、陰性反応的中率は96.5%であった。また、未診断糖尿病の割合は3.0%であった。未診断糖尿病の64.2%の対象者は空腹時血糖値が正常域であったが、負荷後2時間血糖値、HbA1c、のいずれか基準を満たしたため糖尿病と判定された。

結論：: 日本人の集団を対象とした疫学研究において、血液検査を施行することが困難な場合、自己申告により糖尿病を把握することを支持する結果であった。

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Figures

Figure.
Figure.. Proportion of participants with undiagnosed diabetes according to fasting plasma glucose, 2-h post-load glucose, and HbA1c (n = 67) levels. Abbreviations: FPG, fasting plasma glucose; 2-hPG, 2-hour post-load glucose.
See this image and copyright information in PMC

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