Development of a new risk score for incident type 2 diabetes using updated diagnostic criteria in middle-aged and older chinese

Abstract

Type 2 diabetes mellitus (T2DM) reaches an epidemic proportion among adults in China. However, no simple score has been created for the prediction of T2DM incidence diagnosed by updated criteria with hemoglobin A1c (HbA1c) ≥ 6.5% included in Chinese. In a 6-year follow-up cohort in Beijing and Shanghai, China, we recruited a total of 2529 adults aged 50-70 years in 2005 and followed them up in 2011. Fasting plasma glucose (FPG), HbA1c, and C-reactive protein (CRP) were measured and incident diabetes was identified by the recently updated criteria. Of the 1912 participants without T2DM at baseline, 924 were identified as having T2DM at follow-up, and most of them (72.4%) were diagnosed using the HbA1c criterion. Baseline body mass index, FPG, HbA1c, CRP, hypertension, and female gender were all significantly associated with incident T2DM. Based upon these risk factors, a simple score was developed with an estimated area under the receiver operating characteristic curve of 0.714 (95% confidence interval: 0.691, 0.737), which performed better than most of existing risk score models developed for eastern Asian populations. This simple, newly constructed score of six parameters may be useful in predicting T2DM in middle-aged and older Chinese.

Figure 1. Receiver Operating Characteristic Curves for Various Models Applied to the Study Population in the 6-Year Follow-Up Cohort in Beijing and Shanghai, China, 2005–2011.

Red, this study (area under the curve [AUC]: 0.714); Blue, Heianza (AUC: 0.701); Orange, Lim (AUC: 0.689); Gray, Sun (AUC: 0.678); Purple, Chien (AUC: 0.665); Green, Chuang (AUC: 0.661); Pink, Liu (AUC: 0.634); Brown, Doi (AUC: 0.631); Black, reference (AUC: 0.500).