A simple risk score to identify Southern Chinese at high risk for diabetes

• Published in: Diabetic medicine Vol. 27; no. 6; pp. 644 - 649
• Main Authors: Ko, G., So, W., Tong, P., Ma, R., Kong, A., Ozaki, R., Chow, C., Cockram, C., Chan, J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-06-2010; Blackwell
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Asian; Asian Continental Ancestry Group - ethnology; Biological and medical sciences; Blood Glucose - analysis; diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - ethnology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Glucose Tolerance Test; Hong Kong - epidemiology; Hong Kong - ethnology; Humans; Male; Mass Screening; Medical sciences; Middle Aged; oral glucose tolerance test; Predictive Value of Tests; Regression Analysis; Risk Assessment; Risk Factors; screening; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Young Adult; Asia; China; Hong Kong; Endocrinopathy; Obesity; High risk; screening; Asiatic; oral glucose tolerance test; Nutrition; Diabetes mellitus; Nutrition disorder; Oral administration; South; Metabolic diseases; Glucose tolerance test; Risk analysis; Medical screening; Asian; Chinese; diabetes; Endocrinology; Nutritional status
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2010.02993.x

Diabet. Med. 27, 644–649 (2010)
Aims  To develop a simple scoring system for identifying Southern Chinese at risk of diabetes.
Methods  The score was derived from a risk factor matching cohort for Type 2 diabetes in Hong Kong Chinese (cohort 1, 2448 subjects without a history of diabetes; age, mean ± sd 37.2 ± 8.9 years, median 36.0 years; 1649 had risk factors for diabetes and 799 were age‐matched control subjects from the community). Two other cohorts were used to validate the risk score (cohort 2, 3734 subjects with risk factors for diabetes; and cohort 3, 1513 participants of a community diabetes survey). All subjects had a 75 g oral glucose tolerance test (OGTT).
Results  In cohort 1, 270 (11%) of the subjects were found to have diabetes on OGTT. A risk score system was derived using the β values of the corresponding predictors in the logistic regression analysis. The area under the curve (95% confidence intervals) of the score system was 0.735 (0.705, 0.765). The application of a risk score of ≥ 16 increased the detection rate 2.5–4 times in all three cohorts. A high post‐test probability of diabetes of > 60% was derived from a risk score of ≥ 20. Only 10–20 and ∼5% with a score of ≥ 12 and ≥ 16, respectively, are indicated for OGTT. This will considerably improve the yield of OGTT screening.
Conclusions  A simple risk score identifies young‐to‐middle‐aged Southern Chinese at high risk for diabetes. Subjects with a score of 16 or above (out of 30) should undergo OGTT for definitive diagnosis of diabetes.