title: Assessing risk for development of diabetes in young adults.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Family Medicine, Medical University of South Carolina, Charleston, SC.
authors: Arch G
authors: AG
authors: Mainous
authors: Vanessa A
authors: VA
authors: Diaz
authors: Charles J
authors: CJ
authors: Everett
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D044469:Racial Groups; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity