[Validation of the German Diabetes Risk Score with metabolic risk factors for type 2 diabetes].
OBJECTIVE
The German Diabetes Risk Score (DRS) was developed at the German Institute of Human Nutrition from data of the European Prospective Investigation into Cancer and Nutrition (EPIC-Potsdam) in order to estimate the 5-year probability of developing type 2 diabetes, based on anthropometric measures and lifestyle as well as diet information. This study evaluated associations between the DRS and metabolic risk factors of type 2 diabetes for the purpose of further validating the risk score.


METHODS
2500 participants of the EPIC-Potsdam study were randomly selected, and glucose, HbA1c, triglycerides, HDL cholesterol, hs-C-reactive protein, and gamma-glutamyltransferase were determined. After exclusion of participants with known diabetes (n = 120), those for whom not all biomarkers could be determined (n = 92) and those with elevated plasma glucose concentrations (random glucose >or= 200 mg/dl or fasting glucose >or= 126 mg/dl, n = 9) or with low plasma glucose concentrations (< 50 mg/dl, n = 38), the data on 2223 participants (839 men and 1384 women) remained for analysis of which 640 (252 men and 388 women) were fasting at the time blood samples had been obtained.


RESULTS
The DRS significantly correlated with all biomarkers (p < 0.001). Pearson correlation coefficients ranged from 0.25 for glucose and 0.45 for triglycerides. While glucose, HbA (1c), triglycerides, hs-CRP and gamma-glutamyltransferase increased with increasing DRS points, HDL cholesterol was inversely associated. The mean concentrations of glucose, HbA (1c) and triglycerides for persons with < 300 DRS points were 83 mg/dl, 6.2 % und 62 mg/dl. In contrast, mean concentrations were 100 mg/dl for glucose, 6,9 % HbA (1c) und 171 mg/dl triglycerides among participants with >or= 700 DRS points. HDL cholesterol was considerably lower (37.6 mg/dl) among participants with >or= 700 DRS points than those with < 300 DRS points (55 mg/dl). There were also considerable differences in biomarker concentrations for hs-CRP and gamma-glutamyltransferase in relation to the DRS. Associations were generally similar for men and women.


CONCLUSIONS
Our data suggest that the DRS allows to detect persons with prediabetes with high sensitivity and specificity. Thus the DRS could be used as a routine medical checkup in programs for the prevention of type 2 diabetes.
Schulze
M B
MB
Abteilung Epidemiologie, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke. matthias.schulze@wzw.tum.de
Boeing
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Häring
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HU
Fritsche
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Joost
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D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis*; D018570:Risk Assessment / Q000592:standards*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014280:Triglycerides / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
D001786:Blood Glucose; D002097:C-Reactive Protein; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D014280:Triglycerides; D005723:gamma-Glutamyltransferase