Identification of undiagnosed type 2 diabetic individuals by the finnish diabetes risk score and biochemical and genetic markers: a population-based study of 7232 Finnish men.
BACKGROUND
The Finnish Diabetes Risk Score (FINDRISC) is a well established method to evaluate the risk of type 2 diabetes. However, it is unknown whether biochemical markers or confirmed type 2 diabetes risk genes improve the risk evaluation beyond the FINDRISC.


OBJECTIVE
We investigated the role of biochemical markers and type 2 diabetes risk loci in the identification of previously undiagnosed diabetic subjects beyond the FINDRISC in a cross-sectional study.


METHODS
A random sample of 7232 Finnish men aged 45-74 yr (including 518 men with new type 2 diabetes) participated in the study. Insulin sensitivity and insulin secretion were evaluated by oral glucose tolerance test-derived indices. Total triglycerides, high-density lipoprotein cholesterol, adiponectin, and alanine transaminase were measured. Nineteen type 2 diabetes risk single-nucleotide polymorphisms were genotyped.


RESULTS
FINDRISC was the best single indicator of prevalent undiagnosed diabetes among all variables tested and strongly associated with insulin resistance. It was also more strongly associated with insulin secretion compared with the type 2 risk alleles. The receiver operating characteristics area under the curve based on logistic regression models for the identification of previously undiagnosed type 2 diabetic subjects with the FINDRISC alone was 0.727, and 0.772 after adding total triglycerides, high-density lipoprotein cholesterol, adiponectin, and alanine transaminase in the model. Adding type 2 risk alleles did not further improve the model (0.772).


CONCLUSIONS
Biochemical markers, but not genetic markers, improve the identification of previously undiagnosed type 2 diabetes beyond the FINDRISC alone.
Wang
Jianjun
J
Department of Medicine, University of Kuopio and Kuopio University Hospital, 70210 Kuopio, Finland.
Stancáková
Alena
A
Kuusisto
Johanna
J
Laakso
Markku
M
D000368:Aged; D000483:Alleles; D019540:Area Under Curve; D001786:Blood Glucose / Q000235:genetics; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000235:genetics; D005387:Finland; D005819:Genetic Markers; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance / Q000235:genetics*; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011159:Population Surveillance; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors
D001786:Blood Glucose; D005819:Genetic Markers; D008055:Lipids