A simple risk score to identify Southern Chinese at high risk for diabetes.
OBJECTIVE
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 beta 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 > or = 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 > or = 20. Only 10-20 and approximately 5% with a score of > or = 12 and > or = 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.
Ko
G
G
Hong Kong Institute of Diabetes and Obesity, the Chinese University of Hong Kong, Hong Kong SAR, China. gtc_ko@yahoo.com.hk
So
W
W
Tong
P
P
Ma
R
R
Kong
A
A
Ozaki
R
R
Chow
C
C
Cockram
C
C
Chan
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D005951:Glucose Tolerance Test; D006723:Hong Kong / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
D001786:Blood Glucose