title: Validation of a multi-marker model for the prediction of incident type 2 diabetes mellitus: combined results of the Inter99 and Botnia studies.
abstract: OBJECTIVE
  To assess performance of a biomarker-based score that predicts the five-year risk of diabetes (Diabetes Risk Score, DRS) in an independent cohort that included 15-year follow-up.
  
  
  METHODS
  DRS was developed on the Inter99 cohort, and validated on the Botnia cohort. Performance was benchmarked against other risk-assessment tools comparing calibration, time to event analysis, and net reclassification.
  
  
  RESULTS
  The area under the receiver-operating characteristic curve (AUC) was 0.84 for the Inter99 cohort and 0.78 for the Botnia cohort. In the Botnia cohort, DRS provided better discrimination than fasting plasma glucose (FPG), homeostasis model assessment of insulin resistance, oral glucose tolerance test or risk scores derived from Framingham or San Antonio Study cohorts. Overall reclassification with DRS was significantly better than using FPG and glucose tolerance status (p < 0.0001). In time to event analysis, rates of conversion to diabetes in low, moderate, and high DRS groups were significantly different (p < 0.001).
  
  
  CONCLUSIONS
  This study validates DRS performance in an independent population, and provides a more accurate assessment of T2DM risk than other methods.
authors: Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden.
authors: Valeria
authors: V
authors: Lyssenko
authors: Torben
authors: T
authors: Jørgensen
authors: Robert W
authors: RW
authors: Gerwien
authors: Torben
authors: T
authors: Hansen
authors: Michael W
authors: MW
authors: Rowe
authors: Michael P
authors: MP
authors: McKenna
authors: Janice
authors: J
authors: Kolberg
authors: Oluf
authors: O
authors: Pedersen
authors: Knut
authors: K
authors: Borch-Johnsen
authors: Leif
authors: L
authors: Groop
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D049629:Waist-Hip Ratio
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human