title: A risk score to predict type 2 diabetes mellitus in an elderly Spanish Mediterranean population at high cardiovascular risk.
abstract: BACKGROUND
  To develop and test a diabetes risk score to predict incident diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk.
  
  
  METHODS
  A diabetes risk score was derived from a subset of 1381 nondiabetic individuals from three centres of the PREDIMED study (derivation sample). Multivariate Cox regression model ß-coefficients were used to weigh each risk factor. PREDIMED-personal Score included body-mass-index, smoking status, family history of type 2 diabetes, alcohol consumption and hypertension as categorical variables; PREDIMED-clinical Score included also high blood glucose. We tested the predictive capability of these scores in the DE-PLAN-CAT cohort (validation sample). The discrimination of Finnish Diabetes Risk Score (FINDRISC), German Diabetes Risk Score (GDRS) and our scores was assessed with the area under curve (AUC).
  
  
  RESULTS
  The PREDIMED-clinical Score varied from 0 to 14 points. In the subset of the PREDIMED study, 155 individuals developed diabetes during the 4.75-years follow-up. The PREDIMED-clinical score at a cutoff of ≥6 had sensitivity of 72.2%, and specificity of 72.5%, whereas AUC was 0.78. The AUC of the PREDIMED-clinical Score was 0.66 in the validation sample (sensitivity = 85.4%; specificity = 26.6%), and was significantly higher than the FINDRISC and the GDRS in both the derivation and validation samples.
  
  
  CONCLUSIONS
  We identified classical risk factors for diabetes and developed the PREDIMED-clinical Score to determine those individuals at high risk of developing diabetes in elderly individuals at high cardiovascular risk. The predictive capability of the PREDIMED-clinical Score was significantly higher than the FINDRISC and GDRS, and also used fewer items in the questionnaire.
authors.affiliation: Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Guasch-Ferré
authors.forename: Mònica
authors.initials: M
authors.lastname: Bulló
authors.forename: Bernardo
authors.initials: B
authors.lastname: Costa
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Martínez-Gonzalez
authors.forename: Núria
authors.initials: N
authors.lastname: Ibarrola-Jurado
authors.forename: Ramon
authors.initials: R
authors.lastname: Estruch
authors.forename: Francisco
authors.initials: F
authors.lastname: Barrio
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology