title: Development of a Weighted Cardiometabolic Disease Staging (CMDS) System for the Prediction of Future Diabetes.
abstract: BACKGROUND
  Metabolic syndrome traits are important risk factors for diabetes; however, each trait has different predictive power for future diabetes. Additionally, the impact of insulin resistance on metabolic profile can differ by gender and racial group, suggesting that gender-race specific prediction algorithms for diabetes may be warranted.
  
  
  OBJECTIVE
  To develop a quantitative scoring system based on weighting of risk components in the cardiometabolic disease staging (CMDS) system for the prediction of future diabetes.
  
  
  METHODS
  We derived the CMDS score in 2857 participants with valid follow-up information on incident diabetes from the Coronary Artery Risk Development in Young Adults study and validated it in 6425 older participants from the Atherosclerosis Risk in Communities study. We assigned a simple integer value for each CMDS risk factor component.
  
  
  METHODS
  Incident diabetes.
  
  
  RESULTS
  Fasting glucose, 2-hour glucose, waist circumference, and blood pressure components contributed similarly for the prediction of future diabetes (CMDS scores, 23, 21, 26, and 20, respectively). The area under the receiver operating characteristic curve was 0.7158 for the CMDS scoring system, whereas it was 0.7053 for the Framingham diabetes score. The CMDS components performed differently for prediction of future diabetes in Black and White men and women. The components with the highest predictive power for diabetes were waist circumference in Black men, 2-hour glucose in Black women, and fasting glucose in both White men and White women.
  
  
  CONCLUSIONS
  The weighted CMDS score has high model discrimination power for diabetes and can be used clinically to identify patients for weight loss therapy based on differential risk for future diabetes.
authors.affiliation: Department of Obstetrics and Gynecology and Center for Interdisciplinary Research in Women's Health (F.G.), The University of Texas Medical Branch, Galveston, Texas 77555; Department of Nutrition Sciences (W.T.G.), University of Alabama at Birmingham, Birmingham, Alabama 35233; and Birmingham Veterans Affairs Medical Center (W.T.G.), Birmingham, Alabama 35233.
authors.forename: Fangjian
authors.initials: F
authors.lastname: Guo
authors.affiliation: Department of Obstetrics and Gynecology and Center for Interdisciplinary Research in Women's Health (F.G.), The University of Texas Medical Branch, Galveston, Texas 77555; Department of Nutrition Sciences (W.T.G.), University of Alabama at Birmingham, Birmingham, Alabama 35233; and Birmingham Veterans Affairs Medical Center (W.T.G.), Birmingham, Alabama 35233.
authors.forename: W Timothy
authors.initials: WT
authors.lastname: Garvey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D055105:Waist Circumference / Q000502:physiology*; D055815:Young Adult
chemical_list: D001786:Blood Glucose