title: Impact of sex and age on the performance of FINDRISC: the HUNT Study in Norway.
abstract: OBJECTIVE
  The Finnish Diabetes Risk Score (FINDRISC) is recommended as a screening tool for diabetes risk. However, there is a lack of well-powered studies examining the performance of FINDRISC by sex and age. We aim to estimate, by sex and age, the prevalence of elevated FINDRISC and positive predictive value (PPV) of FINDRISC for identifying impaired glucose metabolism (IGM) in a general Norwegian population.
  
  
  METHODS
  We estimated the prevalence of elevated FINDRISC (≥15) among 47 694 adults in the third survey of the Nord-Trøndelag Health Study (HUNT3, 2006-08). Among 2559 participants who participated in oral glucose tolerance testing, we estimated the PPV of elevated FINDRISC for identifying unknown prevalent diabetes and other forms of IGM.
  
  
  RESULTS
  The prevalence of elevated FINDRISC was 12.1% in women, 9.6% in men, and increased from 1.5% at age 20-39 to 25.1% at age 70-79 years. The PPVs of elevated FINDRISC were 9.8% for diabetes, 16.9% for impaired glucose tolerance, 8.2% for impaired fasting glucose, and 34.9% for any form of IGM. The PPV for IGM was lower in women (31.2%) than in men (40.4%), and increased from 19.1% at age 20-39 to 55.5% at age ≥80 years.
  
  
  CONCLUSIONS
  FINDRISC identified more women than men as high-risk individuals for diabetes. FINDRISC had a high PPV for detecting prevalent IGM, and the PPV was higher in men than in women and in the older individuals. Our data indicate that the impact of sex and age on diabetes risk is not fully captured by FINDRISC, and that refinements to it might improve diabetes prediction.
authors.affiliation: Faculty of Medicine, Department of Public Health and General Practice , HUNT Research Centre, NTNU, Norwegian University of Science and Technology , Levanger , Norway.
authors.forename: Anne
authors.identifier: 0000-0001-7048-9719
authors.initials: A
authors.lastname: Jølle
authors.affiliation: Faculty of Medicine, Department of Public Health and General Practice , HUNT Research Centre, NTNU, Norwegian University of Science and Technology , Levanger , Norway.
authors.forename: Kristian
authors.initials: K
authors.lastname: Midthjell
authors.affiliation: Faculty of Medicine, Department of Public Health and General Practice , HUNT Research Centre, NTNU, Norwegian University of Science and Technology , Levanger , Norway.
authors.forename: Jostein
authors.initials: J
authors.lastname: Holmen
authors.affiliation: Dasman Diabetes Insitute, Dasman, Kuwait; Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems an der Donau, Austria; Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland; Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.affiliation: Department of Endocrinology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Unit for Applied Clinical Research, Institute for Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Sven M
authors.initials: SM
authors.lastname: Carlsen
authors.affiliation: Baker IDI, Heart and Diabetes Institute , Melbourne , Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shaw
authors.affiliation: Faculty of Medicine, Department of Public Health and General Practice, HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Levanger, Norway; Department of Endocrinology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Bjørn O
authors.initials: BO
authors.lastname: Åsvold
keywords: Epidemiology; Prediction and Prevention; Sex Difference