title: A competing-risk-based score for predicting twenty-year risk of incident diabetes: the Beijing Longitudinal Study of Ageing study.
abstract: Few risk tools have been proposed to quantify the long-term risk of diabetes among middle-aged and elderly individuals in China. The present study aimed to develop a risk tool to estimate the 20-year risk of developing diabetes while incorporating competing risks. A three-stage stratification random-clustering sampling procedure was conducted to ensure the representativeness of the Beijing elderly. We prospectively followed 1857 community residents aged 55 years and above who were free of diabetes at baseline examination. Sub-distribution hazards models were used to adjust for the competing risks of non-diabetes death. The cumulative incidence function of twenty-year diabetes event rates was 11.60% after adjusting for the competing risks of non-diabetes death. Age, body mass index, fasting plasma glucose, health status, and physical activity were selected to form the score. The area under the ROC curve (AUC) was 0.76 (95% Confidence Interval: 0.72-0.80), and the optimism-corrected AUC was 0.78 (95% Confidence Interval: 0.69-0.87) after internal validation by bootstrapping. The calibration plot showed that the actual diabetes risk was similar to the predicted risk. The cut-off value of the risk score was 19 points, marking mark the difference between low-risk and high-risk patients, which exhibited a sensitivity of 0.74 and specificity of 0.65.
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Xiangtong
authors.initials: X
authors.lastname: Liu
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, 6, Tiantanxili, Beijing, 100050, China.
authors.forename: Zhenghong
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Biostatistics, University of North Carolina, Chapel Hill, 46200, NC, U.S.A.|Department of Statistics &Operations Research, University of North Carolina, Chapel Hill, 319200, NC, U.S.A.
authors.forename: Jason Peter
authors.initials: JP
authors.lastname: Fine
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Long
authors.initials: L
authors.lastname: Liu
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Anxin
authors.initials: A
authors.lastname: Wang
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Guo
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Tao
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Gehendra
authors.initials: G
authors.lastname: Mahara
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Yang
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Sijia
authors.initials: S
authors.lastname: Tian
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Haibin
authors.initials: H
authors.lastname: Li
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Kuo
authors.initials: K
authors.lastname: Liu
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Luo
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Beijing Geriatric Clinical and Research Center, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Tang
authors.affiliation: School of Public Health, Capital Medical University, Beijing 100069, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Guo
mesh_terms: D000368:Aged; D000375:Aging; D000068476:Beijing / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods* / Q000706:statistics & numerical data; D012307:Risk Factors
chemical_list: D001786:Blood Glucose