Identifying individuals at high risk for diabetes

The Atherosclerosis Risk in Communities study

Maria Inès Schmidt, Bruce B. Duncan, Heejung Bang, James S. Pankow, Christie M. Ballantyne, Sherita Hill Golden, Aaron R. Folsom, Lloyd E. Chambless

Research output: Contribution to journalArticle

Abstract

OBJECTIVE - To develop and evaluate clinical rules to predict risk for diabetes in middle-aged adults. RESEARCH DESIGN AND METHODS - The Atherosclerosis Risk in Communities is a cohort study conducted from 1987-1989 to 1996-1998. We studied 7,915 participants 45-64 years of age, free of diabetes at baseline, and ascertained 1,292 incident cases of diabetes by clinical diagnosis or oral glucose tolerance testing. RESULTS - We derived risk functions to predict diabetes using logistic regression in a random half of the sample. Rules based on these risk functions were evaluated in the other half. A risk function based on waist, height, hypertension, blood pressure, family history of diabetes, ethnicity, and age was performed similarly to one based on fasting glucose (area under the receiver-operating characteristic curve [AUC] 0.71 and 0.74, respectively; P = 0.2). Risk functions composed of the clinical variables plus fasting glucose (AUC 0.78) and additionally including triglycerides and HDL cholesterol (AUC 0.80) performed better (P <0.001). Evaluation of scores based on the metabolic syndrome as defined by the National Cholesterol Education Program or with slight variations showed AUCs of 0.75 and 0.78, respectively. Rules based on all these approaches, while identifying 20-56% of the sample as screen positive, achieved sensitivities of 40-87% and specificities of 50-86%. CONCLUSIONS - Rules derived from clinical information, alone or combined with simple laboratory measures, can characterize degrees of diabetes risk in middle-aged adults, permitting preventive actions of appropriate intensity. Rules based on the metabolic syndrome are reasonable alternatives to rules derived from risk functions.

Original languageEnglish (US)
Pages (from-to)2013-2018
Number of pages6
JournalDiabetes Care
Volume28
Issue number8
DOIs
StatePublished - Aug 2005

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Atherosclerosis
Area Under Curve
Fasting
Glucose
Glucose Tolerance Test
ROC Curve
HDL Cholesterol
Triglycerides
Cohort Studies
Research Design
Logistic Models
Cholesterol
Blood Pressure
Hypertension
Education

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Schmidt, M. I., Duncan, B. B., Bang, H., Pankow, J. S., Ballantyne, C. M., Golden, S. H., ... Chambless, L. E. (2005). Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study. Diabetes Care, 28(8), 2013-2018. https://doi.org/10.2337/diacare.28.8.2013

Identifying individuals at high risk for diabetes : The Atherosclerosis Risk in Communities study. / Schmidt, Maria Inès; Duncan, Bruce B.; Bang, Heejung; Pankow, James S.; Ballantyne, Christie M.; Golden, Sherita Hill; Folsom, Aaron R.; Chambless, Lloyd E.

In: Diabetes Care, Vol. 28, No. 8, 08.2005, p. 2013-2018.

Research output: Contribution to journalArticle

Schmidt, MI, Duncan, BB, Bang, H, Pankow, JS, Ballantyne, CM, Golden, SH, Folsom, AR & Chambless, LE 2005, 'Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study', Diabetes Care, vol. 28, no. 8, pp. 2013-2018. https://doi.org/10.2337/diacare.28.8.2013
Schmidt, Maria Inès ; Duncan, Bruce B. ; Bang, Heejung ; Pankow, James S. ; Ballantyne, Christie M. ; Golden, Sherita Hill ; Folsom, Aaron R. ; Chambless, Lloyd E. / Identifying individuals at high risk for diabetes : The Atherosclerosis Risk in Communities study. In: Diabetes Care. 2005 ; Vol. 28, No. 8. pp. 2013-2018.
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