Use of the FHTHWA Index as a Novel Approach for Predicting the Incidence of Diabetes in a Japanese Population Without Diabetes: Data Analysis Study.

Abstract

Background: Many tools have been developed to predict the risk of diabetes in a population without diabetes; however, these tools have shortcomings that include the omission of race, inclusion of variables that are not readily available to patients, and low sensitivity or specificity.

Objective: We aimed to develop and validate an easy, systematic index for predicting diabetes risk in the Asian population.

Methods: We collected the data from the NAGALA (NAfld [nonalcoholic fatty liver disease] in the Gifu Area, Longitudinal Analysis) database. The least absolute shrinkage and selection operator model was used to select potentially relevant features. Multiple Cox proportional hazard analysis was used to develop a model based on the training set.

Results: The final study population of 15464 participants had a mean age of 42 (range 18-79) years; 54.5% (8430) were men. The mean follow-up duration was 6.05 (SD 3.78) years. A total of 373 (2.41%) participants showed progression to diabetes during the follow-up period. Then, we established a novel parameter (the FHTHWA index), to evaluate the incidence of diabetes in a population without diabetes, comprising 6 parameters based on the training set. After multivariable adjustment, individuals in tertile 3 had a significantly higher rate of diabetes compared with those in tertile 1 (hazard ratio 32.141, 95% CI 11.545-89.476). Time receiver operating characteristic curve analyses showed that the FHTHWA index had high accuracy, with the area under the curve value being around 0.9 during the more than 12 years of follow-up.

Conclusions: This research successfully developed a diabetes risk assessment index tailored for the Japanese population by utilizing an extensive dataset and a wide range of indices. By categorizing the diabetes risk levels among Japanese individuals, this study offers a novel predictive tool for identifying potential patients, while also delivering valuable insights into diabetes prevention strategies for the healthy Japanese populace.