在对南非黑人的非洲糖尿病风险评分和其他既定风险预测模型进行外部验证时,HbA1c 可与空腹血糖相媲美。

IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM BMC Endocrine Disorders Pub Date : 2024-10-10 DOI:10.1186/s12902-024-01735-w
Nicola Royce, Héléne T Cronjé, André P Kengne, Herculina S Kruger, Robin C Dolman-Macleod, Marlien Pieters
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引用次数: 0

摘要

背景:使用非侵入性风险评分检测未确诊的 2 型糖尿病(T2D)可确保将侵入性和昂贵的血液检测限制在最有可能确诊该病的人群中。本研究评估并比较了非洲糖尿病风险评分(ADRS)与其他三种糖尿病风险预测模型的性能,以确定基于空腹血浆葡萄糖(FPG)或糖化血红蛋白(HBA1c)筛查出的糖尿病:方法:使用SA-NW-PURE研究中的年龄、性别、腰围、体重指数、血压、糖尿病史和体力活动水平对ADRS和其他已建立的风险预测模型进行外部验证。使用 C 统计量和非参数方法评估和比较了区分度。使用校准图评估重新校准前后的校准情况:共纳入 937 名参与者;根据 FPG 和 HbA1c,分别有 14% 和 26% 的未确诊 T2D 患者。两种诊断方法的区分度均可接受,且不同模型之间的区分度基本相似。按 FPG 诊断的 C 统计量从简化 FINDRISC 模型的 0.69 到 ADRS 模型的 0.77 不等,按 HbA1c 诊断的 C 统计量从简化 FINDRISC 模型的 0.77 到 ADRS 模型的 0.79 不等。校准结果从可接受到良好不等,但也存在高估和低估的情况。所有模型在重新校准后都有明显改善:这些模型的性能相当,其中 ADRS 提供了一种无创方法,可识别高达 79% 的病例。基于其易用性和性能,建议将 ADRS 用于南非某些黑人群体的 T2D 筛查。作为诊断手段的 HbA1c 也显示出与 FPG 相当的性能。因此,进一步的验证研究有可能将 HbA1c 作为比较的标准。
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HbA1c comparable to fasting glucose in the external validation of the African Diabetes Risk Score and other established risk prediction models in Black South Africans.

Background: The use of non-invasive risk scores to detect undiagnosed type 2 diabetes (T2D) ensures the restriction of invasive and costly blood tests to those most likely to be diagnosed with the disease. This study assessed and compared the performance of the African Diabetes Risk Score (ADRS) with three other diabetes risk prediction models for identifying screen-detected diabetes based on fasting plasma glucose (FPG) or glycated haemoglobin (HBA1c).

Methods: Age, sex, waist circumference, body mass index, blood pressure, history of diabetes and physical activity levels from the SA-NW-PURE study were used to externally validate the ADRS and other established risk prediction models. Discrimination was assessed and compared using C-statistics and nonparametric methods. Calibration was assessed using calibration plots, before and after recalibration.

Results: Nine hundred and thirty-seven participants were included; 14% had prevalent undiagnosed T2D according to FPG and 26% according to HbA1c. Discrimination was acceptable and was mostly similar between models for both diagnostic measures. The C-statistics for diagnosis by FPG ranged from 0.69 for the Simplified FINDRISC model to 0.77 for the ADRS model and 0.77 for the Simplified FINDRISC model to 0.79 for the ADRS model for diagnosis by HbA1c. Calibration ranged from acceptable to good, though over- and underestimation were present. All models improved significantly following recalibration.

Conclusions: The models performed comparably, with the ADRS offering a non-invasive way to identify up to 79% of cases. Based on its ease of use and performance, the ADRS is recommended for screening for T2D in certain Black population groups in South Africa. HbA1c as a means of diagnosis also showed comparable performance with FPG. Therefore, further validation studies can potentially use HbA1c as the standard to compare to.

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来源期刊
BMC Endocrine Disorders
BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
280
审稿时长
>12 weeks
期刊介绍: BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
期刊最新文献
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