2007/05/28 by Peter W. F. Wilson, Peter W.F. Wilson, James B Meigs +4 · 32 citations
Medicine · #Diabetes, Cardiovascular Risks, and Lipoproteins #Adipokines, Inflammation, and Metabolic Diseases #Diet and metabolism studies
paper · doi:10.1001/archinte.167.10.1068
Methods: We estimated the 7-year risk of T2DM in middle-aged participants who had an oral glucose tolerance test at baseline. There were 160 cases of new T2DM, and regression models were used to predict new T2DM, starting with characteristics known to the subject (personal model, ie, age, sex, parental history of diabetes, and body mass index [calculated as the weight in kilograms divided by height in meters squared]), adding simple clinical measurements that included metabolic syndrome traits (simple clinical model), and, finally, assessing complex clinical models that included (1) 2-hour post–oral glucose tolerance test glucose, fasting insulin, and C-reactive protein levels; (2) the Gutt insulin sensitivity index; or (3) the homeostasis model insulin resistance and the homeostasis model insulin resistance -cell sensitivity indexes. Discrimination was assessed with area under the receiver operating characteristic curves (AROCs). Results: The personal model variables, except sex, were statisticallysignificantpredictorsofT2DM(AROC,0.72). In the simple clinical model, parental history of diabetes andobesityremainedsignificantpredictors,alongwithhypertension, low levels of high-density lipoprotein cholesterol,elevatedtriglyceridelevels,andimpairedfastingglucose findings but not a large waist circumference (AROC, 0.85). Complex clinical models showed no further improvement in model discriminations (AROC, 0.8500.854)andwerenotsuperiortothesimpleclinicalmodel. Conclusion: Parental diabetes, obesity, and metabolic syndrometraitseffectivelypredictT2DMriskinamiddleaged white population sample and were used to develop a simple T2DM prediction algorithm to estimate risk of new T2DM during a 7-year follow-up interval. Arch Intern Med. 2007;167:1068-1074