Derivation and external validation of a simple prediction model for the diagnosis of type 2 Diabetes Mellitus in the Brazilian urban population

Autor(es)

Pires de Sousa, Andre Gustavo ^{[1, 2]} ; Pereira, Alexandre Costa ^[1] ; Marquezine, Guilherme Figueiredo ^[1] ; do Nascimento-Neto, Raimundo Marques ^{[3, 4]} ; Freitas, Silvia N. ^[5] ; Nicolato, Roney Luiz de C. ^[5] ; Lins Machado-Coelho, George Luiz ^[5] ; Rodrigues, Sergio L. ^[6] ; Mill, Jose G. ^[6] ; Krieger, Jose Eduardo ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Med, Inst Heart, Lab Genet & Mol Cardiol, BR-05403000 Sao Paulo - Brazil

^[2] Univ Fed Rio Grande do Norte, Dept Clin Med, BR-59072970 Natal, RN - Brazil

^[3] Arterial Hypertens Inst, Belo Horizonte, MG - Brazil

^[4] Univ Fed Ouro Preto, Sch Med, Ouro Preto - Brazil

^[5] Univ Fed Ouro Preto, Dept Pharm, Ouro Preto - Brazil

^[6] Univ Fed Espirito Santo, Dept Physiol Sci, Vitoria - Brazil

• Tipo de documento: Artigo Científico
• Fonte: EUROPEAN JOURNAL OF EPIDEMIOLOGY; v. 24, n. 2, p. 101-109, FEB 2009.
• Citações Web of Science: 28

Resumo

A risk score model was developed based in a population of 1,224 individuals from the general population without known diabetes aging 35 years or more from an urban Brazilian population sample in order to select individuals who should be screened in subsequent testing and improve the efficacy of public health assurance. External validation was performed in a second, independent, population from a different city ascertained through a similar epidemiological protocol. The risk score was developed by multiple logistic regression and model performance and cutoff values were derived from a receiver operating characteristic curve. Model's capacity of predicting fasting blood glucose levels was tested analyzing data from a 5-year follow-up protocol conducted in the general population. Items independently and significantly associated with diabetes were age, BMI and known hypertension. Sensitivity, specificity and proportion of further testing necessary for the best cutoff value were 75.9, 66.9 and 37.2%, respectively. External validation confirmed the model's adequacy (AUC equal to 0.72). Finally, model score was also capable of predicting fasting blood glucose progression in non-diabetic individuals in a 5-year follow-up period. In conclusion, this simple diabetes risk score was able to identify individuals with an increased likelihood of having diabetes and it can be used to stratify subpopulations in which performing of subsequent tests is necessary and probably cost-effective. (AU)

• Processo FAPESP: 07/54138-2 - Papel dos polimorfismos do gene tcf7l2 no desenvolvimento de diabetes mellitus em diferentes populacoes brasileiras.
• Beneficiário: José Eduardo Krieger
• Modalidade de apoio: Auxílio à Pesquisa - Regular