Utility of existing diabetes risk prediction tools for young black and white adults: Evidence from the Bogalusa Heart Study

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• 作者：Benjamin D. Pollock^a ; ^{bpollock@tulane.edu} ; ^{benpollock@neo.rr.com} ; Tian Hu^a ; Wei Chen^a ; Emily W. Harville^a ; Shengxu Li^a ; Larry S. Webber^b ; Vivian Fonseca^c ; Lydia A. Bazzano^a
• 关键词：Diabetes ; Risk prediction ; Young adults ; Race ; Pre-diabetes
• 刊名：Journal of Diabetes and its Complications
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：31
• 期：1
• 页码：86-93
• 全文大小：488 K
• 卷排序：31

文摘

To evaluate several adult diabetes risk calculation tools for predicting the development of incident diabetes and pre-diabetes in a bi-racial, young adult population.MethodsSurveys beginning in young adulthood (baseline age ≥ 18) and continuing across multiple decades for 2122 participants of the Bogalusa Heart Study were used to test the associations of five well-known adult diabetes risk scores with incident diabetes and pre-diabetes using separate Cox models for each risk score. Racial differences were tested within each model. Predictive utility and discrimination were determined for each risk score using the Net Reclassification Index (NRI) and Harrell's c-statistic.ResultsAll risk scores were strongly associated (p < .0001) with incident diabetes and pre-diabetes. The Wilson model indicated greater risk of diabetes for blacks versus whites with equivalent risk scores (HR = 1.59; 95% CI 1.11–2.28; p = .01). C-statistics for the diabetes risk models ranged from 0.79 to 0.83. Non-event NRIs indicated high specificity (non-event NRIs: 76%–88%), but poor sensitivity (event NRIs: − 23% to − 3%).ConclusionsFive diabetes risk scores established in middle-aged, racially homogenous adult populations are generally applicable to younger adults with good specificity but poor sensitivity. The addition of race to these models did not result in greater predictive capabilities. A more sensitive risk score to predict diabetes in younger adults is needed.