Article Text
Abstract
Background Currently available tools for identifying individuals at high risk of type 2 diabetes can be invasive, costly and time consuming. This study aims to develop and validate a self-assessment tool for identifying individuals at high risk of type 2 diabetes in the Chinese general population.
Methods A cross-sectional survey was conducted from 2000 to 2001 in a nationally representative sample of 15 540 Chinese adults aged 35–74 years. The diabetes risk level (DRL) was assessed by classification and regression tree (CART) analysis using four predictors: age, body mass index, waist–hip ratio (WHR) and waist circumference (WC).
Results The significant predictors for type 2 diabetes were WHR and age for women and WC and age for men. The categories generated by CART analysis stratified women into eight DRL and men into five DRL. The prevalence of type 2 diabetes increased with the increase in DRL in both women and men. A DRL of 6 or greater predicted type 2 diabetes status with a sensitivity of 0.61 (95% CI 0.55 to 0.67), a specificity of 0.71 (95% CI 0.70 to 0.73) in women, and a DRL of 3 or greater predicted type 2 diabetes status with a sensitivity of 0.59 (95% CI 0.52 to 0.65) and a specificity of 0.63 (95% CI 0.62 to 0.65) in men.
Conclusions This study demonstrates that application of the DRL has identified a substantial proportion of individuals with type 2 diabetes in the Chinese general population. It suggests that there is a great potential for applying the self-assessment tool in healthcare-limited settings.
- diabetes risk level
- predictor
- type 2 diabetes
- AUC, area under the receiver operating characteristics curve
- CART, classification and regression tree
- DRL, diabetes risk level
- NPV, negative predictive value
- PPV, positive predictive value
- WHR, waist-hip ratio
- WC, waist circumference
Statistics from Altmetric.com
Footnotes
Funding The InterASIA study was funded by a contractual agreement between Tulane University, Los Angeles, USA, and Pfizer Inc, New York, USA. Several researchers employed by Pfizer Inc were members of the study steering committee that designed the study. However, the study was conducted, analysed and interpreted by the investigators independently of the sponsor.
Competing Interests None.
Ethics approval The InterASIA study was approved by the Institutional Review Board at the Tulane University Health Sciences Center and the ethics committee and other relevant regulatory bodies in China.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.