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Research Article| Volume 197, 110571, March 2023

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Development and validation of risk prediction models for new-onset type 2 diabetes in adults with impaired fasting glucose

  • Author Footnotes
    1 Contributed equally as first authors.
    Manqi Zheng
    Footnotes
    1 Contributed equally as first authors.
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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  • Author Footnotes
    1 Contributed equally as first authors.
    Shouling Wu
    Footnotes
    1 Contributed equally as first authors.
    Affiliations
    Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
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  • Author Footnotes
    1 Contributed equally as first authors.
    Shuohua Chen
    Footnotes
    1 Contributed equally as first authors.
    Affiliations
    Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
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  • Xiaoyu Zhang
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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  • Yingting Zuo
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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  • Chao Tong
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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  • Haibin Li
    Affiliations
    Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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  • Changwei Li
    Affiliations
    Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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  • Xinghua Yang
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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  • Lijuan Wu
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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  • Anxin Wang
    Correspondence
    Corresponding authors at: No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing 100069, China (D. Zheng). No.119 South 4th Ring West Road, Fengtai District, Beijing 100070, China (A. Wang).
    Affiliations
    China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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  • Deqiang Zheng
    Correspondence
    Corresponding authors at: No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing 100069, China (D. Zheng). No.119 South 4th Ring West Road, Fengtai District, Beijing 100070, China (A. Wang).
    Affiliations
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Lund University, Lund, Sweden
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  • Author Footnotes
    1 Contributed equally as first authors.
Published:February 06, 2023DOI:https://doi.org/10.1016/j.diabres.2023.110571

      Abstract

      Aims

      To develop and validate sex-specific risk prediction models based on easily obtainable clinical data for predicting 5-year risk of type 2 diabetes (T2D) among individuals with impaired fasting glucose (IFG), and generate practical tools for public use.

      Methods

      The data used for model training and internal validation came from a large prospective cohort (N = 18,384). Two independent cohorts were used for external validation. A two-step approach was applied to screen variables. Coefficient-based models were constructed by multivariate Cox regression analyses, and score-based models were subsequently generated. The predictive power was evaluated by the area under the curve (AUC).

      Results

      During a median follow-up of 7.55 years, 5697 new-onset T2D cases were identified. Predictor variables included age, body mass index, waist circumference, diastolic blood pressure, triglycerides, fasting plasma glucose, and fatty liver. The proposed models outperformed five existing models. In internal validation, the AUCs of the coefficient-based models were 0.741 (95% CI 0.723–0.760) for men and 0.762 (95% CI 0.720–0.802) for women. External validation yielded comparable prediction performance. We finally constructed a risk scoring system and a web calculator.

      Conclusions

      The risk prediction models and derived tools had well-validated performance to predict the 5-year risk of T2D in IFG adults.

      Keywords

      Abbreviations:

      ADA (American Diabetes Association), DBP (diastolic blood pressure), FPG (fasting plasma glucose), IFG (impaired fasting glucose), LASSO (least absolute shrinkage and selection operator), ROC (receiver operating characteristic), RP-IFG (type 2 diabetes Risk Prediction in a Chinese population with IFG), RS-IFG (type 2 diabetes Risk Score in a Chinese population with IFG), SBP (systolic blood pressure), WC (waist circumference)
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