A simple tool detected diabetes and prediabetes in rural Chinese.

OBJECTIVE To develop and evaluate a simple tool, using data collected in a rural Chinese general practice, to identify those at high risk of Type 2 diabetes (T2DM) and prediabetes (PDM). STUDY DESIGN AND SETTING A total of 2,261 rural Chinese participants without known diabetes were used to derive and validate the models of T2DM and T2DM plus PDM. Logistic regression and classification tree analysis were used to build models. RESULTS The significant risk factors included in the logistic regression method were age, body mass index, waist/hip ratio (WHR), duration of hypertension, family history of diabetes, and history of hypertension for T2DM and T2DM plus PDM. In the classification tree analysis, WHR and duration of hypertension were the most important determining factors in the T2DM and T2DM plus PDM model. The sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic area for detecting T2DM were 74.6%, 71.6%, 23.6%, 96.0%, and 0.731, respectively. For PDM plus T2DM, the results were 65.3%, 72.5%, 33.2%, 90.7%, and 0.689, respectively. CONCLUSION The classification tree model is a simple and accurate tool to identify those at high risk of T2DM and PDM. Central obesity strongly associates with T2DM in rural Chinese.

[1]  Bendix Carstensen,et al.  A Danish diabetes risk score for targeted screening: the Inter99 study. , 2004, Diabetes care.

[2]  J Tuomilehto,et al.  Prevalence of Type 2 diabetes in urban and rural Chinese populations in Qingdao, China , 2005, Diabetic medicine : a journal of the British Diabetic Association.

[3]  Ambady Ramachandran,et al.  Temporal changes in prevalence of diabetes and impaired glucose tolerance associated with lifestyle transition occurring in the rural population in India , 2004, Diabetologia.

[4]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[5]  K. Ge,et al.  Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China , 2007, International Journal of Obesity.

[6]  K. Reynolds,et al.  Prevalence of diabetes and impaired fasting glucose in the Chinese adult population: International Collaborative Study of Cardiovascular Disease in Asia (InterASIA) , 2003, Diabetologia.

[7]  C. Snehalatha,et al.  The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1) , 2006, Diabetologia.

[8]  Erik Johansson,et al.  On the selection of the training set in environmental QSAR analysis when compounds are clustered , 2000 .

[9]  S. Haffner,et al.  Identification of Persons at High Risk for Type 2 Diabetes Mellitus: Do We Need the Oral Glucose Tolerance Test? , 2002, Annals of Internal Medicine.

[10]  Edward J Boyko,et al.  Comparison of a clinical model, the oral glucose tolerance test, and fasting glucose for prediction of type 2 diabetes risk in Japanese Americans. , 2003, Diabetes care.

[11]  Zhou Bei‐Fan Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut‐off points of body mass index and waist circumference in Chinese adults , 2002 .

[12]  Imran Kurt,et al.  Analysis of intervariable relationships between major risk factors in the development of coronary artery disease: a classification tree approach. , 2007, Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology.

[13]  Nicholas J Wareham,et al.  Should we screen for type 2 diabetes? Evaluation against National Screening Committee criteria , 2001, BMJ : British Medical Journal.

[14]  T. Valle,et al.  Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. , 2001, The New England journal of medicine.

[15]  Heejung Bang,et al.  Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study. , 2005, Diabetes care.

[16]  S. Colagiuri,et al.  Can a screening programme for diabetes be applied to another population? , 2005, Diabetic medicine : a journal of the British Diabetic Association.

[17]  W. Jia,et al.  Prediction of abdominal visceral obesity from body mass index, waist circumference and waist-hip ratio in Chinese adults: receiver operating characteristic curves analysis. , 2003, Biomedical and environmental sciences : BES.

[18]  N. Wareham,et al.  Derivation and validation of diabetes risk score for urban Asian Indians. , 2005, Diabetes research and clinical practice.

[19]  D. Hu,et al.  Body mass index and the prevalence of prehypertension and hypertension in a Chinese rural population. , 2008, Internal medicine.

[20]  David M. Eddy,et al.  Diabetes Risk Calculator , 2008, Diabetes Care.

[21]  Jaakko Tuomilehto,et al.  The diabetes risk score: a practical tool to predict type 2 diabetes risk. , 2003, Diabetes care.