Balkau et al reported models for the risk of a female being diagnosed with diabetes in the future. These can help to identify a patient who should be screened more closely. The authors are from multiple institutions in France participating in the DESIR study.
Patient selection: French adultfemale
Parameters:
(1) diabetes in the family
(2) waist circumference in cm
(3) body mass index in kg per sq meter
(4) hypertension (blood pressure >= 140/90 OR on drugs for hypertension)
(5) fasting glucose in mmol/L
(6) serum triglycerides in mmol/L
(7) number of deleterious alleles in TCF7L2 and IL6
Parameter |
Finding |
Clinical Only |
Clinical + Lab |
All |
family history |
no |
0 |
0 |
0 |
|
yes |
1.09 |
0.80 |
0.75 |
waist circum |
|
0.095 * WC |
NA |
NA |
BMI |
|
NA |
4.38*LN(BMI) |
4.69*LN(BMI) |
hypertension |
no |
0 |
NA |
NA |
|
yes |
0.64 |
NA |
NA |
glucose |
|
NA |
9.66*LN(Glu) |
9.35*LN(Glu) |
serum TG |
|
NA |
0.95*LN(TG) |
0.86*LN(TG) |
number alleles |
|
NA |
NA |
0.36 * (count) |
where:
• Glucose and GGT are reported to be log-transformed.
• The coefficient as published for BMI and fasting glucose results in higher-than-expected values. More reasonable values can be obtained if one assumes that the beta-coefficient was published with a misplaced decimal point.
value of X for clinical model =
= SUM(beta-coefficients) - 11.81
value of X for clinical plus laboratory model =
= SUM(beta-coefficients) - 18.91
value of X for clinical plus laboratory plus genetic model =
= SUM(beta-coefficients) - 20.43
probability of diabetes over the next 9 years=
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is claimed to be 0.84 for the clinical only, 0.92 for the clinical plus laboratory, and 0.91 for all of the parameters.
Specialty: Endocrinology