Shifting from glucose diagnosis to the new HbA1c diagnosis reduces the capability of the Finnish Diabetes Risk Score (FINDRISC) to screen for glucose abnormalities within a real-life primary healthcare preventive strategy
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- 作者：Bernardo Costa (1)
Francisco Barrio (1)
Josep L Pi?ol (1)
Joan J Cabré (1)
Xavier Mundet (1)
Ramon Sagarra (1)
Jordi Salas-Salvadó (2) (3)
Oriol Solà-Morales (4) - 关键词：Type 2 diabetes ; screening ; impaired fasting glucose ; impaired glucose tolerance ; pre ; diabetes ; FINDRISC ; primary healthcare
- 刊名：BMC Medicine
- 出版年：2013
- 出版时间：December 2013
- 年：2013
- 卷：11
- 期：1
- 全文大小：486KB
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26. Costa B, Barrio F, Cabré JJ, Pi?ol JL, Cos X, Solé C, Bolibar B, Castell C, Lindstr?m J, Barengo N, Tuomilehto J, DE-PLAN-CAT Research Group: Shifting from glucose diagnostic criteria to the new HbA1c criteria would have a profound impact on prevalence of diabetes among a high-risk Spanish population. / Diabet Med 2011, 28:1234-237. href="http://dx.doi.org/10.1111/j.1464-5491.2011.03304.x">CrossRef
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28. The pre-publication history for this paper can be accessed here:href="http://www.biomedcentral.com/1741-7015/11/45/prepub" class="a-plus-plus">http://www.biomedcentral.com/1741-7015/11/45/prepub - 作者单位：Bernardo Costa (1)
Francisco Barrio (1)
Josep L Pi?ol (1)
Joan J Cabré (1)
Xavier Mundet (1)
Ramon Sagarra (1)
Jordi Salas-Salvadó (2) (3)
Oriol Solà-Morales (4)
1. Primary Health Care Division, Jordi Gol Primary Care Research Institute, Reus-Tarragona Diabetes Research Group, Catalan Health Institute, Camí de Riudoms 53-55, 43202, Reus, Spain
2. Human Nutrition Unit, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Institute, Rovira i Virgili University, Sant Lloren? 21, 43201, Reus, Spain
3. CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Monforte de Lemos 5, 28029, Madrid, Spain
4. Pere Virgili Health Research Institute, Health Institute Technology Transfer, Tarragona-Barcelona, Sant Lloren? 21, 43201, Reus, Spain
文摘
Background To investigate differences in the performance of the Finnish Diabetes Risk Score (FINDRISC) as a screening tool for glucose abnormalities after shifting from glucose-based diagnostic criteria to the proposed new hemoglobin (Hb)A1c-based criteria. Methods A cross-sectional primary-care study was conducted as the first part of an active real-life lifestyle intervention to prevent type 2 diabetes within a high-risk Spanish Mediterranean population. Individuals without diabetes aged 45-75 years (n = 3,120) were screened using the FINDRISC. Where feasible, a subsequent 2-hour oral glucose tolerance test and HbA1c test were also carried out (n = 1,712). The performance of the risk score was calculated by applying the area under the curve (AUC) for the receiver operating characteristic, using three sets of criteria (2-hour glucose, fasting glucose, HbA1c) and three diagnostic categories (normal, pre-diabetes, diabetes). Results Defining diabetes by a single HbA1c measurement resulted in a significantly lower diabetes prevalence (3.6%) compared with diabetes defined by 2-hour plasma glucose (9.2%), but was not significantly lower than that obtained using fasting plasma glucose (3.1%). The FINDRISC at a cut-off of 14 had a reasonably high ability to predict diabetes using the diagnostic criteria of 2-hour or fasting glucose (AUC = 0.71) or all glucose abnormalities (AUC = 0.67 and 0.69, respectively). When HbA1c was used as the primary diagnostic criterion, the AUC for diabetes detection dropped to 0.67 (5.6% reduction in comparison with either 2-hour or fasting glucose) and fell to 0.55 for detection of all glucose abnormalities (17.9% and 20.3% reduction, respectively), with a relevant decrease in sensitivity of the risk score. Conclusions A shift from glucose-based diagnosis to HbA1c-based diagnosis substantially reduces the ability of the FINDRISC to screen for glucose abnormalities when applied in this real-life primary-care preventive strategy.