Literature DB >> 24742930

Update of the German Diabetes Risk Score and external validation in the German MONICA/KORA study.

Kristin Mühlenbruch1, Tonia Ludwig2, Charlotte Jeppesen1, Hans-Georg Joost3, Wolfgang Rathmann4, Christine Meisinger2, Annette Peters2, Heiner Boeing5, Barbara Thorand2, Matthias B Schulze6.   

Abstract

AIMS: Several published diabetes prediction models include information about family history of diabetes. The aim of this study was to extend the previously developed German Diabetes Risk Score (GDRS) with family history of diabetes and to validate the updated GDRS in the Multinational MONItoring of trends and determinants in CArdiovascular Diseases (MONICA)/German Cooperative Health Research in the Region of Augsburg (KORA) study.
METHODS: We used data from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study for extending the GDRS, including 21,846 participants. Within 5 years of follow-up 492 participants developed diabetes. The definition of family history included information about the father, the mother and/or sibling/s. Model extension was evaluated by discrimination and reclassification. We updated the calculation of the score and absolute risks. External validation was performed in the MONICA/KORA study comprising 11,940 participants with 315 incident cases after 5 years of follow-up.
RESULTS: The basic ROC-AUC of 0.856 (95%-CI: 0.842-0.870) was improved by 0.007 (0.003-0.011) when parent and sibling history was included in the GDRS. The net reclassification improvement was 0.110 (0.072-0.149), respectively. For the updated score we demonstrated good calibration across all tenths of risk. In MONICA/KORA, the ROC-AUC was 0.837 (0.819-0.855); regarding calibration we saw slight overestimation of absolute risks.
CONCLUSIONS: Inclusion of the number of diabetes-affected parents and sibling history improved the prediction of type 2 diabetes. Therefore, we updated the GDRS algorithm accordingly. Validation in another German cohort study showed good discrimination and acceptable calibration for the vast majority of individuals.
Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Entities:  

Keywords:  Receiver operating characteristic; Reclassification; Risk assessment; Type 2 Diabetes mellitus; Validation study

Mesh:

Substances:

Year:  2014        PMID: 24742930     DOI: 10.1016/j.diabres.2014.03.013

Source DB:  PubMed          Journal:  Diabetes Res Clin Pract        ISSN: 0168-8227            Impact factor:   5.602


  22 in total

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4.  Temporal changes in predicted risk of type 2 diabetes in Germany: findings from the German Health Interview and Examination Surveys 1997-1999 and 2008-2011.

Authors:  Rebecca Paprott; Gert B M Mensink; Matthias B Schulze; Silke Thiele; Kristin Mühlenbruch; Christa Scheidt-Nave; Christin Heidemann
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9.  Validation of the German Diabetes Risk Score among the general adult population: findings from the German Health Interview and Examination Surveys.

Authors:  Rebecca Paprott; Kristin Mühlenbruch; Gert B M Mensink; Silke Thiele; Matthias B Schulze; Christa Scheidt-Nave; Christin Heidemann
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10.  Derivation and external validation of a clinical version of the German Diabetes Risk Score (GDRS) including measures of HbA1c.

Authors:  Kristin Mühlenbruch; Rebecca Paprott; Hans-Georg Joost; Heiner Boeing; Christin Heidemann; Matthias B Schulze
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