Gina Agarwal1, Ying Jiang2, Susan Rogers Van Katwyk2, Chantal Lemieux2,3, Heather Orpana2,3, Yang Mao2, Brandan Hanley4, Karen Davis5, Laurel Leuschen5, Howard Morrison2. 1. Departments of Family Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. 2. Public Health Agency of Canada, Ottawa, Ontario, Canada. 3. School of Psychology, University of Ottawa, Ottawa, Ontario, Canada. 4. Yukon Health and Social Services, Whitehorse, Yukon, Canada. 5. Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.
Abstract
INTRODUCTION: First Nations/Métis populations develop diabetes earlier and at higher rates than other Canadians. The Canadian diabetes risk questionnaire (CANRISK) was developed as a diabetes screening tool for Canadians aged 40 years or over. The primary aim of this paper is to assess the effectiveness of the existing CANRISK tool and risk scores in detecting dysglycemia in First Nations/Métis participants, including among those under the age of 40. A secondary aim was to determine whether alternative waist circumference (WC) and body mass index (BMI) cut-off points improved the predictive ability of logistic regression models using CANRISK variables to predict dysglycemia. METHODS: Information from a self-administered CANRISK questionnaire, anthropometric measurements, and results of a standard oral glucose tolerance test (OGTT) were collected from First Nations and Métis participants (n = 1479). Sensitivity and specificity of CANRISK scores using published risk score cut-off points were calculated. Logistic regression was conducted with alternative ethnicity-specific BMI and WC cut-off points to predict dysglycemia using CANRISK variables. RESULTS: Compared with OGTT results, using a CANRISK score cut-off point of 33, the sensitivity and specificity of CANRISK was 68% and 63% among individuals aged 40 or over; it was 27% and 87%, respectively among those under 40. Using a lower cut-off point of 21, the sensitivity for individuals under 40 improved to 77% with a specificity of 44%. Though specificity at this threshold was low, the higher level of sensitivity reflects the importance of the identification of high risk individuals in this population. Despite altered cut-off points of BMI and WC, logistic regression models demonstrated similar predictive ability. CONCLUSION: CANRISK functioned well as a preliminary step for diabetes screening in a broad age range of First Nations and Métis in Canada, with an adjusted CANRISK cutoff point for individuals under 40, and with no incremental improvement from using alternative BMI/WC cut-off points.
INTRODUCTION: First Nations/Métis populations develop diabetes earlier and at higher rates than other Canadians. The Canadian diabetes risk questionnaire (CANRISK) was developed as a diabetes screening tool for Canadians aged 40 years or over. The primary aim of this paper is to assess the effectiveness of the existing CANRISK tool and risk scores in detecting dysglycemia in First Nations/Métis participants, including among those under the age of 40. A secondary aim was to determine whether alternative waist circumference (WC) and body mass index (BMI) cut-off points improved the predictive ability of logistic regression models using CANRISK variables to predict dysglycemia. METHODS: Information from a self-administered CANRISK questionnaire, anthropometric measurements, and results of a standard oral glucose tolerance test (OGTT) were collected from First Nations and Métis participants (n = 1479). Sensitivity and specificity of CANRISK scores using published risk score cut-off points were calculated. Logistic regression was conducted with alternative ethnicity-specific BMI and WC cut-off points to predict dysglycemia using CANRISK variables. RESULTS: Compared with OGTT results, using a CANRISK score cut-off point of 33, the sensitivity and specificity of CANRISK was 68% and 63% among individuals aged 40 or over; it was 27% and 87%, respectively among those under 40. Using a lower cut-off point of 21, the sensitivity for individuals under 40 improved to 77% with a specificity of 44%. Though specificity at this threshold was low, the higher level of sensitivity reflects the importance of the identification of high risk individuals in this population. Despite altered cut-off points of BMI and WC, logistic regression models demonstrated similar predictive ability. CONCLUSION: CANRISK functioned well as a preliminary step for diabetes screening in a broad age range of First Nations and Métis in Canada, with an adjusted CANRISK cutoff point for individuals under 40, and with no incremental improvement from using alternative BMI/WC cut-off points.
Entities:
Keywords:
CANRISK; First Nations and Métis; Type 2 Diabetes; screening; sensitivity; specificity
Authors: Fahad Razak; Sonia S Anand; Harry Shannon; Vladimir Vuksan; Bonnie Davis; Ruby Jacobs; Koon K Teo; Matthew McQueen; Salim Yusuf Journal: Circulation Date: 2007-04-09 Impact factor: 29.690
Authors: Adrian J Cameron; Richard A Sicree; Paul Z Zimmet; K George M M Alberti; Andrew M Tonkin; Beverley Balkau; Jaakko Tuomilehto; Pierrot Chitson; Jonathan E Shaw Journal: Obesity (Silver Spring) Date: 2009-12-17 Impact factor: 5.002
Authors: Sylvia H Ley; Robert A Hegele; Stewart B Harris; Mary Mamakeesick; Henian Cao; Philip W Connelly; Joel Gittelsohn; Ravi Retnakaran; Bernard Zinman; Anthony J Hanley Journal: BMC Med Genet Date: 2011-01-05 Impact factor: 2.103