Abstract:

Objective      To evaluate the effect of the type 2 diabetes risk score (Score) on screening for asymptomatic diabetes and its covariate factors, such as age and gender, by establishing a receiver operating characteristic (ROC) curve model.  Methods    The data from a cross-sectional survey of 4070 subjects who underwent oral glucose tolerance tests (OGTT) for type 2 diabetes screening in the Qingdao Diabetes Prevention Program in 2006 were analyzed. All the subjects filled out the Score designed for the program at the same time. Sensitivity, specificity, and the area under the ROC curve (AUC) of the Score for asymptomatic diabetes screening was calculated. Then the Score was transformed into an ordered variable, and it was used as the dependent variable, and developing diabetes or not, age and/or gender and their interaction as the independent variables to fit an ordered logistic regression model. The AUC was calculated through the model and the influence of the covariates, age or/and gender, on the screening effect of the Score was evaluated.  Results    Sensitivity, specificity and AUC of the Score for asymptomatic diabetes screening were 0.62, 0.62 and 0.67, respectively. The influence of age on the screening effect of the Score was greater in the young age group than that in the old age group, and the influence of gender was greater in women than in men. So the Score had a better effect on screening for asymptomatic diabetes in the young women group.  Conclusion     The Score is a simple and effective tool for screening for asymptomatic type 2 diabetes. In order to achieve a better screening effect,  covariate factors, age and gender should be considered, when developing and conducting the diabetes risk score for population screening.

Key words: Type 2 diabetes; Risk score; Gender; Age; Covariates; Receiver operating characteristic curve model