Development and validation of stroke risk equation for Hong Kong Chinese patients with type 2 diabetes - The Hong Kong Diabetes Registry
Development and validation of stroke risk equation for Hong Kong Chinese patients with type 2 diabetes - The Hong Kong Diabetes Registry
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DOI：
10.2337/dc06-1273
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发表时间：
2007-01-01
期刊：
影响因子：
16.2
通讯作者：
Chan, Juliana C. N.
中科院分区：
文献类型：
--
作者：
Yang, Xilin;So, Wing-Yee;Chan, Juliana C. N.
研究设计和方法-共分析了7，209例基线时无卒中史的香港中国2型糖尿病患者。将数据随机平均分为训练子样本和测试子样本。在训练中，使用子样本逐步考克斯模型来建立风险方程。英国的验证在测试数据集中使用前瞻性糖尿病研究（UKPDS）卒中风险引擎和当前卒中方程，使用寿命表法检查校准，受试者工作特征曲线（aROC）下的面积被用来检查歧视。结果-共有372例患者发生中风的中位数为5.37年年龄、A1 C、尿白蛋白/肌酐比值（ACR）、冠心病史是独立的预测因素。UKPDS冲程发动机的性能在我们的队列中是次优的。由这四个预测因子定义的新开发的风险方程在测试子样本中具有足够的性能。当前公式预测的无卒中概率在观察概率的95% CI内。预测5年内卒中的aROC为0.77。风险评分计算如下：0.0634 X年龄（岁）+ 0.0897 X A1 C + 0.5314 X log（10）（ACR）（mg/mmol）+ 0.5636 X CHD病史（如果是，则为1）。5年卒中概率的计算公式为：1 - 0.9707（EXP（风险评分-4.5674）。）结论：虽然风险方程在中国2型糖尿病患者中表现相当好，但在其他人群中还需要外部验证。
OBJECTIVE - We'sought to develop stroke risk equations for Chinese patients with type 2 diabetes in Hong Kong.RESEARCH DESIGN AND METHODS - A total of 7,209 Hong Kong Chinese type 2 diabetic patients without a history of stroke at baseline were analyzed. The data were randomly and evenly divided into the training subsample and the test subsample. In the training, subsample, stepwise Cox models were used to develop the risk equation. Validation of the U.K. Prospective Diabetes Study (UKPDS) stroke risk engine and the current stroke equation was performed in the test dataset, The life-table method was used to check calibration, and the area under the receiver operating characteristic curve (aROC) was used to check discrimination.RESULTS - A total of 372 patients developed incident stroke during a median of 5.37 years (interquartile range 2.88-7.78) of follow-up, Age, A1C, spot urine albumin-to-creatinine ratio (ACR), and history of coronary heart disease (CHD) were independent predictors. The performance of the UKPDS stroke engine was suboptimal in our cohort. The newly developed risk equation defined by these four predictors had adequate performance in the test subsample. The predicted stroke-free probability by the current equation was within the 95% CI of the observed probability. The aROC was 0.77 for predicting stroke within 5 years. The risk score was computed as follows: 0.0634 X age (years) + 0.0897 X A1C + 0.5314 X log(10) (ACR) (mg/mmol) + 0.5636 X history of CHD (1 if yes). The 5-year stroke probability can be calculated by: 1 - 0.9707(EXP (Risk Score - 4.5674).)CONCLUSIONS - Although the risk equation performed reasonably well in Chinese type 2 diabetic patients, external validation is required in other populations.