UKPDS 60 - Risk of stroke in type 2 diabetes estimated by the UK Prospective Diabetes Study risk engine
UKPDS 60 - Risk of stroke in type 2 diabetes estimated by the UK Prospective Diabetes Study risk engine
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DOI：
10.1161/01.str.0000020091.07144.c7
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发表时间：
2002-07-01
期刊：
影响因子：
8.3
通讯作者：
Holman, RR
中科院分区：
文献类型：
--
作者：
Kothari, V;Stevens, RJ;Holman, RR
背景和目的——与非糖尿病患者相比，2 型糖尿病患者发生中风的风险更高。在早期的工作中已经研究了相对风险，但是没有现成的方法可以预测糖尿病个体中风的绝对风险。我们使用参加英国前瞻性糖尿病研究的 4549 名新诊断的 2 型糖尿病患者的数据开发了数学模型来估计首次中风的风险。方法 - 在 30700 人年的随访期间，发生了 188 例首次中风（其中 52 例死亡）。使用牛顿-拉夫森方法通过最大似然估计进行模型拟合。诊断图用于比较模型计算的生存概率与使用非参数方法计算的生存概率。结果-最终模型中包含的变量包括糖尿病病程、年龄、性别、吸烟、收缩压、总胆固醇与高密度脂蛋白胆固醇的比率以及心房颤动的存在。模型中不包括体重指数、血红蛋白、种族和戒烟状况。该模型的使用通过假设的研究功效计算来说明。结论——该模型使用常规临床实践中容易获得的变量来预测 2 型糖尿病患者首次中风的绝对风险。
Background and Purpose-People with type 2 diabetes are at elevated risk of stroke compared with those without diabetes. Relative risks have been examined in earlier work, but there is no readily available method for predicting the absolute risk of stroke in a diabetic individual. We developed mathematical models to estimate the risk of a first stroke using data from 4549 newly diagnosed type 2 diabetic patients enrolled in the UK Prospective Diabetes Study.Methods-During 30 700 person-years of follow-up, 188 first strokes (52 fatal) occurred. Model fitting was carried out by maximum likelihood estimation using the Newton-Raphson method. Diagnostic plots were used to compare survival probabilities calculated by the model with those calculated using nonparametric methods.Results-Variables included in the final model were duration of diabetes, age, sex, smoking, systolic blood pressure, total cholesterol to high-density lipoprotein cholesterol ratio and presence of atrial fibrillation. Not included in the model were body mass index, hemoglobin Ate, ethnicity, and ex-smoking status. The use of the model is illustrated with a hypothetical study power calculation.Conclusions-This model forecasts the absolute risk of a first stroke in people with type 2 diabetes using variables readily available in routine clinical practice.