Strength of Association for Incident Diabetes Risk Factors According to Diabetes Case Definitions The Atherosclerosis Risk in Communities Study
Strength of Association for Incident Diabetes Risk Factors According to Diabetes Case Definitions The Atherosclerosis Risk in Communities Study
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DOI：
10.1093/aje/kwr326
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发表时间：
2012-03-01
影响因子：
5
通讯作者：
Brancati, Frederick
中科院分区：
文献类型：
--
作者：
Bielinski, Suzette J.;Pankow, James S.;Brancati, Frederick
前瞻性流行病学研究通过不同的糖尿病病例定义确定了糖尿病发病的主要危险因素。不同的定义是否会改变糖尿病与危险因素的联系，在很大程度上还不得而知。利用1987-1998年正在进行的社区动脉粥样硬化风险研究(ARIC)的数据，作者评估了传统危险因素与3种不同的糖尿病病例定义和4种空腹血糖类别的关系。他们将研究方案的病例定义与两个嵌套病例定义、自我报告的糖尿病和多证据定义进行了比较。通过病例定义和筛查截断点，危险因素的关联性有显著差异。具体地说，危险因素(基线代谢综合征、空腹血糖、血压、体重指数和血清胰岛素)与糖尿病发病之间的关联程度因病例定义而异。与其他定义相比，基于自我报告的病例定义与这些风险因素的关联性较弱。这些结果说明了仅依靠自我报告或结合测量的血糖值来确定未诊断病例的病例定义的潜在局限性。尽管识别糖尿病风险因素的能力在所研究的病例定义中是一致的，但对新的风险因素的测试可能会导致对效果大小的不同估计，这取决于所使用的定义。
Prospective epidemiologic studies have characterized major risk factors for incident diabetes by a variety of diabetes case definitions. Whether different definitions alter the association of diabetes with risk factors is largely unknown. Using 1987-1998 data from the ongoing Atherosclerosis Risk in Communities (ARIC) Study, the authors assessed the relation of traditional risk factors with 3 different diabetes case definitions and 4 fasting glucose categories. They compared the study protocol case definition with 2 nested case definitions, self-reported diabetes and a multiple-evidence definition. Significant differences in risk factor associations by case definition and by screening cutpoints were observed. Specifically, the magnitude of the association between the risk factors (baseline metabolic syndrome, fasting glucose, blood pressure, body mass index, and serum insulin) and incident diabetes differed by case definition. Associations with these risk factors were weaker with a case definition based on self-report compared with other definitions. These results illustrate the potential limitations of case definitions that rely solely on self-report or those that incorporate measured glucose values to ascertain undiagnosed cases. Although the ability to identify risk factors of diabetes was consistent for the case definitions studied, tests of novel risk factors may result in different estimates of effect sizes depending on the definition used.