scholarly journals External validation of the UK Prospective Diabetes Study (UKPDS) risk engine in patients with type 2 diabetes identified in the national diabetes program in Iran

2021 ◽  
Author(s):  
Mehrdad Valipour ◽  
Davood Khalili ◽  
Masoud Soleymani Dodaran ◽  
Seyed Abbas Motevalian ◽  
Mohammad Ebrahim Khamseh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Disease ◽  
External Validation ◽  
Accurate Estimation ◽  
C Statistic ◽  
Chd Risk ◽  
The Uk ◽  
Risk Engine

Abstract Background Cardiovascular diseases are the first leading cause of mortality in the world. Practical guidelines recommend an accurate estimation of the risk of these events for effective treatment and care. The UK Prospective Diabetes Study (UKPDS) has a risk engine for predicting CHD risk in patients with type 2 diabetes, but in some countries, it has been shown that the risk of CHD is poorly estimated. Hence, we assessed the external validity of the UKPDS risk engine in patients with type 2 diabetes identified in the national diabetes program in Iran. Methods The cohort included 853 patients with type 2diabetes identified between March 21, 2007, and March 20, 2018 in Lorestan province of Iran. Patients were followed for the incidence of CHD. The performance of the models was assessed in terms of discrimination and calibration. Discrimination was examined using the c-statistic and calibration was assessed with the Hosmer–Lemeshow χ2 statistic (HLχ2) test and a calibration plot was depicted to show the predicted risks versus observed ones. Results During 7464.5 person-years of follow-up 170 first Coronary heart disease occurred. The median follow-up was 8.6 years. The UKPDS risk engine showed moderate discrimination for CHD (c-statistic was 0.72 for 10-year risk) and the calibration of the UKPDS risk engine was poor (HLχ2=69.9, p<0.001) and overestimated the risk of heart disease. Conclusion This study shows that the ability of the UKPDS Risk Engine to discriminate patients who got CHD events from those who did not was moderate and the ability of the risk prediction model to accurately predict the absolute risk of CHD (calibration) was poor and it overestimated the CHD risk. To improve the prediction of CHD in patients with type 2 diabetes, this model should be updated in the Iranian diabetic population.

scholarly journals A retrospective study on the usefulness of the JJ risk engine for predicting the incidence rate of coronary heart disease in type 2 diabetes patients

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yasunari Yamashita ◽  
Rina Kitajima ◽  
Kiyoshi Matsubara ◽  
Gaku Inoue ◽  
Hajime Matsubara
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medical Records ◽  
Low Frequency ◽  
University Hospital ◽  
Diabetes Treatment ◽  
C Statistic ◽  
Risk Engine

Abstract Objective In 2018, we conducted a retrospective survey using the medical records of 484 patients with type 2 diabetes. The observed value of coronary heart disease (CHD) incidence after 5 years and the predicted value by the JJ risk engine as of 2013 were compared and verified using the discrimination and calibration values. Results Among the total cases analyzed, the C-statistic was 0.588, and the calibration was p < 0.05; thus, the JJ risk engine could not correctly predict the risk of CHD. However, in the group expected to have a low frequency of hypoglycemia, the C-statistic was 0.646; the predictability of the JJ risk engine was relatively accurate. Therefore, it is difficult to accurately predict the complication rate of patients using the JJ risk engine based on the diabetes treatment policy after the Kumamoto Declaration 2013. The JJ risk engine has several input items (variables), and it is difficult to satisfy them all unless the environment is well-equipped with testing facilities, such as a university hospital. Therefore, it is necessary to create a new risk engine that requires fewer input items than the JJ risk engine and is applicable to several patients.

scholarly journals External validation of the UK Prospective Diabetes Study (UKPDS) risk engine in patients with type 2 diabetes

Diabetologia ◽  
2010 ◽  
Vol 54 (2) ◽  
pp. 264-270 ◽  
Author(s):  
S. van Dieren ◽  
L. M. Peelen ◽  
U. Nöthlings ◽  
Y. T. van der Schouw ◽  
G. E. H. M. Rutten ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
External Validation ◽  
The Uk ◽  
Risk Engine

scholarly journals Adiposity-Mortality Relationships in Type 2 Diabetes, Coronary Heart Disease, and Cancer Subgroups in the UK Biobank, and Their Modification by Smoking

Diabetes Care ◽  
2018 ◽  
Vol 41 (9) ◽  
pp. 1878-1886 ◽  
Author(s):  
David A. Jenkins ◽  
Jack Bowden ◽  
Heather A. Robinson ◽  
Naveed Sattar ◽  
Ruth J.F. Loos ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Uk Biobank ◽  
The Uk

scholarly journals Silent coronary heart disease in patients with type 2 diabetes: application of a screening approach in a follow-up study

2017 ◽  
Vol 31 (6) ◽  
pp. 952-957 ◽  
Author(s):  
Saula Vigili de Kreutzenberg ◽  
Anna Solini ◽  
Edoardo Vitolo ◽  
Alessandra Boi ◽  
Simonetta Bacci ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Follow Up Study ◽  
Screening Approach

scholarly journals Gender Differences in Risks of Coronary Heart Disease and Stroke in Patients with Type 2 Diabetes Mellitus and Their Association with Metabolic Syndrome in China

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mei-Fang Yao ◽  
Jie He ◽  
Xue Sun ◽  
Xiao-Li Ji ◽  
Yue Ding ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Coronary Heart Disease ◽  
Type 2 Diabetes Mellitus ◽  
Heart Disease ◽  
Stroke Risk ◽  
Chinese Women ◽  
Chd Risk

Coronary heart disease (CHD) and stroke are common complications of type 2 diabetes mellitus (T2DM). We aimed to explore the differences in the risks of CHD and stroke between Chinese women and men with T2DM and their association with metabolic syndrome (MS). This study included 1514 patients with T2DM. The Asian Guidelines of ATPIII (2005) were used for MS diagnosis, and the UKPDS risk engine was used to evaluate the 10-year CHD and stroke risks. Women had lower CHD risk (15.3% versus 26.3%), fatal CHD risk (11.8% versus 19.0%), stroke risk (8.4% versus 10.3%), and fatal stroke risk (1.4% versus 1.6%) compared with men with T2DM (p<0.05–0.001). The CHD risk (28.4% versus 22.6%, p<0.001) was significantly higher in men with MS than in those without MS. The CHD (16.2% versus 11.0%, p<0.001) and stroke risks (8.9% versus 5.8%, p<0.001) were higher in women with MS than in those without MS. In conclusion, our findings indicated that Chinese women with T2DM are less susceptible to CHD and stroke than men. Further, MS increases the risk of both these events, highlighting the need for comprehensive metabolic control in T2DM.

scholarly journals External Validation of the UKPDS Risk Engine in Incident Type 2 Diabetes: A Need for New Type 2 Diabetes-Specific Risk Equations

Diabetes Care ◽  
2013 ◽  
Vol 37 (2) ◽  
pp. 537-545 ◽  
Author(s):  
C. A. Bannister ◽  
C. D. Poole ◽  
S. Jenkins-Jones ◽  
C. L. Morgan ◽  
G. Elwyn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
External Validation ◽  
Incident Type ◽  
Specific Risk ◽  
Incident Type 2 Diabetes ◽  
New Type ◽  
Risk Engine

scholarly journals Association of Serum Amyloid A with Kidney Outcomes and All-Cause Mortality in American Indians with Type 2 Diabetes

2017 ◽  
Vol 46 (4) ◽  
pp. 276-284 ◽  
Author(s):  
Pierre-Jean Saulnier ◽  
Brad P. Dieter ◽  
Stephanie K. Tanamas ◽  
Sterling M. McPherson ◽  
Kevin M. Wheelock ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
American Indians ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Risk Of Death ◽  
Amyloid A ◽  
C Statistic ◽  
Traditional Risk Factors

Background: Serum amyloid A (SAA) induces inflammation and apoptosis in kidney cells and is found to be causing the pathologic changes that are associated with diabetic kidney disease (DKD). Higher serum SAA concentrations were previously associated with increased risk of end-stage renal disease (ESRD) and death in persons with type 2 diabetes and advanced DKD. We explored the prognostic value of SAA in American Indians with type 2 diabetes without DKD or with early DKD. Methods: SAA concentration was measured in serum samples obtained at the start of follow-up. Multivariate proportional hazards models were employed to examine the magnitude of the risk of ESRD or death across tertiles of SAA concentration after adjustment for traditional risk factors. The C statistic was used to assess the additional predictive value of SAA relative to traditional risk factors. Results: Of 256 participants (mean ± SD glomerular filtration rate [iothalamate] = 148 ± 45 mL/min, and median [interquartile range] urine albumin/creatinine = 39 [14-221] mg/g), 76 developed ESRD and 125 died during a median follow-up period of 15.2 and 15.7 years, respectively. After multivariable proportional hazards regression, participants in the 2 highest SAA tertiles together exhibited a 53% lower risk of ESRD (hazard ratio [HR] 0.47, 95% CI 0.29-0.78), and a 30% lower risk of death (HR 0.70, 95% CI 0.48-1.02), compared with participants in the lowest SAA tertile, although the lower risk of death was not statistically significant. Addition of SAA to the ESRD model increased the C statistic from 0.814 to 0.815 (p = 0.005). Conclusions: Higher circulating SAA concentration is associated with a reduced risk of ESRD in American Indians with type 2 diabetes.

scholarly journals Elucidating causal effects of type 2 diabetes on ischemic heart disease from observational data on middle-aged Swedish women: a triangular analytical approach

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kristina Sundquist ◽  
Sven-Erik Johansson ◽  
Ashfaque A. Memon ◽  
Susanna Calling ◽  
Henrik Ohlsson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cox Regression ◽  
Cox Model ◽  
Ischemic Heart ◽  
Causal Association ◽  
Analytical Approaches

AbstractThe association between type 2 diabetes (T2D) and ischemic heart disease (IHD) is well established but the potential causal association needs further studying. In an attempt to elucidate the causal effect of T2D on IHD, we used three different analytical approaches in two different datasets. A well-defined cohort of 6047 women aged 50–59 years were included at baseline (1995 to 2000) and followed until 2015 for IHD. The median follow-up was 16.3 years. We used a Marginal Structural Cox model (MSM Cox) to account for time-varying exposure (time at onset of T2D) and for ten confounders (using inverse probability weighting, IPW). We also compared the MSM-Cox models with traditional Cox regression modelling in the cohort. Finally, we analyzed information on individuals from Swedish population-based registers with national coverage in a comprehensive co-relative design and extrapolated the results to MZ twins. The Hazard Ratio (HR) for IHD in relation to T2D at baseline and T2D occurring during the follow-up in the MSM Cox model weighted by IPW (based on the ten included confounders) was 1.43 (95% confidence interval [CI] 1.07–1.92). The corresponding HR from the traditional Cox regression model was of similar effect size. The average extrapolated MZ twin estimate from our co-relative model was 1.61 (95% CI 1.48–1.86). Our findings, based on a triangular approach, support the existence of a causal association between T2D and IHD and that preventive long-term measures in order to avoid or postpone IHD should include monitoring and treatment of both the T2D itself as well as other cardiovascular risk factors.

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