Assessing Risk for Development of Diabetes in Young Adults

Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina, United States
The Annals of Family Medicine (Impact Factor: 5.43). 09/2007; 5(5):425-9. DOI: 10.1370/afm.705
Source: PubMed


The prevalence of diabetes is increasing to epidemic levels. A multivariable risk score for the development of diabetes has been shown to be predictive for middle-aged adults; however, it is unclear how well it performs in a younger adult population. The purpose of this study was to evaluate a preexisting multivariable risk score for the development of diabetes in a young adult cohort.
We analyzed the Coronary Artery Risk Development in Young Adults (CARDIA), a population-based observational study of participants aged 18 to 30 years recruited in 1985-1986. We observed individuals without diabetes at baseline for 10 years for the development of diabetes (n = 2,543). We computed receiver operating characteristic (ROC) curves for a diabetes risk score composed of the following 6 variables: elevated blood pressure, low high-density lipoprotein cholesterol levels, high triglyceride levels, body mass index, large waist circumference, and hyperglycemia.
The area under the ROC curve was .70 in this population, which was less than the .78 previously found among middle-aged adults. BMI alone (.67) was not significantly different from the risk score. Blacks (.72; 95% CI, .69-.74) and whites (.68; 95% CI, .66-.71) do not significantly differ in the area under the ROC curve for the risk score; however, the area under the ROC curve for BMI is significantly larger for blacks (.69; 95% CI, .66-.72) than for whites (.63; 95% CI, .60-.65).
An established risk score for the development of diabetes among middle-aged persons has limited utility in a younger population. Future research needs to focus on identifying novel factors that may improve the risk stratification for diabetes development among young adults.

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Available from: Charles J. Everett, Dec 27, 2013
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