| Objectives:1.To construct a diabetes screening risk score model for middle-aged and elderly Chinese population,and compare with the performance of other diabetes screening risk score tools for middle-aged and elderly Chinese population.2.To analyze the relationship between diabetes and carotid atherosclerosis in middle-aged and elderly Chinese population,and explore the differences of the risk of carotid atherosclerosis among different states of diabetes,and provide scientific evidence for the prevention and control of diabetes and cardiovascular diseases.Methods:1.Data from 2014-2015 annual national “high-risk population screening and intervention project of stroke”,including demographic information,history of disease and individual way of life,physical examination information and laboratory examination results etc was applied to construct the diabetes risk score model screening by Logistic regression analysis.At the same time,we compared other eight diabetes score screening tools in this study to verify the performance of the samples.2.We collected population with high risk of stroke base on the carotid ultrasound test result from “high-risk population screening and intervention project of stroke”.According to the history of diabetes and fasting plasma glucose,the population were divided into four subgroups including no diabetes,new onset diabetes,previously diagnosed diabetes with good control of blood glucose and previously diagnosed diabetes with poor control of blood glucose.We evaluated the risk of carotid atherosclerosis,intima-media thickness(IMT),and carotid artery plaque and carotid artery stenosis among four subgroups by Logistic regression analysis.Results:1.A diabetes screening risk score model was constructed based on age,gender,waist circumference,BMI,waist-to-hip ratio,hypertension,history of dyslipidemia,smoking,residential area and family history of diabetes.The AUC of the model was 0.702(95%CI:0.680-0.724),the sensitivity was 70.10%,and the specificity was 60.95%.2.We found that the screening model constructed in the present study was better than other eight existed screening tools based on the AUC.The AUC of the present model was 0.701(95%CI:0.689-0.714),the Uae tool was 0.638(95%CI:0.624-0.655),the Japanese tool was 0.638(95%CI:0.624-0.655),and the Qingdao tool was 0.635(95%CI:0.624-0.655),the American tool was 0.664(95%CI:0.650-0.678),the Indian tool was 0.633(95%CI:0.619-0.647),the British tool was 0.682(95%CI: 0.668-0.696),and the Chinese tool was 0.671(95%CI:0.657-0.686)in the validation population.3.The study on the relationship between diabetes and carotid atherosclerosis showed that,compared with people no diabetes,the risk of new onset diabetes on carotid atherosclerosis was 1.13 times(95%CI:1.06-1.20),the risk of previously diagnosed diabetes with good control of blood glucose was 1.19 times(95%CI:1.15-1.24),and the risk of previously diagnosed diabetes with poor control of blood glucose was 1.36 times(95%CI:1.31-1.42).Studies on the relationship between diabetes and TMT revealed that,compared with people no diabetes,the risk of new onset diabetes was 1.10 times(95%CI:1.03-1.17),the risk of previously diagnosed diabetes with good control of blood glucose was 0.97 times(95%CI:0.93-1.01),and the risk of previously diagnosed diabetes with poor control of blood glucose was 1.17 times(95%CI:1.13-1.22).The study on the relationship between diabetes and carotid artery plaque showed that,compared with people no diabetes,the risk of new onset diabetes was 1.11 times(95%CI:1.04-1.18),the risk of previously diagnosed diabetes with good control of blood glucose was 1.26 times(95%CI:1.21-1.31),and the risk of previously diagnosed diabetes with poor control of blood glucose was 1.43 times(95%CI:1.38-1.49).In the study of the relationship between diabetes and moderate or above carotid artery stenosis,compared with people no diabetes,the risk of new onset diabetes was 1.35 times(95%CI:1.05-1.74),the risk of previously diagnosed diabetes with good control of blood glucose was 1.19 times(95%CI:1.00-1.40),and the risk of previously diagnosed diabetes with poor control of blood glucose was 1.66 times(95%CI:1.43-1.92).Conclusions:The diabetes screening risk score model composed of age,gender,waist circumference,BMI,waist-to-hip ratio,hypertension,history of dyslipidemia,smoking,residential area and family history of diabetes can be applied to the preliminary screening of diabetes in the population aged 40 years and above in China.Early detection and treatment of diabetes are associated with a reduced risk of carotid atherosclerosis. |
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