Development and Validation of an Undiagnosed Diabetes Screening Tool: Based on the Korean National Health and Nutrition Examination Survey (2010–2016)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Undiagnosed Diabetes Screening Tool Development
2.2. Variables for Initial Item
2.3. Data Analysis
3. Results
3.1. General Characteristics of the Subjects
3.2. Discriminatory Ability of HbA1c in BMI, WC, and WHR
3.3. Risk Factors for Undiagnosed Type 2 Diabetes and Screening Scores
3.4. Validity Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Normal | Undiagnosed | χ2 Test | p-Value |
---|---|---|---|---|
(N = 12,219) | (N = 624) | |||
N (%) or M ± SD | N (%) or M ± SD | |||
Demographic characteristics | ||||
Age (years) | 49.34 ± 15.89 | 59.16 ± 12.55 | 236.63 | <0.001 |
<40 | 3857 (31.6) | 44 (7.1) | ||
40–49 | 2397 (19.6) | 96 (15.4) | ||
50–59 | 2410 (19.7) | 159 (25.5) | ||
≥60 | 3555 (29.1) | 325 (52.1) | ||
Gender | 8.99 | 0.003 | ||
Women | 7675 (60.4) | 339 (54.3) | ||
Men | 4844 (39.6) | 285 (45.7) | ||
Family history of DM | 13.98 | <0.001 | ||
No | 10,164 (83.2) | 483 (77.4) | ||
Yes | 2055 (16.8) | 141 (22.6) | ||
Diagnosis of HTN | 189.04 | <0.001 | ||
No | 9961 (81.5) | 369 (59.1) | ||
Yes | 2258 (18.5) | 255 (40.9) | ||
Anthropometric characteristics | ||||
Body mass index (kg/m2) | 345.09 | <0.001 | ||
<23 | 5687 (46.6) | 114 (18.3) | ||
23–24.9 | 2873 (23.5) | 137 (22.0) | ||
25–29.9 | 3256 (26.6) | 291 (46.6) | ||
≥30 | 401 (3.3) | 82 (13.1) | ||
Waist circumference (M/W) (cm) | 355.69 | <0.001 | ||
<84/77 | 6167 (50.5) | 115 (18.4) | ||
84–89.9/77–83.9 | 3089 (25.3) | 160 (25.6) | ||
≥90/74 | 2963 (24.2) | 349 (55.9) | ||
Waist-to-height ratio | 325.13 | <0.001 | ||
<0.5 | 6687 (54.7) | 111 (17.8) | ||
≥0.5 | 5532 (45.3) | 513 (82.2) | ||
Lifestyle, health behavior characteristics | ||||
Energy intake (M/W) (kcal) | 9.60 | 0.002 | ||
≤2300/1850 | 7307 (59.8) | 412 (66.0) | ||
>2300/1850 | 4912 (40.2) | 212 (34.0) | ||
Eating out | 45.16 | <0.001 | ||
No | 3939 (32.2) | 282 (45.2) | ||
Yes | 8280 (67.8) | 342 (54.8) | ||
Physically active | 2.12 | 0.145 | ||
No | 10,020 (82.0) | 526 (84.3) | ||
Yes | 2199 (18.0) | 98 (15.7) | ||
Smokers | 3.39 | 0.066 | ||
Non- or past-smokers | 10,010 (81.9) | 493 (79.0) | ||
Present smokers | 2209 (18.1) | 131 (21.0) | ||
Drinkers | 9.24 | 0.002 | ||
Non-drinkers or less than 1 drink per month | 5779 (47.3) | 334 (53.5) | ||
More than one drink per month | 6440 (52.7) | 290 (46.5) | ||
Health check-ups | 0.12 | 0.725 | ||
No | 4653 (38.1) | 242 (38.8) | ||
Yes | 7566 (61.9) | 382 (61.2) |
Variables | Odds Ratio | 95% CI | p-Value | Risk Score |
---|---|---|---|---|
Age (years) (ref: <40) | 0 | |||
40–49 | 3.03 | 2.094–4.373 | <0.001 | 3 |
50–59 | 4.30 | 3.023–6.122 | <0.001 | 4 |
≥60 | 5.06 | 3.569–7.159 | <0.001 | 5 |
Gender (ref: Women) | 0 | |||
Men | 1.26 | 1.047–1.516 | 0.014 | 1 |
Family history of DM (ref: No) | 0 | |||
Yes | 1.92 | 1.571–2.369 | <0.001 | 1 |
Diagnosis with HTN (ref: No) | 0 | |||
Yes | 1.58 | 1.314–1.906 | <0.001 | 1 |
Waist-to-height ratio (ref: <0.5) | 0 | |||
≥0.5 | 3.75 | 3.025–4.669 | <0.001 | 3 |
Smoking (ref: No) | 0 | |||
Yes | 1.40 | 1.113–1.767 | 0.004 | 1 |
Check-ups (ref: Yes) | 0 | |||
No | 1.46 | 1.229–1.739 | <0.001 | 1 |
Measure | Undiagnosed Diabetes Screening Tool | 95% CI | Diabetes Screening Tool [14] | 95% CI |
---|---|---|---|---|
Sensitivity | 82.7 | 79.5–85.6 | 80.3 | 76.9–83.3 |
Specificity | 58.2 | 57.3–59.1 | 57.4 | 56.6–58.3 |
AUC | 0.760 | 0.752–0.767 | 0.740 | 0.732–0.747 |
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Cho, E.; Min, D.; Lee, H.S. Development and Validation of an Undiagnosed Diabetes Screening Tool: Based on the Korean National Health and Nutrition Examination Survey (2010–2016). Healthcare 2021, 9, 1138. https://doi.org/10.3390/healthcare9091138
Cho E, Min D, Lee HS. Development and Validation of an Undiagnosed Diabetes Screening Tool: Based on the Korean National Health and Nutrition Examination Survey (2010–2016). Healthcare. 2021; 9(9):1138. https://doi.org/10.3390/healthcare9091138
Chicago/Turabian StyleCho, Eunhee, Deulle Min, and Hye Sun Lee. 2021. "Development and Validation of an Undiagnosed Diabetes Screening Tool: Based on the Korean National Health and Nutrition Examination Survey (2010–2016)" Healthcare 9, no. 9: 1138. https://doi.org/10.3390/healthcare9091138