Nomogram prediction for the 3-year risk of type 2 diabetes in healthy mainland China residents

Abstract

Aims

To develop a precise personalized type 2 diabetes mellitus (T2DM) prediction model by cost-effective and readily available parameters in a Central China population.

Methods

A 3-year cohort study was performed on 5557 nondiabetic individuals who underwent annual physical examination as the training cohort, and a subsequent validation cohort of 1870 individuals was conducted using the same procedures. Multiple logistic regression analysis was performed, and a simple nomogram was constructed via the stepwise method. Receiver operating characteristic (ROC) curve and decision curve analyses were performed by 500 bootstrap resamplings to assess the determination and clinical value of the nomogram, respectively. We also estimated the optimal cutoff values of each risk factor for T2DM prediction.

Results

The 3-year cumulative incidence of T2DM was 10.71%. We developed simple nomograms that predict the risk of T2DM for females and males by using the parameters of age, BMI, fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), and triglycerides (TG). In the training cohort, the area under the ROC curve (AUC) showed statistical accuracy (AUC = 0.863 for female, AUC = 0.751 for male), and similar results were shown in the subsequent validation cohort (AUC = 0.847 for female, AUC = 0.755 for male). Decision curve analysis demonstrated the clinical value of this nomogram. To optimally predict the risk of T2DM, the cutoff values of age, BMI, FBG, systolic blood pressure, diastolic blood pressure, total cholesterol, LDLc, HDLc, and TG were 47.5 and 46.5 years, 22.9 and 23.7 kg/m ², 5.1 and 5.4 mmol/L, 118 and 123 mmHg, 71 and 85 mmHg, 5.06 and 4.94 mmol/L, 2.63 and 2.54 mmol/L, 1.53 and 1.34 mmol/L, and 1.07 and 1.65 mmol/L for females and males, respectively.

Conclusion

Our nomogram can be used as a simple, plausible, affordable, and widely implementable tool to predict a personalized risk of T2DM for Central Chinese residents. The successful identification of at-risk individuals and intervention at an early stage can provide advanced strategies from a predictive, preventive, and personalized medicine perspective.

Electronic supplementary material

The online version of this article (10.1007/s13167-019-00181-2) contains supplementary material, which is available to authorized users.