Abstract
BackgroundThe aim of this study to compare the diagnostic accuracy of the metabolic syndrome (MetS) with the FINDRISC score to screen for type 2 diabetes mellitus T2DM in an overweight/obese population.MethodsSubjects 18 years or older visiting the obesity clinic of the Antwerp University Hospital were consecutively recruited between 2012 and 2014. Every patient underwent a standard metabolic work-up including a clinical examination with anthropometry. Glucose status was tested using OGTT and Hba1c. FINDRISC questionnaire and MetS were examined.ResultsOf 651 subjects, 50.4% were diagnosed with prediabetes, whereas 11.1% was diagnosed with T2DM. FINDRISC score increased with worsening of glucose status 11 ± 3, 13 ± 4 and 15 ± 5 in respectively, subjects without T2DM, prediabetes and T2DM. 312 subjects had the MetS. The aROC of the FINDRISC to identify subjects with T2DM was 0.76 (95% CI 0.72–0.82), sensitivity was 64% and specificity was 63% with 13 as cutoff point. Adding FPG or HbA1c to FINDRISC, the aROC increased significantly to 0.91(95% CI 0.88–0.95) and 0.93(95% CI 0.90–0.97), respectively (p < 0.001). The aROC of the MetS to identify subjects with diabetes was 0.72 (95% CI 0.65–0.78), sensitivity was 75% and specificity was 55%. The aROC of the FINDRISC + HbA1c was significantly higher than the MetS for predicting T2DM (p < 0.001).ConclusionPrediction of type 2 diabetes is important for timely intervention and to avoid chronic complications associated with the disease. Our findings suggest, that it may be of good clinical practice to use the FINDRISC score + HbA1c in a two-step screening model for diabetes rather than using the metabolic syndrome.
Highlights
The aim of this study to compare the diagnostic accuracy of the metabolic syndrome (MetS) with the FINDRISC score to screen for type 2 diabetes mellitus T2DM in an overweight/obese population
The proportion of subjects with the metabolic syndrome increased with worsening of the glucose tolerance, 32% in subjects without diabetes, 54% in subjects with prediabetes and 75% in subjects with de novo diagnosed diabetes according to the NCEP-ATP III criteria
Prediction of type 2 diabetes is important for timely intervention and to avoid chronic complications associated with the disease
Summary
The aim of this study to compare the diagnostic accuracy of the metabolic syndrome (MetS) with the FINDRISC score to screen for type 2 diabetes mellitus T2DM in an overweight/obese population. Before the diagnosis of the metabolic syndrome can be established, five clinical and biochemical parameters need to be assessed, making it one of the most labor intensive and cost expensive prediction tools for type 2 diabetes mellitus [8]. The Finnish Diabetes Risk Score (FINDRISC) is another commonly used and validated non-invasive diabetes risk score worldwide and has proven its value in the national type 2 diabetes prevention program in Finland [9]. We compared the metabolic syndrome to the FINDRISC score as a screening tool for type 2 diabetes mellitus in a population of apparently healthy overweight and obese subjects without a prior diagnosis of diabetes, considered as an ‘at risk’ population
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