Original Article: Epidemiology A simple risk score to identify Southern Chinese at high risk for diabetes

Aims To develop a simple scoring system for identifying Southern Chinese at risk of diabetes. Methods ThescorewasderivedfromariskfactormatchingcohortforType 2diabetesinHongKongChinese(cohort 1,2448 subjects without a history of diabetes; age, mean sd 37.2 8.9 years, median 36.0 years; 1649 had risk factors for diabetes and 799 were age-matched control subjects from the community). Two other cohorts were used to validate the risk score (cohort 2, 3734 subjects with risk factors for diabetes; and cohort 3, 1513 participants of a community diabetes survey). All subjects had a 75 g oral glucose tolerance test (OGTT). Results In cohort 1, 270 (11%) of the subjects were found to have diabetes on OGTT. A risk score system was derived using the b values of the corresponding predictors in the logistic regression analysis. The area under the curve (95% confidence intervals)ofthescoresystemwas0.735(0.705,0.765).Theapplicationofariskscoreof ‡ 16increasedthedetectionrate2.5‐4 times in all three cohorts. A high post-test probability of diabetes of > 60% was derived from a risk score of ‡ 20. Only 10‐20 and5%withascoreof ‡ 12and ‡ 16,respectively,areindicatedforOGTT.ThiswillconsiderablyimprovetheyieldofOGTT screening. Conclusions A simple risk score identifies young-to-middle-aged Southern Chinese at high risk for diabetes. Subjects with a score of 16 or above (out of 30) should undergo OGTT for definitive diagnosis of diabetes.