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Routinely collected general practice data aids identification of people with hyperglycaemia and metabolic syndrome
Author(s) -
Heldgaard P. E.,
Griffin S. J.
Publication year - 2006
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2006.01929.x
Subject(s) - medicine , diabetes mellitus , metabolic syndrome , impaired glucose tolerance , population , body mass index , anthropometry , glucose tolerance test , insulin resistance , impaired fasting glucose , family history , endocrinology , environmental health
Aims To assess the performance of a risk score comprising data routinely available in general practice records (age, gender, body mass index, family history of diabetes, smoking habits and prescribed anti‐hypertensive drugs or steroids) in detecting diabetes, impaired glucose tolerance and metabolic syndrome. Methods In a population‐based, cross‐sectional study in a semi‐rural general practice in Jutland, Denmark, Cambridge Risk Scores were calculated for 1355 patients without known diabetes (69% response rate) who completed questionnaires and underwent anthropometric measurement and an oral glucose tolerance test. Results Prevalences of diabetes, impaired glucose tolerance and metabolic syndrome were 2.29% (95% CI: 1.56–3.23), 6.64% (95% CI: 5.38–8.10) and 13.4% (95% CI: 11.5–15.2), respectively. Area under the ROC curve for the risk score and diabetes was 83.8% (75.9–91.7) and for metabolic syndrome [European Group for the Study of Insulin Resistance (EGIR)] was 78.1% (74.6–81.6). Twenty per cent of the population had a risk score above 0.246; at this threshold the sensitivity to detect diabetes was 71.0% (53.4–83.9), the specificity 81.2% (79.0–83.2), positive predictive value 8.1% (6.6–10.0) and likelihood ratio 3.77 (2.94–4.85). For metabolic syndrome (EGIR) corresponding values for sensitivity were 50.3% (43.1–57.5), specificity 84.7% (82.5–85.6), positive predictive value 33.6% (28.2–39.4), and likelihood ratio 3.28 (2.69–4.00). Conclusions Undiagnosed hyperglycaemia and metabolic syndrome are common. The Cambridge Risk Score is a practical first step in a screening procedure to identify individuals with these disorders who might benefit from diagnostic testing or to direct preventive interventions.