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[Applications of the NDR and DIAL models for risk prediction on cardiovascular disease in patients with type 2 diabetes in Ningbo].
Li, Q Q; Liang, J Y; Wang, J M; Shen, P; Sun, Y X; Chen, Q; Wu, J G; Lu, P; Zhang, J Y; Lin, H B; Tang, X; Gao, Pei.
Affiliation
  • Li QQ; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
  • Liang JY; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
  • Wang JM; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
  • Shen P; Yinzhou District Center for Disease Control and Prevention of Ningbo, Yinzhou 315100, China.
  • Sun YX; Yinzhou District Center for Disease Control and Prevention of Ningbo, Yinzhou 315100, China.
  • Chen Q; Yinzhou District Center for Disease Control and Prevention of Ningbo, Yinzhou 315100, China.
  • Wu JG; Wonders Information Company Limited, Shanghai 201112, China.
  • Lu P; Wonders Information Company Limited, Shanghai 201112, China.
  • Zhang JY; Wonders Information Company Limited, Shanghai 201112, China.
  • Lin HB; Yinzhou District Center for Disease Control and Prevention of Ningbo, Yinzhou 315100, China.
  • Tang X; Center of Real-world Evidence Evaluation, Clinical Research Institute, Peking University, Beijing 100191, China.
  • Gao P; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing 100191, China.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(6): 945-952, 2022 Jun 10.
Article in Zh | MEDLINE | ID: mdl-35725354
Objective: To validate the performance of cardiovascular risk prediction models based on the Sweden National Diabetes Register (NDR) and Diabetes Lifetime-perspective prediction (DIAL) model for assessing risks of 5-year and 10-year cardiovascular disease (CVD) among Chinese patients with type 2 diabetes. Methods: Based on the Chinese Electronic Health Records Research in Yinzhou study, 83 503 patients with type 2 diabetes aged 30-75 years without a history of CVD at baseline were included from January 1, 2010 to December 31, 2020. Recalibrated NDR model was used to estimate 5-year risk, while the recalibrated DIAL model was used to predict 5-year and 10-year risks. The competing events adjusted Kaplan-Meier analysis was used to obtain the observed cardiovascular events. Discrimination C statistics evaluated model accuracy, calibration χ2 value, and calibration plots. Results: Through a median follow-up of 7.0 years, 7 326 cardiovascular events, and 2 937 non-vascular deaths were identified among a total of 83 503 subjects. The recalibrated NDR model overestimated 5-year risk by 39.4% in men and 8.6% in women, whereas the overestimation for the recalibrated DIAL model was 14.6% in men and 50.1% in women. The DIAL model had a better discriminative ability (C-statistic=0.681, 95%CI: 0.672-0.690) than NDR model (C-statistic=0.667, 95%CI: 0.657-0.677) in 5-year risk prediction for men, and the models had a similar ability for women (C-statistic=0.699, 95%CI: 0.690-0.708 for NDR and C-statistic=0.698, 95%CI: 0.689-0.706 for DIAL). The prediction accuracy of the DIAL model was improved in the 10-year risk, with the underestimation being 1.6% for men and the overestimation being 12.8% for women. Conclusions: Both recalibrated NDR and DIAL models overestimated 5-year cardiovascular risk in Chinese patients with type 2 diabetes, while the higher overestimation was shown using the DIAL model. However, the improvement was found in predicting 10-year CVD risk using the DIAL model, which suggested the value of lifetime risk prediction and indicated the need for research on the lifetime risk prediction model for cardiovascular risk assessment in Chinese patients with type 2 diabetes.
Subject(s)

Full text: 1 Database: MEDLINE Main subject: Cardiovascular Diseases / Diabetes Mellitus, Type 2 Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Female / Humans / Male Language: Zh Journal: Zhonghua Liu Xing Bing Xue Za Zhi Year: 2022 Type: Article Affiliation country: China

Full text: 1 Database: MEDLINE Main subject: Cardiovascular Diseases / Diabetes Mellitus, Type 2 Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Female / Humans / Male Language: Zh Journal: Zhonghua Liu Xing Bing Xue Za Zhi Year: 2022 Type: Article Affiliation country: China