Cited by 52Diabetes, Cardiovascular Risks, and LipoproteinsHealth Promotion and Cardiovascular PreventionDiabetes Management and Research

Update of the German Diabetes Risk Score and external validation in the German MONICA/KORA study

Mühlenbruch, Kristin, Ludwig, Tonia, Jeppesen, Charlotte, Joost, Hans-Georg, Rathmann, Wolfgang, Meisinger, Christine, Peters, Annette, Boeing, Heiner +2 more·2014·Diabetes Research and Clinical Practice

Abstract

Aims Several published diabetes prediction models include information about family history of diabetes. The aim of this study was to extend the previously developed German Diabetes Risk Score (GDRS) with family history of diabetes and to validate the updated GDRS in the Multinational MONItoring of trends and determinants in CArdiovascular Diseases (MONICA)/German Cooperative Health Research in the Region of Augsburg (KORA) study.Methods We used data from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study for extending the GDRS, including 21,846 participants. Within 5 years of follow-up 492 participants developed diabetes. The definition of family history included information about the father, the mother and/or sibling/s. Model extension was evaluated by discrimination and reclassification. We updated the calculation of the score and absolute risks. External validation was performed in the MONICA/KORA study comprising 11,940 participants with 315 incident cases after 5 years of follow-up.Results The basic ROC-AUC of 0.856 (95%-CI: 0.842-0.870) was improved by 0.007 (0.003-0.011) when parent and sibling history was included in the GDRS. The net reclassification improvement was 0.110 (0.072-0.149), respectively. For the updated score we demonstrated good calibration across all tenths of risk. In MONICA/KORA, the ROC-AUC was 0.837 (0.819-0.855); regarding calibration we saw slight overestimation of absolute risks.Conclusions Inclusion of the number of diabetes-affected parents and sibling history improved the prediction of type 2 diabetes. Therefore, we updated the GDRS algorithm accordingly. Validation in another German cohort study showed good discrimination and acceptable calibration for the vast majority of individuals.

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Crossref · 10.1016/j.diabres.2014.03.013

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  • Potential confounders were a priori selected based on the literature on red meat intake and diabetes risk and prior investigations in EPIC-Potsdam.

    “Potential confounders to be included as covariates were a priori selected based on the literature on the association between red meat intake and diabetes risk (2, 3) and prior investigations in EPIC-Potsdam regarding risk factors of type 2 diabetes (5), dietary patterns (27), and determinants of metabolic profiles (28,29).”
  • In EPIC-Potsdam, a 150-g/d portion of red meat had a predictive value for type 2 diabetes risk similar to smoking 20 cigarettes/d, having a 7.6-cm higher waist circumference, or having one parent with diabetes.

    “We have previously reported from the European Prospective Investigation into Cancer and Nutrition (EPIC) 5 -Potsdam study that with regard to type 2 diabetes risk assessment, a 150-g/d portion of red meat had a predictive value similar to smoking .20 cigarettes/d, having a 7.6-cm higher waist circumference, or having one parent with diabetes (5).”

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Authors
Mühlenbruch, K., Ludwig, T., Jeppesen, C., Joost, H.-G., Rathmann, W., Meisinger, C., Peters, A., Boeing, H., Thorand, B., & Schulze, M. B.
Affiliations
  • German Center for Diabetes Research (DE)
  • Helmholtz Munich (DE)
  • Deutsches Diabetes-Zentrum e.V. (DE)
  • German Institute of Human Nutrition (DE)
Corresponding author
Schulze, Matthias B.
Venue
Diabetes Research and Clinical Practice
Publisher
Elsevier BV
Published
2014-06
Volume
104
Issue
3
Pages
459-466
ISSN
0168-8227 (ISSN-L)
OpenAlex
W2127629134
Cited by
52
References
41
Citations by year
2025: 1 · 2024: 3 · 2023: 2 · 2022: 6 · 2021: 7 · 2020: 10 · 2019: 6 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 4 · 2014: 3
FWCI
3.48
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Research and Clinical Practice (publishedVersion)
  • PubMed (publishedVersion)
  • Site cant be reached (submittedVersion)
  • OPUS (Augsburg University) (submittedVersion)
Funders
  • Bundesministerium für Bildung und Forschung
  • Deutsche Krebshilfe
  • Bundesministerium für Wissenschaft und Forschung
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes, diabetes risk prediction, family history of diabetes, parental history, sibling history, external validation, risk reclassification, risk calibration
MeSH terms
Adult, Aged, Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Germany, Glycated Hemoglobin, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, ROC Curve, Prevalence, Risk Assessment

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