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[2022 Mar;46(2)] Performance of Diabetes and Kidney Disease Screening Scores in Contemporary United States and Korean Populations
  • 2022.07.15
  • Hit 361
https://e-dmj.org/journal/view.php?number=2583 (클릭 168회)

Original Article

Cardiovascular Risk/Epidemiology

 

Diabetes Metab J. 2022;46(2):273-285.

Published online: September 9, 2021

DOI: https://doi.org/10.4093/dmj.2021.0054

 
 
 

Performance of Diabetes and Kidney Disease Screening Scores in Contemporary United States and Korean Populations

Liela Meng1, Keun-Sang Kwon2, Dae Jung Kim3, Yong-ho Lee4, Jeehyoung Kim5, Abhijit V. Kshirsagar6, Heejung Bang7,8

1Graduate Group of Biostatistics, Department of Statistics, University of California, Davis, CA, USA

2Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea

3Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea

4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

5Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea

6University of North Carolina Kidney Center & Division of Nephrology and Hypertension, School of Medicine, University of North Carolina, Chapel Hill, NC, USA

7Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA

8Clinical and Translational Science Center & Center for Healthcare Policy and Research, Davis School of Medicine, University of California, Sacramento, CA, USA

 

Corresponding author: Liela Meng https://orcid.org/0000-0001-7767-5354 Department of Statistics, University of California, One Shields Ave, Med-Sci 1C, Davis, CA 95616, USA E-mail: mzcmeng@ucdavis.edu

 

Received March 22, 2021       Accepted May 28, 2021

Copyright © 2022 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 

Abstract

 

Background

Risk assessment tools have been actively studied, and they summarize key predictors with relative weights/importance for a disease. Currently, standardized screening scores for type 2 diabetes mellitus (DM) and chronic kidney disease (CKD)—two key global health problems—are available in United States and Korea. We aimed to compare and evaluate screening scores for DM (or combined with prediabetes) and CKD, and assess the risk in contemporary United States and Korean populations.

Methods

Four (2×2) models were evaluated in the United States-National Health and Nutrition Examination Survey (NHANES 2015-2018) and Korea-NHANES (2016-2018)—8,928 and 16,209 adults. Weighted statistics were used to describe population characteristics. We used logistic regression for predictors in the models to assess associations with study outcomes (undiagnosed DM and CKD) and diagnostic measures for temporal and cross-validation.

Results

Korean adult population (mean age 47.5 years) appeared to be healthier than United States counterpart, in terms of DM and CKD risks and associated factors, with exceptions of undiagnosed DM, prediabetes and prehypertension. Models performed well in own country and external populations regarding predictor-outcome association and discrimination. Risk tests (high vs. low) showed area under the curve >0.75, sensitivity >84%, specificity >45%, positive predictive value >8%, and negative predictive value >99%. Discrimination was better for DM, compared to the combined outcome of DM and prediabetes, and excellent for CKD due to age.

Conclusion

Four easy-to-use screening scores for DM and CKD are well-validated in contemporary United States and Korean populations. Prevention of DM and CKD may serve as first-step in public health, with these self-assessment tools as basic tools to help health education and disparity.

 

Keywords: Diabetes mellitus, type 2; Prediabetic state; Renal insufficiency, chronic; Risk factors; Self-assessment

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Highlights

• Screening scores for Diabetes & Chronic Kidney Disease are available in USA & Korea.
• These scores performed well in contemporary national samples (vs. original samples).
• Korean adults tend to have lower cardiovascular risk than American adults.
• Korea is not a "safe" zone for prehypertension, prediabetes & undiagnosed diabetes.
• Screening scores could be useful tools for self-assessment and health education.
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