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

Authors
 Liela Meng  ;  Keun-Sang Kwon  ;  Dae Jung Kim  ;  Yong-Ho Lee  ;  Jeehyoung Kim  ;  Abhijit V Kshirsagar  ;  Heejung Bang 
Citation
 DIABETES & METABOLISM JOURNAL, Vol.46(2) : 273-285, 2022-03 
Journal Title
DIABETES & METABOLISM JOURNAL
ISSN
 2233-6079 
Issue Date
2022-03
MeSH
Diabetes Mellitus, Type 2* / diagnosis ; Diabetes Mellitus, Type 2* / epidemiology ; Humans ; Middle Aged ; Nutrition Surveys ; Prediabetic State* / diagnosis ; Prediabetic State* / epidemiology ; Renal Insufficiency, Chronic* / diagnosis ; Renal Insufficiency, Chronic* / epidemiology ; Republic of Korea / epidemiology ; United States / epidemiology
Keywords
Diabetes mellitus, type 2 ; Prediabetic state ; Renal insufficiency, chronic ; Risk factors ; Self-assessment
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.
Files in This Item:
T202201727.pdf Download
DOI
10.4093/dmj.2021.0054
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188764
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