A risk score for type 1 diabetes derived from autoantibody-positive participants in the diabetes prevention trial-type 1

Jay M. Sosenko, Jeffrey P. Krischer, Jerry P. Palmer, Jeffrey Mahon, Catherine Cowie, Carla J. Greenbaum, David Cuthbertson, John M. Lachin, Jay S. Skyler

Research output: Contribution to journalArticle

75 Scopus citations

Abstract

OBJECTIVE - The accurate prediction of type 1 diabetes is essential for appropriately identifying prevention trial participants. Thus, we have developed a risk score for the prediction of type 1 diabetes. RESEARCH DESIGN AND METHODS - Diabetes Prevention Trial-Type 1 (DFT-1) participants, islet cell autoantibody (ICA)-positive relatives of type 1 diabetic patients (n = 670), were randomly divided into development and validation samples. Risk score values were calculated for the validation sample from development sample model coefficients obtained through forward stepwise proportional hazards regression. RESULTS - A risk score based on a model including log-BMI, age, log-fasting C-peptide, and postchallenge glucose and C-peptide sums from 2-h oral glucose tolerance tests (OGTTs) was derived from the development sample. The baseline risk score strongly predicted type 1 diabetes in the validation sample (χ 2 = 82.3, P < 0.001). Its strength of prediction was almost the same (χ 2 = 83.3) as a risk score additionally dependent on a decreased first-phase insulin response variable from intravenous glucose tolerance tests (IVGTTs). Biochemical autoantibodies did not contribute significantly to the risk score model. A final type 1 diabetes risk score was then derived from all participants with the same variables as those in the development sample model. The change in the type 1 diabetes risk score from baseline to 1 year was in itself also highly predictive of type 1 diabetes (P < 0.001). CONCLUSIONS - A risk score based on age, BMI, and OGTT indexes, without dependence on IVGTTs or additional autoantibodies, appears to accurately predict type 1 diabetes in ICA-positive relatives.

Original languageEnglish (US)
Pages (from-to)528-533
Number of pages6
JournalDiabetes care
Volume31
Issue number3
DOIs
StatePublished - Mar 1 2008

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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    Sosenko, J. M., Krischer, J. P., Palmer, J. P., Mahon, J., Cowie, C., Greenbaum, C. J., Cuthbertson, D., Lachin, J. M., & Skyler, J. S. (2008). A risk score for type 1 diabetes derived from autoantibody-positive participants in the diabetes prevention trial-type 1. Diabetes care, 31(3), 528-533. https://doi.org/10.2337/dc07-1459