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目的 建立适合健康体检个体糖尿病发病风险的评估方法.方法 结合国内外的研究结果分析近年糖尿病发病率资料及发病风险因素,得出我国成年人糖尿病发病的主要风险因素,将目标人群随机分为两组队列,队列1用于危险因素评分方法的建立,采用非条件logistic回归分析筛选糖尿病的危险因素,根据危险因素的回归系数确定不同变量的积分值,以累计积分值的大小判断个体患病的危险性,并以队列2的资料验证该方法进行人群筛检的价值.结果 研究结果表明男性与女性分别当积分值为65.0与65.5时,约登指数最大,故将65.0与65.5作为判别不同性别发生糖尿病风险的阈值,其筛检的灵敏度分别为90.6％与83.3％,特异度分别为89.4％与97.7％,阳性预测值分别为58.8％与80.0％,阴性预测值为98.3％与98.2％.曲线下面积分别为0.955与0.899,危险因素评分法用于筛查糖尿病,差异有统计学意义(P=0.000).结论 该方法简易经济,可操作性强,有望成为健康体检机构筛查人群糖尿病发病的高危人群的实用、有效的方法.

Objective To develop a simple scoring system to identify individuals with higher risk of type 2 diabetes mellitus ( T2DM ).Methods Major risk factors of T2DM were fixed after literature review.Logistic regression was used to select risk factors of T2DM.Target populations were randomly assigned to 2 groups,and group A was used for the development of risk factor scoring method and group B for the confirmation of this new method.Results The threshold for T2DM risk was 65.0 for men and 65.5 for women ( sensitivity 90.6％ and 83.3％,respectively; specificity 89.4％ and 97.7％,respectively ; positive predictive value 58.8％ and 80.0％,respectively; negative predictive value 98.3％ and 98.2％,respectively ; area under the curve 0.955 and 0.899,respectively).There was significant difference of T2DM detection between screening and risk scoring system ( P =0.000 ).Conclusion Our T2DM risk scoring system may provide an effective tool to identify individuals with a higher risk of developing T2DM.