Validation of Risk Equations for Complications of Type 2 Diabetes (RECODe) Using Individual Participant Data From Diverse Longitudinal Cohorts in the U.S.
Year: 2017
Type: article
Abstract: OBJECTIVE We sought to validate Risk Equations for Complications of Type 2 Diabetes (RECODe) among diverse populations. RESEARCH DESIGN AND METHODS We compared risk predictions from RECODe equations and from two alternative risk models (UK Prospective Diabetes Study Outcomes Model 2 [UKPDS OM2] and American College of Cardiology/American Heart Association Pooled Cohort Equations) to observed outcomes in two studies: the Multi-Ethnic Study of Atherosclerosis (MESA, n = 1,555 adults with type 2 diabetes, median follow-up 9.1 years) and the Jackson Heart Study (JHS, n = 1,746 adults with type 2 diabetes, median follow-up 8.0 years). Outcomes included nephropathy by multiple measures (microalbuminuria, macroalbuminuria, renal failure, end-stage renal disease, and reduction in glomerular filtration rate), moderate to severe diabetic retinopathy by Airlie House classification, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, congestive heart failure, and all-cause mortality. RESULTS RECODe equations for microvascular and cardiovascular outcomes had C-statistics for discrimination ranging from 0.71 to 0.85 in MESA and 0.64 to 0.91 in JHS for alternative outcomes. Calibration slopes in MESA ranged from 0.62 for a composite nephropathy outcome, 0.83–1.04 for individual nephropathy outcomes, 1.07 for retinopathy, 1.00–1.05 for cardiovascular outcomes, and 1.03 for all-cause mortality. Slopes in JHS ranged from 0.47 for retinopathy, 0.97–1.16 for nephropathy, 0.72–1.05 for cardiovascular outcomes, and 1.01 for all-cause mortality. The alternative models had C-statistics 0.50–0.72 and calibration slopes 0.07–0.60. CONCLUSIONS RECODe equations improved risk estimation for diverse patients with type 2 diabetes, as compared with two commonly used alternatives.
Source: Diabetes Care
DOI: 10.2337/dc17-2002
Institutions: Harvard University, Stanford Medicine, Stanford University, University of Michigan, VA Ann Arbor Healthcare System, VA Center for Clinical Management Research, Massachusetts General Hospital, Wake Forest University Health Sciences, Wake Forest University, University of Mississippi Medical Center, Jackson State University, University College London
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: U.S. Department of Veterans Affairs, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences, National Institute on Minority Health and Health Disparities
Awards: G112182703, Understanding & Overcoming Food Insecurity in Diabetes Patients, MESA, G1303440240, G1409423729, G1421216546, G1654440994, G1686417863, G208841273, G2262782284, MESA, G2548340643, MESA, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--EBCT READING, Studying social factors in sodium consumption to reduce hypertension disparities, G3395363768, G3647016462, G3687594596, MESA, G399481048, TITLE: MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA), Stanford Precision Health for Ethnic and Racial Equity (SPHERE) Transdisciplinary Collaborative Center, G4512137732, G4608159596, OPTION 3. 4/1/2014 - 3/31/2015. MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA) - READING CENTER, NHLBI, MESA, G5088122703, G5108002584, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-ULTRASOUND, Targeted Analyses of Jackson Heart Study Data, G5787256936, G6095866717, G6359107525, Institute for Clinical and Translational Research, MESA, G6514094751, G6679697438, G7226679574, MESA, Clinical and Translational Science Award, G898467768, Michigan Center for Diabetes Translational Research, G94668252
OpenAlex ID: W2778919216