Comparison of five different risk scores to predict incident type 2 diabetes in the Swiss HIV cohort study. AIDS
Blondet et al. aimed to assess the capacity of five diabetes risk scores (the Kraege score, the FINDRISC versions 1 and 2, the Swiss Diabetes Association (SDA) score [15], and the Balkau clinical risk score in predicting incident type 2 diabetes (T2D) in people living with HIV (PWH).
The scores are composed of different variables, including age, sex, body mass index, weight, waist, hypertension, positive family history, history of hyperglycemia, physical activity and smoking.
Overall, 3’853 T2D-free PWH (78.5% men, 39.9 ± 11.3 years) were included. After a median follow-up of 4.8 years (interquartile range 2.2–7.8), 62 participants (1.6%) developed T2D, corresponding to an incidence rate of 3.18 per 1’000 person-years (95% confidence interval = 2.47–4.08).
Participants who developed T2D were older (48.7 ± 12.4 vs. 39.8 ±11.2 years), more likely to be obese (22.6% vs. 7.4%), abdominally obese (9.7% vs. 1.5%), and to have a family history of diabetes (32.3% vs. 19.1%) than those without T2D. The area under the curve (AUC) for incident T2D ranged between 0.72 (Kraege 16) and 0.81 (SDA, FINDRISC2 and Balkau). Sensitivity ranged between 3.2% (Balkau) and 67.7% (FINDRISC1) and specificity between 80.9% (FINDRISC1) and 98.3% (Balkau). Positive predictive values of all scores were below 20%, while negative predictive values were above 98%
In conclusion, the study shows that the performance of conventional diabetes risk scores in PWH is promising, especially for Balkau and FINDRISC2, which showed good discriminatory power. These scores may help identify patients at a low risk of T2D in whom careful assessment of modifiable T2D risk factors can be spared.