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目的构建受试者工作特征(ROC)曲线模型,评价2型糖尿病危险评分表(Score)筛查无症状糖尿病人群的效果,并评价年龄和性别等协变量因素对Score筛查效果的影响。方法使用2006年青岛糖尿病预防计划中的4070名受试者的横断面调查资料,所有受试者均填写Score,并行口服糖耐量实验(OGTT)以确诊无症状2型糖尿病患者。研究使用Score累计得分筛查无症状糖尿病人群的灵敏度、特异度及ROC曲线下的面积(AUC)。然后基于协变量ROC模型,将Score转化为有序变量,分别以其为因变量,以是否为糖尿病、年龄和性别及其交互作用项为协变量拟合有序Logistic回归模型,根据AUC,评价年龄和性别对Score筛查糖尿病效果的影响。结果 Score筛查无症状糖尿病人群的灵敏度为0.62,特异度为0.62,AUC为0.67;年龄和性别等协变量因素对Score筛查效果的影响为低年龄组大于高年龄组,女性大于男性,即Score用于筛查无症状糖尿病人群的效果为低年龄组优于高年龄组,女性优于男性。结论 Score是筛查无症状糖尿病人群简单有效的方法;Score制定和使用时应考虑年龄和性别等协变量因素,以期达到最佳筛查效能。
Objective To construct ROC curve model to evaluate the effect of Type 2 diabetes screening on asymptomatic diabetic patients and to evaluate the effect of covariates such as age and gender on Score screening. Methods The cross-sectional data of 4070 subjects in Qingdao Diabetes Prevention Program in 2006 were used. All participants completed Score and conducted Oral Glucose Tolerance Test (OGTT) to diagnose asymptomatic type 2 diabetic patients. Scores were scored to assess the sensitivity, specificity, and area under the ROC curve (AUC) for asymptomatic diabetic patients using the Score score. Then, based on the covariate ROC model, Score was transformed into ordered variable, respectively, and then Logistic regression model was fitted as an independent variable based on whether it was diabetes, age and gender, and their interaction as covariates. According to AUC, Effect of Age and Sex on the Screening of Diabetes by Score. Results Score screening asymptomatic diabetic patients sensitivity was 0.62, specificity was 0.62, AUC was 0.67; covariates such as age and gender on Score screening results were lower than the older age group, women than men, that is, Score for screening asymptomatic diabetic population effect is better than the younger age group than the high age group, women than men. Conclusion Score is a simple and effective method for screening asymptomatic diabetic subjects. Coefficients such as age and gender should be taken into consideration when setting and using Score in order to achieve the best screening performance.