Dataset Information

Validation of the Diabetes Prevention Trial-Type 1 Risk Score in the TrialNet Natural History Study.

ABSTRACT:

Objective

We assessed the accuracy of the Diabetes Prevention Trial-Type 1 Risk Score (DPTRS), developed from the Diabetes Prevention Trial-Type 1 (DPT-1), in the TrialNet Natural History Study (TNNHS).

Research design and methods

Prediction accuracy of the DPTRS was assessed with receiver-operating characteristic curve areas. The type 1 diabetes cumulative incidence within the DPTRS intervals was compared between the TNNHS and DPT-1 cohorts.

Results

Receiver-operating characteristic curve areas for the DPTRS were substantial in the TNNHS (P < 0.001 at both 2 and 3 years). The type 1 diabetes cumulative incidence did not differ significantly between the TNNHS and DPT-1 cohorts within DPTRS intervals. In the TNNHS, 2-year and 3-year risks were low for DPTRS intervals <6.50 (<0.10 and <0.20, respectively). Thresholds ?7.50 were indicative of high risk in both cohorts (2-year risks: 0.49 in the TNNHS and 0.51 in DPT-1).

Conclusions

The DPTRS is an accurate and robust predictor of type 1 diabetes in autoantibody-positive populations.

SUBMITTER: Sosenko JM

PROVIDER: S-EPMC3142063 | biostudies-literature | 2011 Aug

REPOSITORIES: biostudies-literature

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Publications

Validation of the Diabetes Prevention Trial-Type 1 Risk Score in the TrialNet Natural History Study.

Sosenko Jay M JM Skyler Jay S JS Mahon Jeffrey J Krischer Jeffrey P JP Beam Craig A CA Boulware David C DC Greenbaum Carla J CJ Rafkin Lisa E LE Cowie Catherine C Cuthbertson David D Palmer Jerry P JP

Diabetes care 20110616 8

<h4>Objective</h4>We assessed the accuracy of the Diabetes Prevention Trial-Type 1 Risk Score (DPTRS), developed from the Diabetes Prevention Trial-Type 1 (DPT-1), in the TrialNet Natural History Study (TNNHS).<h4>Research design and methods</h4>Prediction accuracy of the DPTRS was assessed with receiver-operating characteristic curve areas. The type 1 diabetes cumulative incidence within the DPTRS intervals was compared between the TNNHS and DPT-1 cohorts.<h4>Results</h4>Receiver-operating char ...[more]

PMID: 21680724

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Project description:Aims/hypothesisMethods to identify individuals at highest risk for type 1 diabetes are essential for the successful implementation of disease-modifying interventions. Simple metabolic measures are needed to help stratify autoantibody-positive (Aab+) individuals who are at risk of developing type 1 diabetes. HOMA2-B is a validated mathematical tool commonly used to estimate beta cell function in type 2 diabetes using fasting glucose and insulin. The utility of HOMA2-B in association with type 1 diabetes progression has not been tested.MethodsBaseline HOMA2-B values from single-Aab+ (n = 2652; mean age, 21.1 ± 14.0 years) and multiple-Aab+ (n = 3794; mean age, 14.5 ± 11.2 years) individuals enrolled in the TrialNet Pathway to Prevention study were compared. Cox proportional hazard models were used to determine associations between HOMA2-B tertiles and time to progression to type 1 diabetes, with adjustments for age, sex, HLA status and BMI z score. Receiver operating characteristic (ROC) analysis was used to test the association of HOMA2-B with type 1 diabetes development in 1, 2, 5 and 10 years.ResultsAt study entry, HOMA2-B values were higher in single- compared with multiple-Aab+ Pathway to Prevention participants (91.1 ± 44.5 vs 83.9 ± 38.9; p < 0.001). Single- and multiple-Aab+ individuals in the lowest HOMA2-B tertile had a higher risk and faster rate of progression to type 1 diabetes. For progression to type 1 diabetes within 1 year, area under the ROC curve (AUC-ROC) was 0.685, 0.666 and 0.680 for all Aab+, single-Aab+ and multiple-Aab+ individuals, respectively. When correlation between HOMA2-B and type 1 diabetes risk was assessed in combination with additional factors known to influence type 1 diabetes progression (insulin sensitivity, age and HLA status), AUC-ROC was highest for the single-Aab+ group's risk of progression at 2 years (AUC-ROC 0.723 [95% CI 0.652, 0.794]).Conclusions/interpretationThese data suggest that HOMA2-B may have utility as a single-time-point measurement to stratify risk of type 1 diabetes development in Aab+ individuals.

Dataset Information

Validation of the Diabetes Prevention Trial-Type 1 Risk Score in the TrialNet Natural History Study.

Objective

Research design and methods

Results

Conclusions

Publications

Validation of the Diabetes Prevention Trial-Type 1 Risk Score in the TrialNet Natural History Study.

Similar Datasets

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