Objective: To evaluate the effectiveness single index and combined index on early screening diabetesand to offer a suitable strategy for screening type 2 diabetes and pre-diabetes in a community. Methods: Based on apopulationof 2013 Chronic Disease Risk Factor Surveillance, information on sex, age, height, weight, waist circumference, blood pressure, FPG(fasting plasma glucose),2 h PG(2 h postprandial glucose) were collected. Individuals diagnosed as diabetes at the time of survey and individuals missing information were excluded. A total of 2 642 individuals were involved in a supplementary investigation on family history and diagnosis of diabetes. The response rate was 98.6% (2 605/2 642). Newly diagnosed diabetes or pre-diabetes were considered as positive events,Receiver Operating Characteristic Curve(ROC) analysis was used to explore the optimal cut-off point and efficacy for screening asymptomatic diabetes and pre-diabetes when noninvasive method (risk score) as well as lab testing method (FPG, 2 h PG) were used alone or combined. Results: The optimal cut-off point of risk score for screening diabetes was 30 point. The area under the ROC was 0.808. The sensitivity and specificity were 76% and 72%, respectively. By using risk score, at least 76% of individuals could be identified asdiabetes and the number of subsequent blood tests was reduced to 32%, and the cost for detecting every single diabetic reduced from RMB 219 (OGTT for all people) to 92. Combined method had a higher sensitivity and specificity than single index method for screening DM, and also had alower rate of missed diagnosis and misdiagnosis, and the cost for detecting every single case reduced to RMB 79. Conclusion: Risk score is much helpful for screening high risk population in the community with its high efficiency, economy and simplicity, thus reducing sample size for OGTT and increasing DM screening efficiency in the community. We can use a simplified method combing risk score and 2 h PG for screening asymptomatic patients with diabetes, to achieve the target of improving compliance of the subjects, reducing screening cost and increasing screening efficiency. |