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Strength of association for incident diabetes risk factors according to diabetes case definitions: the Atherosclerosis Risk in Communities Study.

TitleStrength of association for incident diabetes risk factors according to diabetes case definitions: the Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2012
AuthorsBielinski SJ, Pankow JS, Rasmussen-Torvik LJ, Bailey K, Li M, Selvin E, Couper DJ, Vazquez G
Secondary AuthorsBrancati F
JournalAm J Epidemiol
Volume175
Issue5
Pagination466-72
Date Published2012 Mar 01
ISSN1476-6256
KeywordsAtherosclerosis, Blood Glucose, Diabetes Mellitus, Type 2, Epidemiologic Research Design, Humans, Incidence, Linear Models, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Risk Factors, Self Report, United States
Abstract

Prospective epidemiologic studies have characterized major risk factors for incident diabetes by a variety of diabetes case definitions. Whether different definitions alter the association of diabetes with risk factors is largely unknown. Using 1987-1998 data from the ongoing Atherosclerosis Risk in Communities (ARIC) Study, the authors assessed the relation of traditional risk factors with 3 different diabetes case definitions and 4 fasting glucose categories. They compared the study protocol case definition with 2 nested case definitions, self-reported diabetes and a multiple-evidence definition. Significant differences in risk factor associations by case definition and by screening cutpoints were observed. Specifically, the magnitude of the association between the risk factors (baseline metabolic syndrome, fasting glucose, blood pressure, body mass index, and serum insulin) and incident diabetes differed by case definition. Associations with these risk factors were weaker with a case definition based on self-report compared with other definitions. These results illustrate the potential limitations of case definitions that rely solely on self-report or those that incorporate measured glucose values to ascertain undiagnosed cases. Although the ability to identify risk factors of diabetes was consistent for the case definitions studied, tests of novel risk factors may result in different estimates of effect sizes depending on the definition used.

DOI10.1093/aje/kwr326
Alternate JournalAm J Epidemiol
PubMed ID22247044
PubMed Central IDPMC3282875
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
K01 DK076595 / DK / NIDDK NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
P60 DK079637 / DK / NIDDK NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
P60DK079637-04 / DK / NIDDK NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
R21 DK080294 / DK / NIDDK NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States