Comparison of five different risk scores to predict incident type 2 diabetes in the Swiss HIV cohort study.

Blondet, Fanny; Kraege, Vanessa; Matthias, Cavassini; Fernandez, José Damas; Vollenweider, Peter; Wandeler, Gilles; Hoffman, Matthias; Calmy, Alexandra; Stoeckle, Marcel; Bernasconi, Enos; Hasse, Barbara; Marques-Vidal, Pedro; Mean, Marie (2023). Comparison of five different risk scores to predict incident type 2 diabetes in the Swiss HIV cohort study. AIDS, 37(6), pp. 935-939. Wolters Kluwer Health 10.1097/QAD.0000000000003486

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OBJECTIVE

People living with HIV (PLWH) have a higher risk of type 2 diabetes (T2D) than HIV negative individuals. In the general population, diabetes risk scores are used to identify persons at risk of developing T2D, but little is known regarding their performance in PLWH.

DESIGN

Assessment of the capacity of five diabetes risk scores to predict T2D in PLWH.

METHODS

Prospective study including all Swiss HIV cohort study (SHCS) participants followed between 2009 and 2019. Five diabetes risk scores were assessed: FINDRISC versions 1 and 2, Balkau, Swiss Diabetes Association (SDA) and Kraege.

RESULTS

3853 T2D-free PLWH (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 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%.

CONCLUSION

In conclusion, our study shows that the performance of conventional diabetes risk scores in PLWH is promising, especially for Balkau and FINDRISC2 which showed good discriminatory power. These scores may help identify patients at low risk of T2D in whom careful assessment of modifiable T2D risk factors can be spared.

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