Article Text
Abstract
Objective Identifying individuals with high risk of type 2 diabetes is important. To evaluate discriminatory ability of multiple biomarkers for type 2 diabetes in a Chinese population.
Methods Plasma adiponectin, plasminogen activator inhibitor-1, retinol-binding protein 4, resistin, C-reactive protein, interleukin 6 (IL-6), tumour necrosis factor α receptor 2 and ferritin were measured in a population-based sample of 3189 Chinese (1419 men and 1770 women) aged 50–70 years. A weighted biomarkers risk score (BRS) was developed based on the strength of associations of these biomarkers with type 2 diabetes. The discriminatory ability was tested by the area under receiver operating characteristics curve (AUC).
Results Adiponectin, plasminogen activator inhibitor-1, IL-6 and ferritin were independently associated with the prevalence of type 2 diabetes, and they were used to calculate the biomarkers risk score (BRS). After adjustment for the confounding factors, the ORs for type 2 diabetes and impaired fasting glucose with each point increment of BRS were 1.28 (95% CI 1.22 to 1.34) and 1.16 (1.12 to 1.20), respectively. Compared with those in the lowest quintile of the BRS, the participants in the highest quintile have an OR (95% CI) of 6.67 (4.21 to 10.55) for type 2 diabetes. The area under the curve for the BRS and conventional risk factors alone was 0.73 and 0.76, respectively, and substantially increased to 0.81 after combining both BRS and conventional risk factors (p<0.001).
Conclusions These data suggest that combining multiple biomarkers and conventional risk factors might substantially enhance the ability to identify individuals with type 2 diabetes. More prospective data are warranted to confirm this observation.
- Type 2 diabetes
- biomarker risk score
- receiver operating characteristic
- AUC
- population-based study
- general diabetes
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Footnotes
To cite: Wu H, Yu Z, Qi Q, et al. Joint analysis of multiple biomarkers for identifying type 2 diabetes in middle-aged and older Chinese: a cross-sectional study. BMJ Open 2011;1:e000191. doi:10.1136/bmjopen-2011-000191
Funding This study was financially supported by the Chief Scientist Program of Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences (SIBS2008006), the Ministry of Science and Technology of China (973 program 2011CB504002). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests None.
Patient consent Obtained.
Ethics approval This study was approved by the institutional review board of the Institute for Nutritional Sciences.
Contributors The authors' responsibilities were as follows: HW: study design, data collection and analysis, manuscript production; ZY, XL: study design and editing of the manuscript. QQ, HL, QS: study conception and design, data collection and analysis, and discussing and editing of the manuscript. All authors were responsible for critical revisions and final approval of the manuscript.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data available.