A Point System for Predicting 10-Year Risk of Developing Type 2 Diabetes Mellitus in Japanese Men: Aichi Workers’ Cohort Study

Abstract

BackgroundRelatively little evidence exists for type 2 diabetes mellitus (T2DM) prediction models from long-term follow-up studies in East Asians. This study aims to develop a point-based prediction model for 10-year risk of developing T2DM in middle-aged Japanese men.MethodsWe followed 3,540 male participants of Aichi Workers’ Cohort Study, who were aged 35–64 years and were free of diabetes in 2002, until March 31, 2015. Baseline age, body mass index (BMI), smoking status, alcohol consumption, regular exercise, medication for dyslipidemia, diabetes family history, and blood levels of triglycerides (TG), high density lipoprotein cholesterol (HDLC) and fasting blood glucose (FBG) were examined using Cox proportional hazard model. Variables significantly associated with T2DM in univariable models were simultaneously entered in a multivariable model for determination of the final model using backward variable selection. Performance of an existing T2DM model when applied to the current dataset was compared to that obtained in the present study’s model.ResultsDuring the median follow-up of 12.2 years, 342 incident T2DM cases were documented. The prediction system using points assigned to age, BMI, smoking status, diabetes family history, and TG and FBG showed reasonable discrimination (c-index: 0.77) and goodness-of-fit (Hosmer-Lemeshow test, P = 0.22). The present model outperformed the previous one in the present subjects.ConclusionThe point system, once validated in the other populations, could be applied to middle-aged Japanese male workers to identify those at high risk of developing T2DM. In addition, further investigation is also required to examine whether the use of this system will reduce incidence.

The Dose-Response Relationship between Alcohol Consumption and the Risk of Type 2 Diabetes among Asian Men: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

“…Alcohol Consumption and T2D. All 8 studies included in the meta-analysis evaluated the association between alcohol intake and the T2D risk [12][13][14][15][29][30][31][32]. The summary RRs showed that alcohol intake, compared with no alcohol intake, was not associated with risk of T2D among Asian men (RR = 1:01, 95% CI: 0.88-1.15, p = 0:931; Q statistic, p < 0:001; I 2 = 76%) ( Supplementary Figure 1).…”

“…Meta-Analysis. Eight cohorts were included in the dose-response analysis, estimating the relationship between alcohol intake and risk of T2D [12][13][14][15][29][30][31][32]. There was a nonlinear dose-response relationship between alcohol intake and T2D risk among Asian men (p nonlinearity = 0:003) (Figure 3).…”

“…However, a meta-analysis of studies on Asian populations has not been reported to date. Historically, alcohol intake has been widespread among Asian men, but not among Asian women, and the studies examining the impact of alcohol on the risk of T2D in Asian populations have focused primarily on men [ 12 – 15 ]. Therefore, a meta-analysis was warranted to provide a summary of the existing literature and clarify the association between average daily alcohol consumption and T2D risk among Asian men.…”

“…Following initial screening, 71 potentially eligible studies were selected. After detailed evaluations, 8 prospective studies were included in the meta-analyses[12][13][14][15][29][30][31][32]. The 8 included studies reported data on 89,842 individuals (3,975 T2D cases), enrolled in prospective cohort studies.…”

“…The range of follow-up period was 4-12.2 years. A total of 4 studies originated in Japan[15,29,31,32], 2 in Korea…”