PMID- 35972686 OWN - NLM STAT- MEDLINE DCOM- 20230124 LR - 20230201 IS - 1720-8386 (Electronic) IS - 0391-4097 (Linking) VI - 46 IP - 2 DP - 2023 Feb TI - Development and validation of risk prediction models for stroke and mortality among patients with type 2 diabetes in northern China. PG - 271-283 LID - 10.1007/s40618-022-01898-0 [doi] AB - BACKGROUND: Stroke is one of the leading causes of disability and mortality in patients with type 2 diabetes mellitus (T2DM). Risk models have been developed for predicting stroke and stroke-associated mortality among patients with T2DM. Here, we evaluated risk factors of stroke for individualized prevention measures in patients with T2DM in northern China. METHODS: In the community-based Tianjin Chronic Disease Cohort study, 58,042 patients were enrolled between January 2014 and December 2019. We used multiple imputation (MI) to impute missing variables and univariate and multivariate Cox's proportional hazard regression to screen risk factors of stroke. Furthermore, we established and validated first-ever prediction models for stroke (Model 1 and Model 2) and death from stroke (Model 3) and evaluated their performance. RESULTS: In the derivation and validation groups, the area under the curves (AUCs) of Models 1-3 was better at 5 years than at 8 years. The Harrell's C-index for all models was above 0.7. All models had good calibration, discrimination, and clinical net benefit. Sensitivity analysis using the MI dataset indicated that all models had good and stable prediction performance. CONCLUSION: In this study, we developed and validated first-ever risk prediction models for stroke and death from stroke in patients with T2DM, with good discrimination and calibration observed in all models. Based on lifestyle, demographic characteristics, and laboratory examination, these models could provide multidimensional management and individualized risk assessment. However, the models developed here may only be applicable to Han Chinese. CI - (c) 2022. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE). FAU - Shao, X AU - Shao X AD - NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China. AD - Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China. FAU - Liu, H AU - Liu H AD - NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China. AD - Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China. FAU - Hou, F AU - Hou F AD - Community Health Service Center, Jiefang Road, Tanggu Street, Binhai New District, Tianjin, China. FAU - Bai, Y AU - Bai Y AD - NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China. AD - Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China. FAU - Cui, Z AU - Cui Z AD - Department of Epidemiology and Health Statistics, Tianjin Medical University, Heping District, Tianjin, China. FAU - Lin, Y AU - Lin Y AD - NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China. AD - Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China. FAU - Jiang, X AU - Jiang X AD - NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China. AD - Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China. FAU - Bai, P AU - Bai P AD - NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China. AD - Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China. FAU - Wang, Y AU - Wang Y AD - NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China. AD - Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China. FAU - Zhang, Y AU - Zhang Y AD - Community Health Service Center, Jiefang Road, Tanggu Street, Binhai New District, Tianjin, China. FAU - Lu, C AU - Lu C AD - Community Health Service Center, Jiefang Road, Tanggu Street, Binhai New District, Tianjin, China. FAU - Liu, H AU - Liu H AD - Community Health Service Center, Jiefang Road, Tanggu Street, Binhai New District, Tianjin, China. FAU - Zhou, S AU - Zhou S AD - NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China. AD - Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China. FAU - Yu, P AU - Yu P AUID- ORCID: 0000-0001-6137-5824 AD - NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China. peiyu@tmu.edu.cn. AD - Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China. peiyu@tmu.edu.cn. LA - eng GR - ZXY-ZDSYSZD2021-1/Open Project of Tianjin Key Laboratory of Metabolic Diseases/ GR - no.91746205/the National Natural Science Foundation of China/ GR - No.21ZXGWSY00100/Tianjin Science and Technology Plan Project Public Health Science and Technology Major Special Project/ PT - Journal Article DEP - 20220816 PL - Italy TA - J Endocrinol Invest JT - Journal of endocrinological investigation JID - 7806594 SB - IM MH - Humans MH - *Diabetes Mellitus, Type 2/complications/epidemiology/diagnosis MH - Cohort Studies MH - Risk Factors MH - *Stroke/epidemiology/etiology MH - China/epidemiology OTO - NOTNLM OT - Prediction model OT - Risk factors OT - Stroke OT - Stroke prevention OT - Type 2 diabetes EDAT- 2022/08/17 06:00 MHDA- 2023/01/25 06:00 CRDT- 2022/08/16 11:21 PHST- 2022/03/18 00:00 [received] PHST- 2022/08/01 00:00 [accepted] PHST- 2022/08/17 06:00 [pubmed] PHST- 2023/01/25 06:00 [medline] PHST- 2022/08/16 11:21 [entrez] AID - 10.1007/s40618-022-01898-0 [pii] AID - 10.1007/s40618-022-01898-0 [doi] PST - ppublish SO - J Endocrinol Invest. 2023 Feb;46(2):271-283. doi: 10.1007/s40618-022-01898-0. Epub 2022 Aug 16.