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Validation of the ST1RE risk engine in Chinese with type 1 diabetes and comparison with the JADE, RECODe, and UKPDS
Andre Kh Ma1, Claudia Ht Tam1,2,3,4, Andrea Oy Luk1,2,3,4
1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
Aims:
The Steno Type 1 Risk Engine (ST1RE) was developed to improve cardiovascular risk prediction in people with type 1 diabetes (T1D), but its applicability in Asian populations remains uncertain.
Methods:
Data from the Hong Kong Diabetes Register were analyzed. Cardiovascular risk was assessed using four models: ST1RE, the Joint Asia Diabetes Evaluation (JADE) coronary heart disease equation, Risk Equations for Complications of Type 2 Diabetes (RECODe), and the United Kingdom Prospective Diabetes Study Outcomes Model version 2 (UKPDS-OM2). Associations between risk scores and incident cardiovascular disease (CVD) were examined using Cox regression, and predictive performance was evaluated using the concordance index (C-index).
Results:
The analysis included 172 Chinese T1D patients (50% male), with a mean age of 31.0 ± 15.8 and 9.3 ± 6.7 years of T1D at baseline. Over 21.8 ± 5.78 years of follow-up, 16 (9.30%) patients developed CVD. All risk scores were significantly associated with incident CVD (P < 0.05) and achieved C-indices >0.8, indicating good discrimination. The limited sample size reduced statistical power.
Conclusions:
ST1RE and other risk models developed for people with type 2 diabetes may be suitable for cardiovascular risk prediction in Chinese with T1D. Further investigation with a larger cohort is advised.
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