芬兰、德国、中国版糖尿病风险筛查量表的比较及中国版量表的修订
Comparison of the Finland, German and Chinese Versions of Diabetes Risk Screening Scales and Revision of Chinese Version

摘要：目的：1）选择芬兰版糖尿病风险筛查量表、德国版糖尿病风险筛查量表、中国版糖尿病风险筛查量表，对同一批研究对象进行筛查，以评价3个量表在中国糖尿病筛查中的应用效果；2）对中国版糖尿病风险筛查量表进行修订。方法：选取北京某医院参与日常体检者，对其进行问卷调查；由经过培训的调查人员对其进行测量，并记录其年龄、性别、身高、体重、腰围、臀围等形态指标以及空腹血浆葡萄糖和餐后2 h血浆葡萄糖指标。用受试者工作特征曲线（ROC曲线）的曲线下面积（AUC）反应筛查方法的准确度；用约登指数反应不同累计分值对目标人群筛检的效果。结果：1）芬兰版、德国版、中国版量表的AUC分别为0.770（95%CI：0.707~0.826，P<0.0001）、0.658（95%CI：0.589~0.722，P=0.0001）和0.819（95%CI：0.760~0.869，P<0.0001）;2）中国改编版量表的AUC为0.814（95%CI：0.755~0.865，P<0.0001）。结论：1）中国版量表的筛查效果优于芬兰版和德国版量表，较适用于中国人群的糖尿病筛查;2）中国改编版量表包括年龄、BMI、腰围、收缩压、舒张压、体力活动、DM家族史和高血糖史共8个条目（评分范围为0~124分），它具有较好的筛查效果，适用于中国人群的糖尿病筛查。
Abstract: Objective: 1) This study screened the same subjects by three versions diabetes risk screening scales of Finland, Germany and China, for evaluating their effect on screening Chinese diabetes; 2) This study aimed at revising Chinese version of this scale. Methods: People participated in daily physical examination in a hospital of Beijing were selected, and they finished questionnaires. Their age, sex, the morphological indexes such as height, weight, waist circumference, hip circumference, fasting plasma glucose and postprandial 2 hour plasma glucose were tested and recorded. The accuracy of screening scales was tested by the AUC of ROC; the screening effect of targeted people was showed by Youden index. Results: 1) The AUC of Finland, German, and Chinese versions of the scale are 0.770 (95%CI：0.707-0.826, P < 0.0001), 0.658 (95%CI：0.589-0.722, P=0.0001) and 0.819 (95%CI: 0.760-0.869, P < 0.0001) respectively. 2) The AUC of Chinese revised edition of the scale is 0.814 (95%CI: 0.755-0.865, P < 0.0001). Conclusion: 1) The screening effect of the Chinese version of scale is better than that of Finland and German versions; it is suitable for Chinese people's diabetes screening. 2) The Chinese revised edition of the scale includes eight items which are age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, physical activity, DM family history and high blood glucose history (scored ranges for 0-124); it has good screening effect, and is more suitable for Chinese people's diabetes screening than the Chinese version