Dietary Information Improves Model Performance and Predictive Ability of a Noninvasive Type 2 Diabetes Risk Model

PLoS One. 2016 Nov 16;11(11):e0166206. doi: 10.1371/journal.pone.0166206. eCollection 2016.

Abstract

There is no diabetes risk model that includes dietary predictors in Asia. We sought to develop a diet-containing noninvasive diabetes risk model in Northern China and to evaluate whether dietary predictors can improve model performance and predictive ability. Cross-sectional data for 9,734 adults aged 20-74 years old were used as the derivation data, and results obtained for a cohort of 4,515 adults with 4.2 years of follow-up were used as the validation data. We used a logistic regression model to develop a diet-containing noninvasive risk model. Akaike's information criterion (AIC), area under curve (AUC), integrated discrimination improvements (IDI), net classification improvement (NRI) and calibration statistics were calculated to explicitly assess the effect of dietary predictors on a diabetes risk model. A diet-containing type 2 diabetes risk model was developed. The significant dietary predictors including the consumption of staple foods, livestock, eggs, potato, dairy products, fresh fruit and vegetables were included in the risk model. Dietary predictors improved the noninvasive diabetes risk model with a significant increase in the AUC (delta AUC = 0.03, P<0.001), an increase in relative IDI (24.6%, P-value for IDI <0.001), an increase in NRI (category-free NRI = 0.155, P<0.001), an increase in sensitivity of the model with 7.3% and a decrease in AIC (delta AIC = 199.5). The results of the validation data were similar to the derivation data. The calibration of the diet-containing diabetes risk model was better than that of the risk model without dietary predictors in the validation data. Dietary information improves model performance and predictive ability of noninvasive type 2 diabetes risk model based on classic risk factors. Dietary information may be useful for developing a noninvasive diabetes risk model.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diet*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Biological*
  • Reproducibility of Results
  • Risk Factors

Grants and funding

This work was supported by the National High Technology Research and the National 12th five-year Scientific and Technical Support Program of China (2012BAI02B00) [Sun]; Wu Liande Grant of Harbin Medical University (WLD-QN1406) [Na].