Risk stratification of type 2 diabetes in the Russian population depending on FINDRISC category: results of prospective follow-up

Abstract

Aim. To study the risk of type 2 diabetes (T2D) using the Finnish Diabetes Risk Score (FINDRISC) and its contribution to all-cause mortality and cardiovascular events in the Russian population aged ­25-64 years.Material and methods. Data from cross-sectional studies ESSE-RF and ESSE-RF2 are included. The random sample was formed using the Kish method. Response was ~80%. The modular questionnaire in­cluded socio-demographic variables, medical history, and main risk factors for noncommunicable diseases. Blood was collected from the antecubital vein on an empty stomach. Biochemical parameters were determined in the clinical diagnostic laboratory of the National Medical Research Center for Therapy and Preventive Medicine. The presence of T2D was determined by questionnaire and/or fasting plasma glucose level ≥7,0 mmol/L. Obesity was defined as a body mass index of ≥30,0 kg/m2; abdominal obesity was defined as a waist circumference of ≥102 cm in men and ≥88 cm in women. FINDRISC risk was graduated as follow: low (<7), slight (7-11), moderate (12-14), high (15-20), very high (>20). Persons with diabetes and pregnant women were excluded. The final sample included 26418 people (10268 men and 16150 women). From 14 regions, ESSE-RF and ESSE-RF2 formed a prospective follow-up cohort (n=22812), median follow-up — 7,5 years). Statistical processing was performed using the open-source statistical programming language and environ­ment R (version 4.1).Results. A fifth of people aged 25-64 years are at ≥ moderate risk of T2D. The rate of FINDRISC ≥15 was 10,1% (women 12,4% vs men 6,4%, p<0,001); ≥12 points — 23,7%. A close relationship was found between impaired fasting glucose and the risk of T2D with FINDRISC ≥15 and ≥12 (p<0,001). Survival worsens for FINDRISC ≥12 and ≥15, with the worst survival rates in individuals with T2D (p<0,001). The likelihood of cardiovascular events consistently increases with FINDRISC ≥12, ≥15, and T2D. In the Cox model, only T2D is significant for all-cause mortality; FINDRISC ≥15 and T2D are significant for the cardiovascular and combined endpoints.Conclusion. An important task of the medical community is to identify individuals at risk of T2D at the population level. Early prevention of T2D risk factors can delay or prevent both T2D and cardiovascular events.