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Metabolic Risk/Epidemiology
A Comparison of Predictive Performances between Old versus New Criteria in a Risk-Based Screening Strategy for Gestational Diabetes Mellitus
Subeen Hong, Seung Mi Lee, Soo Heon Kwak, Byoung Jae Kim, Ja Nam Koo, Ig Hwan Oh, Sohee Oh, Sun Min Kim, Sue Shin, Won Kim, Sae Kyung Joo, Errol R. Norwitz, Souphaphone Louangsenlath, Chan-Wook Park, Jong Kwan Jun, Joong Shin Park
Diabetes Metab J. 2020;44(5):726-736.   Published online April 13, 2020
DOI: https://doi.org/10.4093/dmj.2019.0126
  • 6,599 View
  • 123 Download
  • 9 Web of Science
  • 9 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

The definition of the high-risk group for gestational diabetes mellitus (GDM) defined by the American College of Obstetricians and Gynecologists was changed from the criteria composed of five historic/demographic factors (old criteria) to the criteria consisting of 11 factors (new criteria) in 2017. To compare the predictive performances between these two sets of criteria.

Methods

This is a secondary analysis of a large prospective cohort study of non-diabetic Korean women with singleton pregnancies designed to examine the risk of GDM in women with nonalcoholic fatty liver disease. Maternal fasting blood was taken at 10 to 14 weeks of gestation and measured for glucose and lipid parameters. GDM was diagnosed by the two-step approach.

Results

Among 820 women, 42 (5.1%) were diagnosed with GDM. Using the old criteria, 29.8% (n=244) of women would have been identified as high risk versus 16.0% (n=131) using the new criteria. Of the 42 women who developed GDM, 45.2% (n=19) would have been mislabeled as not high risk by the old criteria versus 50.0% (n=21) using the new criteria (1-sensitivity, 45.2% vs. 50.0%, P>0.05). Among the 778 patients who did not develop GDM, 28.4% (n=221) would have been identified as high risk using the old criteria versus 14.1% (n=110) using the new criteria (1-specificity, 28.4% vs. 14.1%, P<0.001).

Conclusion

Compared with the old criteria, use of the new criteria would have decreased the number of patients identified as high risk and thus requiring early GDM screening by half (from 244 [29.8%] to 131 [16.0%]).

Citations

Citations to this article as recorded by  
  • Predicting the Risk of Insulin-Requiring Gestational Diabetes before Pregnancy: A Model Generated from a Nationwide Population-Based Cohort Study in Korea
    Seung-Hwan Lee, Jin Yu, Kyungdo Han, Seung Woo Lee, Sang Youn You, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
    Endocrinology and Metabolism.2023; 38(1): 129.     CrossRef
  • Metabolic Dysfunction-Associated Fatty Liver Disease and Subsequent Development of Adverse Pregnancy Outcomes
    Seung Mi Lee, Young Mi Jung, Eun Saem Choi, Soo Heon Kwak, Ja Nam Koo, Ig Hwan Oh, Byoung Jae Kim, Sun Min Kim, Sang Youn Kim, Gyoung Min Kim, Sae Kyung Joo, Bo Kyung Koo, Sue Shin, Errol R. Norwitz, Chan-Wook Park, Jong Kwan Jun, Won Kim, Joong Shin Park
    Clinical Gastroenterology and Hepatology.2022; 20(11): 2542.     CrossRef
  • Nonalcoholic fatty liver disease and early prediction of gestational diabetes mellitus using machine learning methods
    Seung Mi Lee, Suhyun Hwangbo, Errol R. Norwitz, Ja Nam Koo, Ig Hwan Oh, Eun Saem Choi, Young Mi Jung, Sun Min Kim, Byoung Jae Kim, Sang Youn Kim, Gyoung Min Kim, Won Kim, Sae Kyung Joo, Sue Shin, Chan-Wook Park, Taesung Park, Joong Shin Park
    Clinical and Molecular Hepatology.2022; 28(1): 105.     CrossRef
  • Nonalcoholic fatty liver disease-based risk prediction of adverse pregnancy outcomes: Ready for prime time?
    Seung Mi Lee, Won Kim
    Clinical and Molecular Hepatology.2022; 28(1): 47.     CrossRef
  • Postprandial Free Fatty Acids at Mid-Pregnancy Increase the Risk of Large-for-Gestational-Age Newborns in Women with Gestational Diabetes Mellitus
    So-Yeon Kim, Young Shin Song, Soo-Kyung Kim, Yong-Wook Cho, Kyung-Soo Kim
    Diabetes & Metabolism Journal.2022; 46(1): 140.     CrossRef
  • Effect of Different Types of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Neonatal Outcomes: A Systematic Review, Meta-Analysis, and Meta-Regression
    Fahimeh Ramezani Tehrani, Marzieh Saei Ghare Naz, Razieh Bidhendi-Yarandi, Samira Behboudi-Gandevani
    Diabetes & Metabolism Journal.2022; 46(4): 605.     CrossRef
  • Development of early prediction model for pregnancy-associated hypertension with graph-based semi-supervised learning
    Seung Mi Lee, Yonghyun Nam, Eun Saem Choi, Young Mi Jung, Vivek Sriram, Jacob S. Leiby, Ja Nam Koo, Ig Hwan Oh, Byoung Jae Kim, Sun Min Kim, Sang Youn Kim, Gyoung Min Kim, Sae Kyung Joo, Sue Shin, Errol R. Norwitz, Chan-Wook Park, Jong Kwan Jun, Won Kim,
    Scientific Reports.2022;[Epub]     CrossRef
  • The Clinical Characteristics of Gestational Diabetes Mellitus in Korea: A National Health Information Database Study
    Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
    Endocrinology and Metabolism.2021; 36(3): 628.     CrossRef
  • The risk of pregnancy‐associated hypertension in women with nonalcoholic fatty liver disease
    Young Mi Jung, Seung Mi Lee, Subeen Hong, Ja Nam Koo, Ig Hwan Oh, Byoung Jae Kim, Sun Min Kim, Sang Youn Kim, Gyoung Min Kim, Sae Kyung Joo, Sue Shin, Errol R. Norwitz, Chan‐Wook Park, Jong Kwan Jun, Won Kim, Joong Shin Park
    Liver International.2020; 40(10): 2417.     CrossRef
Cardiovascular Risk/Epidemiology
Validation of Risk Prediction Models for Atherosclerotic Cardiovascular Disease in a Prospective Korean Community-Based Cohort
Jae Hyun Bae, Min Kyong Moon, Sohee Oh, Bo Kyung Koo, Nam Han Cho, Moon-Kyu Lee
Diabetes Metab J. 2020;44(3):458-469.   Published online January 13, 2020
DOI: https://doi.org/10.4093/dmj.2019.0061
  • 6,866 View
  • 225 Download
  • 14 Web of Science
  • 15 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

To investigate the performance of the 2013 American College of Cardiology/American Heart Association Pooled Cohort Equations (PCE) in a large, prospective, community-based cohort in Korea and to compare it with that of the Framingham Global Cardiovascular Disease Risk Score (FRS-CVD) and the Korean Risk Prediction Model (KRPM).

Methods

In the Korean Genome and Epidemiology Study (KOGES)-Ansan and Ansung study, we evaluated calibration and discrimination of the PCE for non-Hispanic whites (PCE-WH) and for African Americans (PCE-AA) and compared their predictive abilities with the FRS-CVD and the KRPM.

Results

The present study included 7,932 individuals (3,778 men and 4,154 women). The PCE-WH and PCE-AA moderately overestimated the risk of atherosclerotic cardiovascular disease (ASCVD) for men (6% and 13%, respectively) but underestimated the risk for women (−49% and −25%, respectively). The FRS-CVD overestimated ASCVD risk for men (91%) but provided a good risk prediction for women (3%). The KRPM underestimated ASCVD risk for men (−31%) and women (−31%). All the risk prediction models showed good discrimination in both men (C-statistic 0.730 to 0.735) and women (C-statistic 0.726 to 0.732). Recalibration of the PCE using data from the KOGES-Ansan and Ansung study substantially improved the predictive accuracy in men.

Conclusion

In the KOGES-Ansan and Ansung study, the PCE overestimated ASCVD risk for men and underestimated the risk for women. The PCE-WH and the FRS-CVD provided an accurate prediction of ASCVD in men and women, respectively.

Citations

Citations to this article as recorded by  
  • Risk Factors for Infertility in Korean Women
    Juyeon Lee, Chang-Woo Choo, Kyoung Yong Moon, Sang Woo Lyu, Hoon Kim, Joong Yeup Lee, Jung Ryeol Lee, Byung Chul Jee, Kyungjoo Hwang, Seok Hyun Kim, Sue K. Park
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Evaluating cardiovascular disease risk stratification using multiple-polygenic risk scores and pooled cohort equations: insights from a 17-year longitudinal Korean cohort study
    Yi Seul Park, Hye-Mi Jang, Ji Hye Park, Bong-Jo Kim, Hyun-Young Park, Young Jin Kim
    Frontiers in Genetics.2024;[Epub]     CrossRef
  • Moderation of Weight Misperception on the Associations Between Obesity Indices and Estimated Cardiovascular Disease Risk
    Kayoung Lee
    International Journal of Behavioral Medicine.2023; 30(1): 89.     CrossRef
  • Validation of the general Framingham Risk Score (FRS), SCORE2, revised PCE and WHO CVD risk scores in an Asian population
    Sazzli Shahlan Kasim, Nurulain Ibrahim, Sorayya Malek, Khairul Shafiq Ibrahim, Muhammad Firdaus Aziz, Cheen Song, Yook Chin Chia, Anis Safura Ramli, Kazuaki Negishi, Nafiza Mat Nasir
    The Lancet Regional Health - Western Pacific.2023; 35: 100742.     CrossRef
  • Principles of cardiovascular risk management in perimenopausal women with type 2 diabetes
    F. O. Ushanova, T. Yu. Demidova, T. N. Korotkova
    FOCUS. Endocrinology.2023; 4(2): 19.     CrossRef
  • Prediction of the 10-year risk of atherosclerotic cardiovascular disease in the Korean population
    Sangwoo Park, Yong-Giun Kim, Soe Hee Ann, Young-Rak Cho, Shin-Jae Kim, Seungbong Han, Gyung-Min Park
    Epidemiology and Health.2023; 45: e2023052.     CrossRef
  • Triglyceride-Glucose Index Predicts Future Atherosclerotic Cardiovascular Diseases: A 16-Year Follow-up in a Prospective, Community-Dwelling Cohort Study
    Joon Ho Moon, Yongkang Kim, Tae Jung Oh, Jae Hoon Moon, Soo Heon Kwak, Kyong Soo Park, Hak Chul Jang, Sung Hee Choi, Nam H. Cho
    Endocrinology and Metabolism.2023; 38(4): 406.     CrossRef
  • Validity of the models predicting 10-year risk of cardiovascular diseases in Asia: A systematic review and prediction model meta-analysis
    Mahin Nomali, Davood Khalili, Mehdi Yaseri, Mohammad Ali Mansournia, Aryan Ayati, Hossein Navid, Saharnaz Nedjat, Hean Teik Ong
    PLOS ONE.2023; 18(11): e0292396.     CrossRef
  • Assessing the Validity of the Criteria for the Extreme Risk Category of Atherosclerotic Cardiovascular Disease: A Nationwide Population-Based Study
    Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
    Journal of Lipid and Atherosclerosis.2022; 11(1): 73.     CrossRef
  • Mediation of Grip Strength on the Association Between Self-Rated Health and Estimated Cardiovascular Disease Risk
    Kayoung Lee
    Metabolic Syndrome and Related Disorders.2022; 20(6): 344.     CrossRef
  • Implications of the heterogeneity between guideline recommendations for the use of low dose aspirin in primary prevention of cardiovascular disease
    Xiao-Ying Li, Li Li, Sang-Hoon Na, Francesca Santilli, Zhongwei Shi, Michael Blaha
    American Journal of Preventive Cardiology.2022; 11: 100363.     CrossRef
  • The Risk of Cardiovascular Disease According to Chewing Status Could Be Modulated by Healthy Diet in Middle-Aged Koreans
    Hyejin Chun, Jongchul Oh, Miae Doo
    Nutrients.2022; 14(18): 3849.     CrossRef
  • Management of Cardiovascular Risk in Perimenopausal Women with Diabetes
    Catherine Kim
    Diabetes & Metabolism Journal.2021; 45(4): 492.     CrossRef
  • Comparative performance of the two pooled cohort equations for predicting atherosclerotic cardiovascular disease
    Alessandra M. Campos-Staffico, David Cordwin, Venkatesh L. Murthy, Michael P. Dorsch, Jasmine A. Luzum
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  • Usefulness of Relative Handgrip Strength as a Simple Indicator of Cardiovascular Risk in Middle-Aged Koreans
    Won Bin Kim, Jun-Bean Park, Yong-Jin Kim
    The American Journal of the Medical Sciences.2021; 362(5): 486.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal