Diabetes Care
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Diabetes Care 30:e90 2007
DOI: 10.2337/dc07-0859
© 2007 by the American Diabetes Association
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Online Letters: Comments and Responses

An Accurate Risk Score Based on Anthropometric, Dietary, and Lifestyle Factors to Predict the Development of Type 2 Diabetes

Response to Chien

Matthias B. Schulze, DRPH and Kurt Hoffmann, PHD

From the Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany

Address correspondence to Matthias B. Schulze, German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany. E-mail: mschulze{at}dife.de

We appreciate Chien's comment (1) and his interest in our article (2). He noted an alleged error in our formula for estimating the probability to develop diabetes in the next 5 years. He proposed to subtract the sample mean values of the risk factors in advance, as should be done in applying the Framingham coronary heart disease risk score. However, the Framingham score is based on a slightly different statistical approach that works with a baseline survival rate at the mean values of the risk factors (3). In contrast, our approach is based on a baseline survival rate at the 0 values of the risk factors; thus, standardizing the risk factors by subtracting the sample means would create biased estimates of the probability of interest. Doing so would strongly underestimate the diabetes incidence in the European Prospective Investigation into Cancer and Nutrition Potsdam cohort compared with the observed incidence rate.

References

  1. Chien KL: An accurate risk score based on anthropometric, dietary, and lifestyle factors to predict the development of type 2 diabetes (Letter). Diabetes Care 30:eXX, 2007. DOI: 10.2337/dc07-0814
  2. Schulze MB, Hoffmann K, Boeing H, Linseisen J, Rohrmann S, Mohlig M, Pfeiffer AF, Spranger J, Thamer C, Haring HU, Fritsche A, Joost HG: An accurate risk score based on anthropometric, dietary, and lifestyle factors to predict the development of type 2 diabetes. Diabetes Care 30:510–515, 2007[Abstract/Free Full Text]
  3. Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB: Prediction of coronary heart disease using risk factor categories. Circulation 97:1837–1847, 1998[Abstract/Free Full Text]

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This Article
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