Key result
Diabetes diagnosed according to the 2020 Chinese guidelines was significantly associated with increased cardiovascular disease risk (HR 1.607) and demonstrated better predictive value than previous criteria.
Why the study?
The Chinese Diabetes Society published new diagnostic criteria for diabetes in 2020, prompting an evaluation of their predictive value for cardiovascular diseases compared with the previous version.
Does diabetes diagnosed by the 2020 Chinese guidelines better predict future cardiovascular disease compared to the previous diagnostic criteria?
Cohort (n=5,884)
Yes
Does diabetes diagnosed by the 2020 Chinese guidelines better predict future cardiovascular disease compared to the previous diagnostic criteria?
The 2020 Chinese diabetes diagnostic criteria, which incorporate HbA1c ≥ 6.5%, demonstrate superior predictive value for future cardiovascular events compared to previous criteria.
Answers are grounded in this paper and cite their sources.
Supports refined CVD risk assessment with 2020 Chinese diabetes criteria; leaves open need for validation before clinical adoption.
OBJECTIVE: Chinese diabetes society has published the new diagnostic criteria for diabetes in China (2020 edition). We aimed to investigate the predictive value of new diabetes-diagnosed criteria for cardiovascular diseases (CVD). METHODS: A total of 5884 individuals from the China Health and Retirement Longitudinal Study in 2011 and 2018 were enrolled. Baseline characteristics and outcome data were compared. The association between diabetes diagnosed by two criteria and future CVD was identified by Kaplan-Meier curves, Cox regression analyses, and receiver-operating characteristic analyses. Delong's test was conducted to compare the predictive value for future CVD between diabetes diagnosed by the 2020 edition and diabetes diagnosed by the previous version. RESULTS: After multivariate adjustment, both diabetes diagnosed by the 2020 edition and diabetes diagnosed by the previous edition is associated with CVD (HR 1.607, 95% CI 1.221-2.115, P < 0.001; HR 1.244, 95% CI 1.060-1.460, P = 0.007, respectively). The Kaplan-Meier analysis indicated that diabetes patients have more cardiovascular risk (log-rank P<0.001). Moreover, diabetes diagnosed in the 2020 edition illustrated an area under the curve (AUC) of 0.673 for predicting CVD, while diabetes diagnosed in the previous edition showed an AUC of 0.638 (DeLong's test P<0.01). CONCLUSION: Diabetes diagnosis criteria (2020 edition) in China had better performance in predicting cardiovascular diseases than the previous edition.
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Ye et al. (2022) conducted a cohort in Cardiovascular disease (n=5,884). Diabetes diagnosed by 2020 Chinese guidelines (including HbA1c ≥ 6.5%) vs. Non-diabetes was evaluated on Cardiovascular disease incidence (HR 1.607, 95% CI 1.221-2.115, p=<0.001). Diabetes diagnosed according to the 2020 Chinese guidelines was significantly associated with increased cardiovascular disease risk (HR 1.607) and demonstrated better predictive value than previous criteria.
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