Background: It is unknown how the identification of undiagnosed DM (UDM) among Chinese changes the estimation of atherosclerotic cardiovascular disease (ASCVD) risk using the Chinese and the U.S. risk calculators.
Methods: We included 1884 adults aged 30-75 free of ASCVD from 4 urban and rural communities in Shanxi Province, China. UDM was defined as newly found DM by glucose or HbA1c with no DM history or DM medication. 10-year ASCVD risk was estimated using the Prediction for ASCVD Risk in China (China-PAR) score and 2013 AHA/ACC Pooled Cohort Equation (PCE) and classified into risk categories. For those with UDM, the risk scores were calculated before and after DM diagnosis.
Results: Among 266 (14.1%) DM patients, 161 (8.5%) were UDM. Compared to those with diagnosed DM, those with UDM had milder DM and better CVD risk profiles. The mean China-PAR among non-DM, UDM (before diagnosis) and diagnosed DM were 6.0% 14.3% and 18.8% and mean PCE were 2.5%, 5.3% and 13.0%, respectively. Among those with UDM, the mean China-PAR and PCE increased to 16.7% and 9.2% after DM diagnosis (both p <0.0001); 6.2% and 34.8% were reclassified into higher risk groups according to the Chinese and U.S. guidelines (Figure).
Conclusion: Identification of UDM had greater impact on estimated ASCVD risk using PCE than China-PAR among Chinese and may change the preventive treatment by risk reclassification.
J. Yang: None. Y. Zhao: None. Y. Ren: None. L. Lan: None. L. Xu: None. J. Yin: None. Q. Xu: None. Y. Li: None.
Research Fund for Public Welfare, National Health, and Family Planning Commission of China (201402005)