ArticleBMJ open diabetes research & care2019
Derivation and external validation of a risk prediction algorithm to estimate future risk of cardiovascular death among patients with type 2 diabetes and incident diabetic nephropathy: prospective cohort study.
Article in BMJ open diabetes research & care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Prognostic models for all-cause and cardiovascular mortality in type 2 diabetes: Systematic review.Diabetic medicine : a journal of the British Diabetic Association · 2026Pooled it
- Establishment and validation of a clinical model for predicting diabetic ketosis in patients with type 2 diabetes mellitus.Frontiers in endocrinology · 2022Trial
- Risk stratification in diabetic kidney disease: a review of prediction models for methodological advances and clinical application.Journal of translational medicine · 2026Review
- A nomograph model for predicting the risk of diabetes nephropathy.International urology and nephrology · 2025Article
- Navigating the future of diabetes: innovative nomogram models for predicting all-cause mortality risk in diabetic nephropathy.BMC nephrology · 2024Article
- Precision prognostics for cardiovascular disease in Type 2 diabetes: a systematic review and meta-analysis.Communications medicine · 2024Article
- Prediction of Five-Year Cardiovascular Disease Risk in People with Type 2 Diabetes Mellitus: Derivation in Nanjing, China and External Validation in Scotland, UK.Global heart · 2022Article
- Functional role of miR-34a in diabetes and frailty.Frontiers in aging · 2022Review
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To derive, and externally validate, a risk score for cardiovascular death among patients with type 2 diabetes and newly diagnosed diabetic nephropathy (DN). Research design and methods: Two independent prospective cohorts with type 2 diabetes were used to develop and externally validate the risk score. The derivation cohort comprised 2282 patients with an incident, clinical diagnosis of DN. The validation cohort includes 950 patients with incident, biopsy-proven diagnosis of DN. The outcome was cardiovascular death within 2 years of the diagnosis of DN. Logistic regression was applied to derive the risk score for cardiovascular death from the derivation cohort, which was externally validated in the validation cohort. The score was also estimated by applying the United Kingdom Prospective Diabetes Study (UKPDS) risk score in the external validation cohort. Results: The 2-year cardiovascular mortality was 12.05% and 11.79% in the derivation cohort and validation cohort, respectively. Traditional predictors including age, gender, body mass index, blood pressures, glucose, lipid profiles alongside novel laboratory test items covering five test panels (liver function, serum electrolytes, thyroid function, blood coagulation and blood count) were included in the final model.C-statistics was 0.736 (95% CI 0.731 to 0.740) and 0.747 (95% CI 0.737 to 0.756) in the derivation cohort and validation cohort, respectively. The calibration slope was 0.993 (95% CI 0.974 to 1.013) and 1.000 (95% CI 0.981 to 1.020) in the derivation cohort and validation cohort, respectively.The UKPDS risk score substantially underestimated cardiovascular mortality. Conclusions: A new risk score based on routine clinical measurements that quantified individual risk of cardiovascular death was developed and externally validated. Compared with the UKPDS risk score, which underestimated the cardiovascular disease risk, the new score is a more specific tool for patients with type 2 diabetes and DN. The score could work as a tool to identify individuals at the highest risk of cardiovascular death among those with DN.
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