{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:13:24Z","timestamp":1790612004001,"version":"4.1.0"},"reference-count":57,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T00:00:00Z","timestamp":1648425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["17181641"],"award-info":[{"award-number":["17181641"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>More than half of diabetes mellitus (DM) and pre\u2010diabetes (pre\u2010DM) cases remain undiagnosed, while existing risk assessment models are limited by focusing on diabetes mellitus only (omitting pre\u2010DM) and often lack lifestyle factors such as sleep. This study aimed to develop a non\u2010laboratory risk assessment model to detect undiagnosed diabetes mellitus and pre\u2010diabetes mellitus in Chinese adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Based on a population\u2010representative dataset, 1,857 participants aged 18\u201384\u2009years without self\u2010reported diabetes mellitus, pre\u2010diabetes mellitus, and other major chronic diseases were included. The outcome was defined as a newly detected diabetes mellitus or pre\u2010diabetes by a blood test. The risk models were developed using logistic regression (LR) and interpretable machine learning (ML) methods. Models were validated using area under the receiver\u2010operating characteristic curve (AUC\u2010ROC), precision\u2010recall curve (AUC\u2010PR), and calibration plots. Two existing diabetes mellitus risk models were included for comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of newly diagnosed diabetes mellitus and pre\u2010diabetes mellitus was 15.08%. In addition to known risk factors (age, BMI, WHR, SBP, waist circumference, and smoking status), we found that sleep duration, and vigorous recreational activity time were also significant risk factors of diabetes mellitus and pre\u2010diabetes mellitus. Both LR (AUC\u2010ROC\u2009=\u20090.812, AUC\u2010PR\u2009=\u20090.448) and ML models (AUC\u2010ROC\u2009=\u20090.822, AUC\u2010PR\u2009=\u20090.496) performed well in the validation sample with the ML model showing better discrimination and calibration. The performance of the models was better than the two existing models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sleep duration and vigorous recreational activity time are modifiable risk factors of diabetes mellitus and pre\u2010diabetes in Chinese adults. Non\u2010laboratory\u2010based risk assessment models that incorporate these lifestyle factors can enhance case detection of diabetes mellitus and pre\u2010diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.13790","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T07:58:29Z","timestamp":1647417509000},"page":"1374-1386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Non\u2010laboratory\u2010based risk assessment model for case detection of diabetes mellitus and pre\u2010diabetes in primary care"],"prefix":"10.1111","volume":"13","author":[{"given":"Weinan","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7409-9507","authenticated-orcid":false,"given":"Tsui Yee Emily","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"},{"name":"Department of Family Medicine The\u00a0University of Hong Kong Shenzhen Hospital  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn Ivy","family":"Mak","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6895-6071","authenticated-orcid":false,"given":"Carlos King Ho","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"},{"name":"Department of Pharmacology and Pharmacy Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuk Fai Eric","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"},{"name":"Department of Pharmacology and Pharmacy Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4196-8686","authenticated-orcid":false,"given":"Ho Man Eric","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weng Yee","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Elizabeth","family":"Bedford","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee Tak Esther","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"},{"name":"Department of Family Medicine The\u00a0University of Hong Kong Shenzhen Hospital  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Kit Welchie","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Healthcare Hong Kong West Cluster Hospital Authority  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vai Kiong David","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Family Medicine &amp; Primary Health Care United Christian Hospital &amp; Tseung Kwan O Hospital Hospital Authority  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9037-0416","authenticated-orcid":false,"given":"Choon Beng Kathryn","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Medicine Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lo Kuen Cindy","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"},{"name":"Department of Family Medicine The\u00a0University of Hong Kong Shenzhen Hospital  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/2468-8827.184853"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-2345"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107843"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.07891109"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7596"},{"key":"e_1_2_9_7_1","first-page":"12","volume-title":"National Diabetes Statistics Report, 2020","author":"Centers for Disease Control and Prevention","year":"2020"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60283-9"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2007.05.004"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.685628"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1737"},{"key":"e_1_2_9_12_1","volume-title":"Screening for Type 2 Diabetes: Report of a World Health Organization and International Diabetes Federation Meeting","author":"World Health Organization","year":"2003"},{"key":"e_1_2_9_13_1","volume-title":"Hong Kong Reference Framework for Diabetes Care for Adults in Primary Care Settings","author":"Hong Kong Department of Health","year":"2017"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-11-200912010-00005"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e4624"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2010.tb03478.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1499-2671(09)34008-3"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0152054"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-0593"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13144"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-0227"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1124"},{"key":"e_1_2_9_23_1","volume-title":"Report of Population Health Survey 2014\/15","author":"Department of Health HKSAR Government","year":"2017"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9736"},{"key":"e_1_2_9_25_1","volume-title":"Use of Glycated Haemoglobin (HbA1c) in Diagnosis of Diabetes Mellitus: Abbreviated Report of A WHO Consultation","author":"World Health Organization","year":"2011"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-S002"},{"key":"e_1_2_9_27_1","first-page":"238","article-title":"The reference framework for diabetes care in primary care settings","volume":"18","author":"Wong MCS","year":"2012","journal-title":"Hong Kong Med J"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.16.1789"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-006-0024-x"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11135-006-9018-6"},{"key":"e_1_2_9_31_1","doi-asserted-by":"crossref","unstructured":"ChenT GuestrinC editors.Xgboost: A scalable tree boosting system. Proceedings of the 22nd acm sigkdd international conference on knowledge discovery and data mining 2016.","DOI":"10.1145\/2939672.2939785"},{"key":"e_1_2_9_32_1","doi-asserted-by":"crossref","unstructured":"Niculescu\u2010MizilA CaruanaR editors.Predicting good probabilities with supervised learning. Proceedings of the 22nd international conference on Machine learning 2005.","DOI":"10.1145\/1102351.1102430"},{"key":"e_1_2_9_33_1","unstructured":"LundbergSM LeeS\u2010I (eds).A unified approach to interpreting model predictions. Advances in Neural Information Processing Systems 2017."},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i11"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118548387"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118432"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1466-7"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.12.005"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_2_9_41_1","volume-title":"Area under the precision\u2010recall curve: point estimates and confidence intervals","author":"Boyd K","year":"2013"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2929"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(13)70103-7"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12454"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003408"},{"key":"e_1_2_9_46_1","volume-title":"Waist Circumference and Waist\u2010hip Ratio: Report of a WHO Expert Consultation","author":"WH Organization","year":"2011"},{"key":"e_1_2_9_47_1","first-page":"470","article-title":"Body mass index, waist circumference, and the risk of type 2 diabetes mellitus: implications for routine clinical practice","volume":"107","author":"Feller S","year":"2010","journal-title":"Deutsches \u00c4rzteblatt Int"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.3164\/jcbn.16-116"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1455"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-09-0739"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0310-7"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-2073"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-2362-5"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyl209"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1123\/jpah.9.5.634"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-015-0056-z"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d7163"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1038\/s42256-019-0048-x"}],"container-title":["Journal of Diabetes Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.13790","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdi.13790","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.13790","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T21:49:48Z","timestamp":1692827388000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdi.13790"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,28]]},"references-count":57,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1111\/jdi.13790"],"URL":"https:\/\/doi.org\/10.1111\/jdi.13790","archive":["Portico"],"relation":{},"ISSN":["2040-1116","2040-1124"],"issn-type":[{"value":"2040-1116","type":"print"},{"value":"2040-1124","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,28]]},"assertion":[{"value":"2021-07-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}