{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T12:05:36Z","timestamp":1781093136476,"version":"3.54.1"},"reference-count":38,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T00:00:00Z","timestamp":1708300800000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Androgen Excess and PCOS Society Azziz-Baumgartner Young Travel Award","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"CUHK Research Sustainability for RGC Research Schemes","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["17180431"],"award-info":[{"award-number":["17180431"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Asia Diabetes Foundation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Li Ka Shing Charitable Foundation","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2024,1,20]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Type 2 diabetes is preventable in subjects with impaired glucose tolerance based on 2-hour plasma glucose (2hPG) during 75\u2009g oral glucose tolerance test (OGTT). We incorporated routine biochemistry to improve the performance of a non-invasive diabetes risk score to identify individuals with abnormal glucose tolerance (AGT) defined by 2hPG\u22657.8\u2009mmol\/L during OGTT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>We used baseline data of 1938 individuals from the community-based \u201cBetter Health for Better Hong Kong - Hong Kong Family Diabetes Study (BHBHK-HKFDS) Cohort\u201d recruited in 1998\u20132003. We incorporated routine biochemistry in a validated non-invasive diabetes risk score, and evaluated its performance using area under receiver operating characteristics (AUROC) with internal and external validation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The AUROC of the original non-invasive risk score to predict AGT was 0.698 (95% CI, 0.662 to 0.733). Following additional inclusion of fasting plasma glucose, serum potassium, creatinine, and urea, the AUROC increased to 0.778 (95% CI, 0.744 to 0.809, p&lt;0.001). Net reclassification improved by 31.9% (p&lt;0.001) overall, by 30.8% among people with AGT and 1.1% among people without AGT. The extended model showed good calibration (\u03c7<jats:sup>2<\/jats:sup>=11.315, p=0.1845) and performance on external validation using an independent data set (AUROC=0.722, 95% CI, 0.680 to 0.764).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The extended risk score incorporating clinical and routine biochemistry can be integrated into an electronic health records system to select high-risk subjects for evaluation of AGT using OGTT for prevention of diabetes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2023-003768","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T12:55:13Z","timestamp":1708347313000},"page":"e003768","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Enhanced prediction of abnormal glucose tolerance using an extended non-invasive risk score incorporating routine renal biochemistry"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04588896","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04441216","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Jie","family":"He","sequence":"first","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baoqi","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"},{"name":"Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1581-5643","authenticated-orcid":false,"given":"Eric S H","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natural","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel Yat Hey","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy Ho Ting","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily W M","family":"Poon","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Pik Shan","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"},{"name":"Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China"},{"name":"Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1227-803X","authenticated-orcid":false,"given":"Ronald Ching Wan","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"},{"name":"Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China"},{"name":"Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea O Y","family":"Luk","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"},{"name":"Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China"},{"name":"Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China"},{"name":"Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana C N","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China"},{"name":"Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China"},{"name":"Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, 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