BMC public health · 2025
Community-based evaluation of cardiovascular risk using QRISK®3 in type 2 diabetes mellitus population in Gujarat, India.
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M Yogesh, Vamja Roshni, Vala Vijay, Surati Bhumika, Nagda Jay
Аннотация
INTRODUCTION: Cardiovascular disease (CVD) rates are rising rapidly among Indians with type 2 diabetes mellitus (T2DM). This study compared two cardiovascular risk assessment tools - QRISK®3 and Lipid Association of India (LAI) risk scores - in a community-based sample of T2DM patients in Gujarat, India.
METHODS: We conducted a cross-sectional study in 600 T2DM patients aged 25-84 years recruited from urban and rural areas of the Jamnagar district using stratified random sampling. Sociodemographic details, anthropometrics, and fasting blood tests were recorded. QRISK®3 and LAI risk scores were calculated for each participant. Risk categories were defined as moderate (10-19%), high (20-30%), and very high risk (> 30%) for both scoring systems. Agreement between scoring systems was assessed using Cohen's kappa. Multiple linear regression was used to identify and compare predictors of both risk scores.
RESULTS: The mean age was 55 ± 8.5 years, and 60% were male. Using QRISK®3, 42% had moderate risk, 14.7% had high risk, and 43.3% had very high risk, while LAI classified 40%, 15%, and 45% in these categories, respectively. Agreement between scoring systems was substantial (weighted κ = 0.83, 95% CI: 0.79-0.87). The concordance improved with age, from moderate agreement in younger adults (κ = 0.75 for 25-44 years) to strong agreement in older adults (κ = 0.87 for ≥ 65 years). LAI identified more high-risk patients among those aged < 50 years compared to QRISK®3 (16.6% vs. 11.3%, p = 0.03). Linear regression revealed LAI placed greater emphasis on smoking (β = 6.85 vs. β = 5.63), family history (β = 5.28 vs. β = 3.12), and obesity (β = 3.27 vs. β = 2.43) compared to QRISK3.
CONCLUSION: Both scoring systems showed substantial agreement in risk classification, with better concordance in older age groups. LAI risk score classified more younger patients as high-risk and weighted smoking and family history more heavily than QRISK®3. These findings suggest potential complementary roles for both scoring systems in comprehensive cardiovascular risk assessment among Indian T2DM patients, particularly when evaluating younger individuals.
METHODS: We conducted a cross-sectional study in 600 T2DM patients aged 25-84 years recruited from urban and rural areas of the Jamnagar district using stratified random sampling. Sociodemographic details, anthropometrics, and fasting blood tests were recorded. QRISK®3 and LAI risk scores were calculated for each participant. Risk categories were defined as moderate (10-19%), high (20-30%), and very high risk (> 30%) for both scoring systems. Agreement between scoring systems was assessed using Cohen's kappa. Multiple linear regression was used to identify and compare predictors of both risk scores.
RESULTS: The mean age was 55 ± 8.5 years, and 60% were male. Using QRISK®3, 42% had moderate risk, 14.7% had high risk, and 43.3% had very high risk, while LAI classified 40%, 15%, and 45% in these categories, respectively. Agreement between scoring systems was substantial (weighted κ = 0.83, 95% CI: 0.79-0.87). The concordance improved with age, from moderate agreement in younger adults (κ = 0.75 for 25-44 years) to strong agreement in older adults (κ = 0.87 for ≥ 65 years). LAI identified more high-risk patients among those aged < 50 years compared to QRISK®3 (16.6% vs. 11.3%, p = 0.03). Linear regression revealed LAI placed greater emphasis on smoking (β = 6.85 vs. β = 5.63), family history (β = 5.28 vs. β = 3.12), and obesity (β = 3.27 vs. β = 2.43) compared to QRISK3.
CONCLUSION: Both scoring systems showed substantial agreement in risk classification, with better concordance in older age groups. LAI risk score classified more younger patients as high-risk and weighted smoking and family history more heavily than QRISK®3. These findings suggest potential complementary roles for both scoring systems in comprehensive cardiovascular risk assessment among Indian T2DM patients, particularly when evaluating younger individuals.