TY - JOUR
T1 - Lifetime and 10-year cardiovascular risk prediction in individuals with type 1 diabetes
T2 - The LIFE-T1D model
AU - Helmink, Marga A. G.
AU - Hageman, Steven H. J.
AU - Eliasson, Björn
AU - Sattar, Naveed
AU - Visseren, Frank L. J.
AU - Dorresteijn, Jannick A. N.
AU - Harris, Katie
AU - Peters, Sanne A. E.
AU - Woodward, Mark
AU - Szentkúti, P. ter
AU - Højlund, Kurt
AU - Henriksen, Jan Erik
AU - Sørensen, Henrik Toft
AU - Serné, Erik H.
AU - van Sloten, Thomas T.
AU - Thomsen, Reimar W.
AU - Westerink, Jan
N1 - Publisher Copyright: © 2024 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
PY - 2024
Y1 - 2024
N2 - Aims: To develop and externally validate the LIFE-T1D model for the estimation of lifetime and 10-year risk of cardiovascular disease (CVD) in individuals with type 1 diabetes. Materials and Methods: A sex-specific competing risk-adjusted Cox proportional hazards model was derived in individuals with type 1 diabetes without prior CVD from the Swedish National Diabetes Register (NDR), using age as the time axis. Predictors included age at diabetes onset, smoking status, body mass index, systolic blood pressure, glycated haemoglobin level, estimated glomerular filtration rate, non-high-density lipoprotein cholesterol, albuminuria and retinopathy. The model was externally validated in the Danish Funen Diabetes Database (FDDB) and the UK Biobank. Results: During a median follow-up of 11.8 years (interquartile interval 6.1–17.1 years), 4608 CVD events and 1316 non-CVD deaths were observed in the NDR (n = 39 756). The internal validation c-statistic was 0.85 (95% confidence interval [CI] 0.84–0.85) and the external validation c-statistics were 0.77 (95% CI 0.74–0.81) for the FDDB (n = 2709) and 0.73 (95% CI 0.70–0.77) for the UK Biobank (n = 1022). Predicted risks were consistent with the observed incidence in the derivation and both validation cohorts. Conclusions: The LIFE-T1D model can estimate lifetime risk of CVD and CVD-free life expectancy in individuals with type 1 diabetes without previous CVD. This model can facilitate individualized CVD prevention among individuals with type 1 diabetes. Validation in additional cohorts will improve future clinical implementation.
AB - Aims: To develop and externally validate the LIFE-T1D model for the estimation of lifetime and 10-year risk of cardiovascular disease (CVD) in individuals with type 1 diabetes. Materials and Methods: A sex-specific competing risk-adjusted Cox proportional hazards model was derived in individuals with type 1 diabetes without prior CVD from the Swedish National Diabetes Register (NDR), using age as the time axis. Predictors included age at diabetes onset, smoking status, body mass index, systolic blood pressure, glycated haemoglobin level, estimated glomerular filtration rate, non-high-density lipoprotein cholesterol, albuminuria and retinopathy. The model was externally validated in the Danish Funen Diabetes Database (FDDB) and the UK Biobank. Results: During a median follow-up of 11.8 years (interquartile interval 6.1–17.1 years), 4608 CVD events and 1316 non-CVD deaths were observed in the NDR (n = 39 756). The internal validation c-statistic was 0.85 (95% confidence interval [CI] 0.84–0.85) and the external validation c-statistics were 0.77 (95% CI 0.74–0.81) for the FDDB (n = 2709) and 0.73 (95% CI 0.70–0.77) for the UK Biobank (n = 1022). Predicted risks were consistent with the observed incidence in the derivation and both validation cohorts. Conclusions: The LIFE-T1D model can estimate lifetime risk of CVD and CVD-free life expectancy in individuals with type 1 diabetes without previous CVD. This model can facilitate individualized CVD prevention among individuals with type 1 diabetes. Validation in additional cohorts will improve future clinical implementation.
KW - cardiovascular disease
KW - diabetes complications
KW - macrovascular disease
KW - type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85187114003&partnerID=8YFLogxK
U2 - 10.1111/dom.15531
DO - 10.1111/dom.15531
M3 - Article
C2 - 38456579
SN - 1462-8902
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
ER -