External validation of Prediabetes Risk Test in Indian population for screening prediabetes

Background

Prediabetes Risk Test (PRT) has been found valid in the Western population for screening prediabetes. However, ethnicity, race, geographical and other biological characteristics have been linked to the development of prediabetes. There is a dearth of literature on the external validity of PRT in the Indian population. So, the objective of this study was to assess the external validity of the PRT in the Indian population for screening prediabetes.

Methods

The study contained 522 participants aged between 18 and 60 years. The medical history, physical activity level and anthropometric measures were assessed. Prediabetes was diagnosed using fasting blood sugar and HbA_1C levels. External validation of PRT was performed using specificity, sensitivity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio. The receiver operating curve was plotted to identify the optimum cut-off value for Indians.

Results

The study found that the sensitivity of PRT was 48.1%, specificity 95.5%, positive predictive value 66.1% and negative predictive value 90.9% for screening prediabetes in the Indian population. Receiver operating curve analysis revealed that the optimum cut-off of PRT was around 3 for Indians.

Conclusion

The results showed that PRT might not be useful in the Indian population to identify the true positives of prediabetes as it has a sensitivity of 48.1%. However, it can be helpful to identify the true negatives as the specificity is 95.5%. Further study is required to modify PRT for the Indian context to make it more appropriate for the Indian population.