Development and validation of a nomogram to estimate future risk of type 2 diabetes mellitus in adults with metabolic syndrome: prospective cohort study

Abstract Objectives: To develop and validate the 4-year risk of type 2 diabetes mellitus among adults with metabolic syndrome. Design: Retrospective cohort study of a large multicenter cohort with broad validation. Settings: The derivation cohort was from 32 sites in China and the geographic validation cohort was from Henan population-based cohort study. Results: 568(17.63%) and 53(18.67%) participants diagnosed diabetes during 4-year follow- up in the developing and validation cohort, separately. Age, gender, body mass index, diastolic blood pressure, fasting plasma glucose and alanine aminotransferase were included in the final model. The area under curve for the training and external validation cohort was 0.824(95%CI, 0.759-0.889) and 0.732(95%CI, 0.594-0.871), respectively. Both the internal and external validation have good calibration plot. A nomogram was constructed to predict the probability of diabetes during 4-year follow-up, and on online calculator is also available for a more convenient usage (https://lucky0708.shinyapps.io/dynnomapp/). Conclusion: We developed a simple diagnostic model to predict 4-year risk of type 2 diabetes mellitus among adults with metabolic syndrome, which is also available as web-based tools (https://lucky0708.shinyapps.io/dynnomapp/).