Added value of novel circulating and genetic biomarkers in type 2 diabetes prediction: a systematic review

Abstract

Aims: To provide a systematic overview of the added value of novel circulating and genetic biomarkers in predicting type 2 diabetes (T2DM).

Methods: We searched MEDLINE and EMBASE (January 2000 to September 2012) for studies that reported a measure of improvement in the performance of T2DM risk prediction models subsequent to adding novel biomarkers to traditional risk factors. We extracted data on study methods and metrics of incremental predictive value of novel biomarkers.

Results: We included 34 publications from 30 studies. All studies reported a change in the area under the receiver-operating characteristic curve, which was modest, ranging from -0.004 to 0.1, with claims of statistically significant improvements in eleven studies. The net reclassification index was evaluated in 11 studies, and ranged from -2.2% to 10.2% after inclusion of genetic markers in six studies (statistically significant in two cases), and from -0.5% to 27.5% after inclusion of non-genetic markers in five studies (non-significant in two studies). The integrated discrimination index (0-2.04) was reported in eight studies, being statistically significant in five of these.

Conclusions: Currently known novel circulating and genetic biomarkers do not substantially improve T2DM risk prediction above and beyond the ability of traditional risk factors.

Keywords: Biomarkers; Diabetes; Genetics; Prediction.