Creation and validation of the Anthropometry-Blood Pressure-Age Index for prediabetes and diabetes risk assessment in Peru

Introduction: Early, massive and efficient identification of people at risk of diabetes is key to its prevention. Objective To develop and validate the Anthropometry-Blood Pressure-Age Index (IAPAE) as a tool for determining the risk of prediabetes and diabetes in the Peruvian population. Materials and Methods Secondary data from the National Demographic Health Survey-2022 (n=31,748) were analyzed, validated in the ENDES-2021 (n=32,221) and 2023 (n=32,270), with anthropometric variables, blood pressure and age. Principal component analysis (PCA) was used to assess its evaluative capacity using the Bang diabetes risk scale as a reference with the area under the curve (AUC), sensitivity tests, specificity, positive predictive value (PPV), negative predictive value (NPV) and Odds Ratio (OR). Results The formula resulting from the factor analysis was: (0.868waist circumference)+(0.561age)+(0.657systolic pressure)+(0.710diastolic pressure)+(0.827*BMI), which in the general population had AUC=0.914(ENDES-2022),0.887(ENDES-2021), 0.915(ENDES-2023). In people ≤59 years, they were 0.924(ENDES-2022), 0.893(ENDES-2021) and 0.926(ENDES-2023). In people ≤39 years, they were 0.941(ENDES-2022), 0.902(ENDES-2021), 0.955(ENDES-2023). The IAPAE had a higher AUC than the waist-to-height ratio (0.712 in the general population, 0.775 in ≤39 years, 0.728 in ≤59 years), abdominal circumference (0.742 in the general population, 0.893 in ≤39 years, 0.799 in ≤59 years), body mass index (0.673 in the general population, 0.880 in ≤39 years, 0.753 in ≤59 years) and age (0.911 in the general population, 0.635 in ≤39 years, 0.857 in ≤59 years). The performance of the IAPAE was: sensitivity = 87.40% (2021), 91.30% (2022), 89.20% (2023); specifi65.40%(2021), 72.80%(2022), 75.30%(2023); PPV=41.70%(2021), 65.20%(2022), 64.40%(2023); NPV=94.80%(2021), 93.80%(2022), 93.30%(2023); OR=12.97(2021), 28.12(2022), 25.15(2023). ## Conclusions The IAPAE is an efficient tool for determining the risk of prediabetes and diabetes in the Peruvian population.