Validation of the ST1RE risk engine in Chinese with type 1 diabetes and comparison with the JADE , RECODe , and UKPDS risk scores

AIMS: The Steno Type 1 Risk Engine (ST1RE) was developed to improve cardiovascular risk prediction in people with type 1 diabetes (T1D), but its applicability in Asian populations remains uncertain. METHODS: Data from the Hong Kong Diabetes Register were analyzed. Cardiovascular risk was assessed using four models: ST1RE, the Joint Asia Diabetes Evaluation (JADE) coronary heart disease equation, Risk Equations for Complications of Type 2 Diabetes (RECODe), and the United Kingdom Prospective Diabetes Study Outcomes Model version 2 (UKPDS-OM2). Associations between risk scores and incident cardiovascular disease (CVD) were examined using Cox regression, and predictive performance was evaluated using the concordance index (C-index). RESULTS: The analysis included 172 Chinese T1D patients (50% male), with a mean age of 31.0 ± 15.8 and 9.3 ± 6.7 years of T1D at baseline. Over 21.8 ± 5.78 years of follow-up, 16 (9.30%) patients developed CVD. All risk scores were significantly associated with incident CVD (P < 0.05) and achieved C-indices >0.8, indicating good discrimination. The limited sample size reduced statistical power. CONCLUSIONS: ST1RE and other risk models developed for people with type 2 diabetes may be suitable for cardiovascular risk prediction in Chinese with T1D. Further investigation with a larger cohort is advised.