Prognostic assessment of risk factors for type 2 diabetes mellitus in young military personnel

Abstract

Risk factors for the development of type 2 diabetes mellitus were assessed in 212 military personnel aged 2045 years serving under a contract, of which 95 people (an experienced group with risk factors) and 117 people without risk factors (an experienced group), as well as 60 practically healthy males who are not military personnel Ministry of Defense of the Russian Federation aged between 18 and 45 years (control group). It was revealed that the indicators with the greatest influence on the development of type 2 diabetes include older age, body mass index, waist circumference, insulin resistance index, and the results of the psychological questionnaire Tendency to deviant behavior on the scale of Aggressiveness as well as the questionnaire Strong-willed self-control. It was found, on 3-year follow-up, that prediabetes developed in 8 (8.4%) patients of the experimental group with risk factors for type 2 diabetes mellitus who did not have carbohydrate metabolism disorders, and in 8 (6.8%) patients of the experimental group. At the same time, type 2 diabetes mellitus occurred in 2 (2.5%) patients of the experimental group and in 2 (1.7%) military personnel of the experimental group with risk factors for type 2 diabetes but initially normal glycemic indices, as well as in 8 (8.4%) patients of the same group who had prediabetes at the beginning of the study. In addition, prediabetes was detected in 2 people of the control group after 3 years and type 2 diabetes mellitus in 1 person. According to the results of the study, a mathematical model is proposed to assess the likelihood of developing type 2 diabetes in military personnel with a waist circumference 94 cm. The proposed model has a sensitivity of 95% and a specificity of 91%. The prognostic value of a negative result is 89.2%, and that of a positive result is 87%. Thus, military personnel with a waist circumference of 94 cm are characterized by a more frequent development of new cases of prediabetes and type 2 diabetes mellitus than civilians, which is due to the stressful nature of military service. The use of the proposed mathematical model will make it possible to predict the development of carbohydrate metabolism disorders in military personnel with a waist circumference of 94 cm over a 3-year period with the identification of a risk group requiring the use of a set of preventive measures aimed at reducing body weight.