ArticleJournal of diabetes research2026
Ability of the DHAM Score to Predict 5-Year All-Cause Mortality in Patients With Diabetes and Comorbid Hypertension: Validation and Risk Stratification in Two Prospective Cohorts.
Article in Journal of diabetes research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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11 authors.
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Abstract
objectiveIndividuals with both diabetes and hypertension face a heightened risk of all-cause death. We aimed to validate the DHAM score's performance in predicting 5-year overall mortality in two prospective cohorts.
methodsThe internal validation cohort comprised 3291 patients with diabetes and hypertension drawn from the 1999-2014 cycles of the National Health and Nutrition Examination Survey database. The external validation cohort comprised 2478 patients from the 2008-2015 China Kailuan cohort. The DHAM score was constructed from eight predictors (age, sex, education, marriage, smoking, cardiovascular disease, serum albumin, and urea nitrogen). Renal dysfunction was determined by an estimated glomerular filtration rate < 60 mL/min/1.73 m
resultsThe C-index was 0.758 (95% CI: 0.743-0.833) in the NHANES database and 0.741 (95% CI: 0.731-0.790) in the Kailuan cohort. A DHAM score > 148 independently predicted 5-year all-cause death in NHANES (adjusted-HR 10.03, 95% CI: 3.37-18.83, p < 0.001); after recalibration, a score > 152 independently predicted mortality in Kailuan (adjusted-HR 9.24, 95% CI: 4.71-16.84, p < 0.001). The patients were further stratified by DHAM score and renal function into three risk groups. Intermediate- and high-risk categories showed higher 5-year all-cause death rates than low-risk categories across both cohorts (log-rank p < 0.001).
conclusionThe DHAM score had a robust prognostic value for 5-year all-cause death among individuals with both diabetes and hypertension. Higher DHAM score combined with renal dysfunction could identify patients at highest risk of all-cause death.
trial registrationChinese Registry of Clinical Trials: ChiCTR2000029767.
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