3种代谢综合征工作定义在男性健康体检者中的比较

Comparison of 3 working definitions of metabolic syndrome in male medical examinees

目的:比较1999年WHO, 2001年美国第三次胆固醇教育计划(NECP ATPIII)及2003年中华医学会糖尿病学会(CDS)提出的3种代谢综合征(MS)工作定义在同一健康体检人群中检出的异同。方法:在739例男性健康体检人群中分别应用上述3种工作定义诊断MS,比较MS患病率,分析各定义诊断MS的一致性及临床特点结果:WHO( 1999 ),ATPIII( 2001 )及CDS( 2003 )MS工作定义诊断的MS标化患病率分别为36. 9%, 11. 8%21. 0%。3种定义对MS总的诊断符合率为68. 6%。WHO定义与ATPIII定义、CDS定义的诊断符合率分别为72. 5%, 81. 2%; ATPIII定义与CDS定义符合率为83. 5%。WHO定义的各组分中胰岛素抵抗患病率最高(标化率为49. 4% );ATPIII定义中高血压患病率最高(标化率为48. 5% ),腹型肥胖患病率最低(标化率为1. 87% );CD定义中肥胖患病率最高(标化率为63. 3% )。3种定义检出的MS组的空腹胰岛素水平及HOMA IR均高于其相应的非MS组。结论: 3种定义具有较高的诊断符合率,但对同一人群的应用仍存在差异,提示制定国内外统一的诊断定义势在必行。

Objective To compare the prevalence of the metabolic syndrome (MS) using 3 working definitions proposed respectively by the World Health Organization (WHO, 1999), the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III, 2001), and the Chinese Diabetes Society (CDS, 2003).Methods MS was diagnosed in 739 male medical examinees by the 3 working definitions respectively, then the prevalence and the concordance of 3 working definitions was compared. Results Among 739 participants the prevalence was 36.9% by the WHO definition, 11.8% by the ATP III definition and 21.0% by the CDS definition. Among all the testees 68.6% were classified as either having or not having the MS under the 3 definitions. The consistency in the diagnosis of MS was 72.5% by the WHO definition and the ATP III definition, 81.2% by the WHO definition and the CDS definition, and 83.5% by the ATP III definition and the CDS definition. The prevalence of insulin resistance was the highest among the components of the WHO definition. The prevalence of hypertension was the highest while the prevalence of obesity was the lowest by the ATP III definition. Among the components of the CDS definition, the prevalence of obesity was the highest. The fasting insulin and insulin resistant index (HOMA-IR) were both significantly higher in the MS subjects than that in the non-MS subjects. Conclusion A universally accepted definition of the metabolic syndrome is needed.