三种适合中国人群代谢综合征诊断标准在江苏省社区人群中应用的比较

Study on the comparison of three diagnostic criteria of metabolic syndrome in Jiangsu population

目的比较IDF(2005)、ATPⅢ(2005)和CDS(2004)三个既便于操作又有中国人肥胖指标的代谢综合征(MS)诊断标准在江苏省社区人群中应用的异同。方法采用“江苏省多代谢异常和MS综合防治研究”资料,对具有MS组分测量值的社区人群(5888人),分别采用IDF(2005)、ATPⅢ(2005)和CDS(2004)诊断MS,并比较MS的患病率及诊断的一致性。结果IDF(2005)、ATPⅢ(2005)和CDS(2004)诊断出的MS患病率分别为17．48％、21．95％和9．59％。ATPⅢ(2005)与CDS(2004)、IDF(2005)与CDS(2004)和IDF(2005)与ATPⅢ(2005)标准分别同时诊断85．11％、87．35％和95．14％的个体为MS或非MS者。IDF(2005)与ATPⅢ(2005)标准诊断MS相比,仍有4．5％仅被ATPⅢ(2005)诊断为MS。ATPⅢ(2005)标准诊断出的MS是IDF标准的1．26倍。女性与男性高腰围(男≥90 cm,女≥80 cm)、MS_IDF(2005)和MS_ATPⅢ(2005)患病率比值分别为2．17、1．99和1．54。结论IDF(2005)与ATPⅢ(2005)标准的诊断一致性高于IDF(2005)、ATPⅢ(2005)与CDS(2004)的一致性,但前两者之间仍存在不一致。IDF(2005)和ATPⅢ(2005)标准对中国人群腰围的取值可能不恰当。

Objective To compare the significance of the application in Jiangsu population using the diagnostic criteria for metabolic syndrome（MS） proposed by the IDF in 2005, ATP Ⅲ in 2005 and CDS in 2004. Methods Based on the populations in Jiangsu province from a project of Multiple Metabolic Disorders and MS, the study was conducted including 5888 cases, with data of plasma glucose, lipid profile, blood pressure, serum insulin etc. MS was diagnosed and compared according to these three definitions respeegvely. Results The age-adjusted MS prevalence rates were 17.48 % ,21.95 % and 9.59 % according to the IDF（2005）,ATP Ⅲ （2005） and CDS（2004） respectively, The agreement in the diagnosis of MS using ATP Ⅲ （2005） and CDS（2004） definitions was 85.11%, and the agreement in the diagnosis of MS using IDF（2005） and CDS definitions was 87,35%, The agreement in the diagnosis of MS using IDF （2005） and ATP Ⅲ （2005） definitions was 95.14%, The MS subjects diagnoaed by the ATP Ⅲ （2005） was 1.26 higher than subjects diagnosed by the IDF（2005） definition, The ratios of prevalence rates of high waist circumference（WC）, MS IDF （2005） and MS _ ATP Ⅲ （2005） was 2. 17, 1.99 and 1.54 in sex ratio （woman to man）, Conclusion The agreement in the diagnosis of MS using the IDF（2005） and ATP Ⅲ （2005） definition was higher than using CDS（2004） and other two definitions. For diagnosing MS, the cut off of WC in IDF（2005） and ATP Ⅲ （2005） seemed not appropriate and the diagnostic criteria used for ATP Ⅲ （2005）（waist circumference of man 85 era, woman 80 cm） could identify more MS.