2种代谢综合征诊断标准在中国高血压人群中的比较

Comparison Between Two Criteria for Diagnosing Metabolic Syndrome in Hypertension Patients

目的比较中国糖尿病学会(CDS)及国际糖尿病联盟(IDF)的代谢综合征(MS)标准在中国高血压人群的应用。方法分别依据 CDS 和 IDF 标准对 HOT-CHINA 临床研究入选患者(n=58 289)的基础资料进行再次分析(n=17 861),研究不同标准下 MS 患病率,及其与年龄、性别、血压水平的关系。结果提示1)依据 CDS 和IDF 标准我国高血压人群 MS 患病率分别为42.2%,46.3%。IDF 标准诊断率高(P<0.01);2)根据两种标准诊断的各年龄组患病率变化趋势相似,40～60岁组,60～80组 MS 患病率相似,且高于<40岁组及>80岁组,除>80岁组外,IDF 标准诊断率高(P<0.05);3)依据 CDS 标准,男女患病率相似;依据 IDF 标准,女性患病率增高,男性患病率降低,且女性高于男性;4)根据不同标准诊断的不同血压水平组患病率变化趋势相同,随血压水平升高,MS 患病率增高,各级高血压组 IDF 标准诊断率高(P<0.05)。结论与 CDS 标准相比,IDF 标准在高血压患者中诊断率更高,有利于早期更积极的控制高血压人群的多种危险因素。

Objective To compare the prevalence rate of metabolic syndrome （MS） using the criteria of Chinese Diabetes Society（CDS） or International Diabetes Federation（IDF） in hypertension patients in China. Methods The prevalence of MS in hypertension patients（n= 17861 ） in China and its relations with age, gender and levels of blood pressure were studied. Results 1 ）the prevalence of MS in hypertension patients was 42.2 % or 46.3 %, according to the definition of CDS or of IDF. The diagnostic rate of the definition of IDF was higher（P〈0.01 ）. 2） Using the definition either of CDS or of IDF, similar trend of prevalence of MS was found in 40--60 years group and 60--80 years group, However, except in 〉80 years group, the diagnostic rate by IDF definition was slightly but significantly higher in all ages groups（P〈0. 05）. 3）Using the definition of CDS, the male and female prevalence were same（P〉0.05）, on contrary, the female prevalence was increased while the male prevalence decreased by IDF. The prevalence of MS increased with levels of blood pressure by both definition. 4） The prevalence rate was increased with the elevation of BP, compare with CDS criteria the diagnostic rate of MS was slightly higher by IDF criteria in all levels of BP. Conclusion Compared with the definition of CDS, the diagnostic rate of MS by the definition of IDF was higher in hypertension patients, addressing more aggressively control global risk factors.