新疆维吾尔族30～80岁人群代谢综合征调查及三种诊断标准的对比研究

Epidemiological investigation and comparison of three different diagnostic criteria regarding metabolic syndrome among population age 30-80 in Xinjiang Uigur areas

目的了解新疆维吾尔族人群代谢综合征（MS）患病情况，比较美国国家胆固醇教育计划成人治疗组第三次报告（ATPIII）、国际糖尿病联盟（IDF）和中华医学会糖尿病学分会（CDS）建议的MS诊断标准在维吾尔族人群中应用的差异。方法对新疆地区2053名维吾尔族30～80岁居民进行横断面调查，根据3种诊断标准分别计算MS患病率，分析不同诊断标准下MS异常组分及危险因素聚集的检出情况，比较3种诊断标准在维吾尔族人群中的一致性。结果（1）3种诊断标准患病率（标化患病率）分别为35．80％（29．64％）、39．41％（35．88％）和23．72％（19．17％）；（2）3种标准对MS患者3个以上危险凶素聚集的检出率分别为98，64％、97．90％和92．81％：（3）3种诊断标准在维吾尔族人群中应用的一致性两两比较，ATPHI标准与IDF标准的一致性较好（一致率为0．9026，Youden指数为0．7928，Kappa值为0．7801），CDS标准与另外两种标准（ATPⅢ和1DF）的一致性不高。结论在新疆维吾尔族人群中应用3种MS诊断标准，获得的患病率、危险组分聚集情况和一致性差异较大，IDF标准检出率最高，ATPⅢ标准对危险因素聚集检率最高，且两者一致性较好，优于CDS标准。

Objective To investigate the prevalence of metabolic syndrome （MS） among Xinjiang Uigur population aged 30-80 and to compare the differences of the three diagnostic criteria used for MS. The three diagnostic criteria were developed by the National Cholesterol Education Program （ATP 4）, International Diabetes Federation （IDF） and Chinese Medical Association Diabetes Branch （CDS）. Methods A cross-sectional study was conducted on 2053 Xinjiang Uigur people aged 30-80. The prevalence of MS and the degree of agreement were both calculated according to the three definitions. The results of MS components were also analyzed. Results （ 1 ） According to the three definitions （ATP Ⅲ, IDF and CDS）, the prevalence and adjusted prevalence rates of MS were 35.80% （29.64%）, 39.41% （35.88%） and 23.72% （ 19.17% ）. （2） According to the three definitions （the ATP Ill , IDF and CDS） , the prevalence rates of subjects who had at least 3 risk factors were 98.64%, 97.90% and 92.81%. （3） Among all the subjects with MS, the MS diagnostic criteria of ATP Ⅲ and IDF were in good accordance with the Kappa index （0.7801）, Youden index （0.7928） and the concordance rate （0.9026）. CDS was in relatively weak agreement when comparing with other definitions （ATP Ⅲ and IDF）. Conclusion Our findings revealed big differences regarding the prevalence rates, the degree of agreement and the aggregation of risk components on MS among Xinjiang Uigur population. The detection rate of IDF criteria on MS and the highest while detection rate ofATP Ⅲ criteria on subjects presented at least 3 risk factors were the highest. The concordance of ATP IU criteria and IDF seemed to be a better one.