不同代谢综合征诊断标准在上海35～74岁人群中的应用比较

Comparison of Different Diagnostic Criteria of Metabolic Syndrome in Shanghai Adults Aged 35-74 Years

[目的]运用国际糖尿病联盟[International Diabetes Federation,IDF（2005）]、美国国家胆固醇教育项目成人治疗组第三次指南[National Cholesterol Education Program Adult treatment panelⅢ,ATPⅢ（2001）]和中华医学会糖尿病分会[Chinese Diabetes Society,CDS（2004）]诊断标准,分析比较上海市社区人群代谢综合征（metabolic syndrome,MS）的集聚情况。[方法]采用分层整群随机抽样方法,在上海社区35~74岁人群中进行横断面调查,共调查7 414名个体。[结果]分析结果显示,按照3种诊断标准,MS的患病率（标化率）分别为IDF标准25.75%（21.45%）、ATPⅢ标准19.81%（16.21%）、CDS标准22.23%（17.78%）。其性别分布结果显示,IDF和ATPⅢ标准诊断的患病率均为女性高于男性。城乡间患病率的比较为城市高于农村。Kappa检验显示,3种诊断标准的符合率均较高,但是以CDS和ATPⅢ判断的一致性更高（Kappa=0.593）。[结论]MS已成为影响上海城乡居民健康的重大公共卫生问题,IDF（2005）、ATPⅢ（2001）和CDS（2004）3种MS诊断标准都可用于上海人群,但每一种MS诊断标准的使用价值的评价仍需进一步研究。

[Objective] To compare the prevalence of metabolic syndrome（MS） disease cluster under different diagnostic criteria of International Diabetes Federation（IDF,2005）,Adult Treatment Panel Ⅲ（ATPⅢ,2001） of the U.S.National Cholesterol Education Program,and Chinese Diabetes Society（CDS,2004）.[Methods] A cross-sectional survey was conducted in Shanghai among 7 414 35-74-year-old adults selected by stratified cluster random sampling method.[Results] According to definitions in IDF,ATPⅢ and CDS,the prevalence of MS was 25.75%（21.45%）,19.81%（16.21%） and 22.23%（17.78%） respectively（age-standardized prevalence shown in the parenthesis）.MS prevalence was higher in female than in male under IDF and ATPⅢ definitions,and was higher in urban residents than in rural ones.Kappa test showed that the agreement among three definitions was high and the highest Kappa coefficient was 0.593 between CDS and ATPⅢ.[Conclusion] MS is becoming a major public health problem in Shanghai.All the three definitions may apply to Shanghai adults,however,each need to be further evaluated and studied for better application.