三种诊断标准下代谢综合征的适用性比较

Comparison of applicability of metabolic syndrome by three different criterion among community residents of Harbin

目的按照美国国家胆固醇教育计划(national cholesterol education program,NCEP)成人组第三次报告(adult treatment panelⅢ,ATPⅢ)、国际糖尿病联盟(international diabetes federation,IDF)、中华医学会糖尿病学分会(Chinese diabetes society,CDS)的3种诊断标准计算代谢综合征(metabolic syndrome,MS)的患病率,探讨不同诊断标准下MS的患病特点并对其进行一致性检验。方法采用多阶段整群抽样方法,在哈尔滨市6个社区中抽取925位居民作为研究对象进行现况调查。结果按照ATPⅢ、IDF、CDS的诊断标准,MS的人群粗患病率分别为24.69%、34.55%、19.49%,其患病率间的差异有统计学意义(P<0.001);使用ATPⅢ和IDF诊断标准,男性MS的患病率低于女性,而使用CDS诊断标准则相反。ATPⅢ、IDF和CDS标准对诊断女性MS的一致性好于男性,ATPⅢ与IDF标准对诊断女性MS的一致性较高,Kappa值为0.678 4;而CDS与IDF标准的一致性较低。结论哈尔滨市居民MS患病率较高;采用ATPⅢ与IDF标准对人群诊断MS较CDS标准灵敏,有助于及早发现MS。

Objective To calculate prevalence according to national cholesterol education program-adult treatment panelⅢ（ATPⅢ）,international diabetes federation（IDF）,Chinese diabetes society（CDS） criterion for metabolic syndrome（MS） and to explore characteristic of prevalence for MS and test consistency check by Kappa test.Methods 925 participants were recruited from six communities in Harbin with multistage stratified sampling.The prevalence of MS and the unity of the three criteria were analyzed.Results The prevalence of MS was 24.69%,34.55% and 19.49% according to ATPⅢ,IDF and CDS criteria respectively and was significantly different among them（P〈0.001）.The prevalence of MS in males diagnosed with ATPⅢ and IDF was significantly lower than those in females with these two criterion.However,the prevalence of genders with CDS criterion was opposite.Consistency check diagnosed with females was better than that in males according to ATPⅢ,IDF and CDS.Kappa value,which calculated from ATPⅢ and IDF,was higher in females at different criteria.By contrast,Kappa value,which calculated from CDS and IDF,was lower.Conclusions MS of community residents in Harbin was prevalent,ATPⅢ and IDF criterion are more sensitive to MS than CDS criterion.