四种代谢综合征诊断标准在贵阳市成人流行病学调查中的应用比较

Comparison of four different diagnostic criteria on metabolic syndrome in an epidemiological study in Guiyang city

目的 了解不同诊断标准下,贵阳市居民代谢综合征（MS）的患病率及四种诊断标准间的一致性,并探讨2009年国际多学会联合声明（JIS）标准的应用价值.方法 分析2009至2010年贵阳市糖尿病和代谢性疾病研究数据.分别用2004年中华医学会糖尿病学分会（CDS）、美国国家胆固醇教育计划成人治疗方案第三次报告（ATPⅢ）、2005年国际糖尿病联盟（IDF）及2009年JIS的MS标准,分析贵阳市社区居民总体及不同性别MS的患病率,并使用k值比较诊断结果的一致性.结果 贵阳市社区20岁及以上成人共1 512人（男性634人,女性878人）中,MS的标化患病率分别为21.7％（CDS标准）、29.1％（IDF标准）、40.3％（ATPⅢ标准）和43.6％ （JIS标准）.IDF标准下女性MS患病率高于男性（31.0％比26.2％,P＜0.01）,而JIS标准下男性患病率高于女性（45.1％比38.8％,P＜0.01）.ATPⅢ标准和JIS标准的诊断一致性最好（k=0.94,P＜0.05）,其次为IDF标准与ATPⅢ标准k值为0.78（P＜0.05）.结论 不同的诊断标准下,贵阳市成人MS的患病率均较高,JIS标准与ATPⅢ标准的诊断一致性最好.

objective To determine the current prevalence and risk factors of metabolic syndrome （MS） among adult residents in Guiyang by the four different diagnostic criteria.Methods Data came from healthy examination of Guiyang community population.Age and sex standardized prevalences of MS were calculated according to the criteria of Chinese Diabetes Society （CDS）,US National Cholesterol Education Program Adult Treatment Panel Ⅲ （ATP Ⅲ）,International Diabetes Federation （IDF） and Joint Interim Statement （JIS）.The four MS diagnostic concordance were compared by the value of Kappa.Results The MS prevalence were 43.6 % for JIS,29.1% for IDF,21.7 %for C DS and 40.3 %for ATP Ⅲ,respectively.MS was more popular in female than in male by the IDF criterion（31.0% vs 26.2%,P〈0.01）.While the prevalence was higher in male by JIS criteria （45.1% vs 38.8%,P〈0.01）.The highest value of kappa was 0.94 between JIS and ATP Ⅲ.The value of kappa was 0.78 between IDF and ATP Ⅲ.Conclusion The prevalence rate of MS in Guiyang City was higher than other area in different diagnostic criteria in China.The MS diagnostic criteria of ATPⅢ and JIS are in good accordance.