济南市儿童青少年代谢综合征不同诊断标准检出情况

Comparison of the prevalence of metabolic syndrome according to three definitions among children and adolescents aged 7-17 years in urban area of Jinan

目的采用3种代谢综合征(Metabolic Syndrome,MS)诊断标准描述济南市儿童青少年的MS检出率,为儿童青少年MS及心血管疾病预防提供基础数据。方法选取济南市城区4所中小学1 170名7~17岁儿童青少年进行身体测量和血生化检测。采用国际糖尿病联盟诊断标准(IDF标准)、中华医学会推荐的诊断标准(中国标准)和Cook等参照NCEP ATPIII制定的诊断标准(Cook标准)筛查MS的检出率,并比较3种标准的一致性。采用2010年中国人口普查的年龄性别构成对MS检出率进行标准化。结果采用IDF标准、中国标准和Cook标准诊断的MS标化检出率分别为3.24%,5.30%和6.79%,3种标准诊断的MS标化检出率均为男生高于女生(χ~2值分别为8.537,5.132,12.141,P值均<0.05);采用IDF标准和中国标准,年龄组间的MS检出率差异无统计学意义(P值均>0.05)。采用Cook标准,年龄组间的MS检出率差异有统计学意义(χ~2=6.355,P<0.05)。关于MS检出率,中国标准与Cook标准一致性较好,Kappa值为0.784;IDF标准与中国标准、Cook标准之间的一致性中等,Kappa值分别为0.700和0.547。结论采用3种标准诊断的济南市城区儿童青少年的MS标化检出率均处于较高水平,应引起足够重视。Cook标准与中国标准诊断的MS标化检出率较高且一致性较好。

Objective To examine the prevalence of metabolic syndrome（MS） based on three definitions among children and adolescents,and to provide the scientific basis for identification and prevention of pediatric MS.Methods A total of 1 170 adolescents aged 7-17 years old from four schools in urban area of Jinan were included in the present study.Anthropometric and biochemical data were collected.The prevalence of MS was determined by three definitions：International Diabetes Federation（IDF definition）,Society of Pediatrics,Chinese Medical Association（Chinese definition） and National Cholesterol Education Program-Adult Treatment Panel III modified by Cook（Cook definition）.Consistency was evaluated by the kappa coefficient.The prevalence of MS was standardized by the age-sex composition of Chinese population census in 2010.Results The standardized prevalence of MS was 3.24%,5.30% and 6.79%,respectively,according to IDF,Chinese and Cook definitions.The standardized prevalence of MS in males was higher than in females（χ~2=8.537,5.132,12.741,P〈0.05）.There was no statistical difference in prevalence of MS between three age groups according to IDF and Chinese definitions（P〉0.05）.However,there was statistical difference in MS prevalence using Cook definition between three age groups（χ~2=6.355,P〈0.05）.The consistency was high between the Chinese and Cook definitions,with kappa coefficient of 0.784,but it was weak between IDF definition and Chinese and Cook definitions,with kappa coefficients of 0.700 and 0.547,respectively.Conclusion The standardized prevalence of MS is high among children and adolescents in urban area of Jinan,which should be paid more attentions.In addition,the Chinese and Cook definitions shows high consistency.