五种诊断标准下中国青少年代谢综合征的检出情况

Prevalence of metabolic syndrome in Chinese adolescents under five diagnostic criteria

目的采用五种不同代谢综合征(metabolic syndrome,MetS)诊断标准描述中国青少年的MetS检出率差异,为预防与控制青少年MetS提供参考。方法基于中国健康与营养调查,采用中华医学会儿科学分会推荐的中国标准(简称CHN2012)、国际糖尿病联盟诊断标准(简称IDF标准)、Cook标准、Noubiap标准和MetS-IDFm标准分别计算了12~17岁中国青少年MetS检出率,并进行Kappa一致性检验。结果Noubiap标准下总检出率最高(5.61%),其次为Cook标准(4.76%)、MetS-IDFm标准(3.27%)、CHN2012标准(2.56%)和IDF标准(1.35%);5种诊断标准中,男性检出率均高于女性,组分中高血压和高甘油三酯的检出率最高。在总人群和男性中,Cook标准和Noubiap标准的一致性最高,Kappa值分别为0.913和0.923;女性中CHN2012标准和MetS-IDFm标准一致性最高,Kappa值为0.956。结论总体上,Noubiap标准下青少年MetS检出率最高,且与Cook标准的一致性较好。IDF标准下青少年MetS检出率最低,与其他标准的一致性较差。

Objective Five different diagnostic criteria for metabolic syndrome(MetS)were used to describe the differences in the detection rates of MetS among Chinese adolescents so as to provide references for MetS prevention and control in the adolescents.Methods Based on the China Health and Nutrition Survey,the detection rates of MetS among Chinese adolescents aged 12-17 years were calculated separately using the Chinese definition(abbreviated as the CHN2012 definition)recommended by the Pediatric Academy of Chinese Medical Association,the International Diabetes Federation criterion(abbreviated as the IDF criterion),the Cook criterion,the Noubiap criterion and the modified definition of MetS based on IDF criteria(the MetS-IDFm criterion).Kappa test was used to evaluate the consistency.Results The overall detection rate of MetS under the Noubiap criterion was found to be the highest(5.61%),followed by the Cook criterion(4.76%),the MetS-IDFm criterion(3.27%),the CHN2012 definition(2.56%)and the IDF criterion(1.35%).Under the five diagnostic criteria,the detection rates of MetS were all higher in males than in females,and the detection rates of hypertension and high triglyceride were the highest among all components.Among the total population and males,the consistency was found to be the strongest between the Cook and Noubiap criteria,with the Kappa values being 0.913 and 0.923 respectively.Among females,the consistency was found to be the strongest between the CHN2012 definition and the MetS-IDFm criterion,with the Kappa value being 0.956.Conclusion Overall,the detection rate of MetS under the Noubiap criterion is found to be the highest in the adolescents,and it is in good agreement with that under the Cook criterion.The detection rate of MetS under the IDF criterion is found to be the lowest in the adolescents,and it is in poor agreement with those under the other criteria.