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1.
目的探讨国际糖尿病联盟(IDF)以腰围作为诊断代谢综合征(MS)的必要条件在预测心血管疾病方面的价值.方法 对1998~2002年在该院门诊体检人群中年龄28~74岁,身高、体重、腰围、臀围、血压、血脂、葡萄糖耐量试验(OGTT)资料完整,既往无大血管病史者857人平均随访6.8年,记录此期间内新发生的心血管事件.分别应用WHO关于MS定义和 IDF的MS定义诊断MS,比较两种定义的诊断符合率及对心血管事件的风险预测.结果 两种定义对MS诊断一致性为80.3%(阳性一致208例,阴性一致480例),WHO(1999) 与IDF(2005)定义的MS患心血管事件的风险基本一致,OR值分别为3.44 和3.84(男),3.06和3.83(女).结论 以腰围代替胰岛素抵抗诊断MS从而预防心血管事件的发生,在临床实践中简便易行,具有较大的实用性.  相似文献   

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1 WHO的工作定义和NCEP-ATP Ⅲ的诊断标准的比较与应用NCEP-ATP Ⅲ的诊断标准在美国主要用于MS筛查,操作起来比较简单,适用于大样本人群的流行病学调查:而WHO的工作定义则兼顾了各方面的意见和建议,具有指导意义.  相似文献   

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目的比较1999年世界卫生组织(WHO)、2001年美国胆固醇教育计划成人治疗组第三次报告(NCEP-ATPⅢ)和2005年国际糖尿病联盟(IDF)提出的3种代谢综合征(MS)定义在上海地区老年糖尿病人群中的适用性及异同。方法选择华山医院老年糖尿病患者896例,检测血糖、血脂、胰岛素、血压、身高、腰围、体重指数、腰臀比、胰岛素抵抗指数,分析3种定义标准诊断的MS患病率及其诊断一致性。以及与心脑血管疾病的关系。结果(1)WHO、ATPⅢ、IDF定义诊断的MS患病率分别为70.6%、56.1%和50.8%;ATPⅢ定义诊断出的中心性肥胖患病率低于其他2种定义;IDF定义诊断的MS组体重指数和腰围水平高于其他2种定义,ATPⅢ定义诊断的MS组HDL-C水平低于其他2种定义;(2)3种MS定义总体诊断符合率为65.7%,IDF与WHO定义的诊断符合率为70.8%,IDF与ATPⅢ定义的诊断符合率为70.1%;(3)IDF定义的MS组冠心病和脑梗死患病率高于其他2种定义。结论IDF诊断标准可能更适合本组老年糖尿病。  相似文献   

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目的 比较WHO(1999年)、国际糖尿病联盟(IDF,2005年)、美国国家胆固醇教育计划成人治疗组(NCEP-ATPⅢ,2001年)的代谢综合征(MS)诊断标准和中华医学会糖尿病学分会(CDS,2004年)制定的MS诊断标准在我国初发老年2型糖尿病人群中应用的异同.方法 对初诊2型糖尿病患者1399例进行MS诊断相关指标测定,按年龄分为老年组259例和非老年组1140例,计算不同标准的MS诊断率,比较两组结果的异同.结果 (1)MS患病率以WHO诊断标准检出率最高(68.0%),NCEP-ATPⅢ标准次之(54.8%),CDS标准(47.9%)与IDF标准(46.7%)相近,NCEP-ATPUI标准、WHO诊断标准、IDF标准与CDS标准诊断率比较,差异均有统计学意义(P<0.01);(2)NCEP-ATPⅢ标准与CDS标准诊断符合率较高,WHO、IDF标准稍差.结论 对初诊2型糖尿病患者,应用WHO标准诊断MS阳性率最高,NCEP标准与CDS标准一致性最高,WHO诊断标准可能更适合本组初发老年2型糖尿病患者.  相似文献   

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国际糖尿病联盟代谢综合征全球共识定义解读   总被引:39,自引:4,他引:35  
自1999年世界卫生组织(WHO)制订了“代谢综合征(MS)的工作定义”(简称“WHO定义”)后,6年来国际上相继有多个主要的学术组织先后发布了各自与WHO不同的定义,如美国成人胆固醇教育计划成人组第3次报告中关于MS定义(简称“ATPⅢ定义”)、欧洲胰岛素抵抗工作组定义和美国临床内分泌医师学会定义。中华医学会糖尿病学分会也在2004年提出了中国人MS诊断的建议。  相似文献   

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目的 探讨不同代谢综合征(MS)诊断标准与中老年人心脑血管病( CCVD)患病的关系.方法 于2009年在北京城区、近郊区平原和远郊山区对55岁及以上中老年人进行调查和检查,共1458名中老年人完成问卷调查和实验室检查.分别采用世界卫生组织(WHO)定义、美国国家胆固醇教育计划成人治疗组第3次报告( NCEP-ATPⅢ)修订定义、国际糖尿病联盟(IDF)定义和中华医学会糖尿病分会(CDS)定义计算MS患病率,分析MS患病与CCVD患病的关系.结果 无论采用何种定义,MS患者CCVD、脑卒中、冠心病患病危险均明显高于非MS者,WHO定义、NCEP-ATPⅢ修订定义、IDF定义和CDS定义的MS者CCVD危险均明显增加,其中WHO定义和CDS定义的MS与CCVD患病的关联程度最高,这2种定义的MS患者CCVD患病的危险分别是非MS者的2.14倍(OR=2.14,95%CI:1.59~2.87)和1.91倍(OR=1.91,95%CI:1.43~2.55),而NCEP-ATPⅢ修订定义和IDF定义的MS患者CCVD患病的危险分别是非MS者的1.68倍(OR=1.68,95%CI:1.32~2.15)和1.64倍(OR=1.64,95%CI:1.26~2.13).采用Logistic回归模型控制年龄、性别、地区、吸烟和饮酒史后,上述4种定义所计算的OR值分别是1.91、1.88、1.67、1.80.分别分析上述4种MS定义与脑卒中和冠心病患病的危险,结果依然显示WHO定义和CDS定义的MS与这2种疾病的关联程度最高.结论 采用WHO定义和CDS定义的MS是反映55岁及以上中老年人CCVD患病危险的最佳指标.  相似文献   

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程晔  张舵舵 《中国老年学杂志》2008,28(24):2481-2482
非酒精性脂肪肝病(NAFLD)世界平均患病率约20%[1].上海一项抽样调查成人代谢综合征(MS)(WHO标准)发病率17.14%[2].美国临床内分泌医师协会已经把NAFLD列为MS成分之一,但世界卫生组织(WHO)和美国国家胆固醇教育计划成人治疗组第三次报告(NCEP-ATPⅢ)关于MS的诊断标准并未含有NAFLD.  相似文献   

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目的 在糖代谢异常高危人群中,评价WHO的代谢综合征(MS)诊断标准和中国的MS建议定义诊断MS的一致性,探讨适合于中国人群的MS诊断标准。方法 对首都钢铁公司2882例30岁以上、无糖尿病史、经口服葡萄糖耐量试验(OGTT)初筛后2h血糖≥6.67mmol/L者重复进行OGTT后的资料进行分析,计算标准化患病率,同时试对MS诊断标准进行调整。结果 在该人群中:(1)糖代谢异常、超重、高血压、高甘油三酯(TG)血症、胰岛素抵抗(IR)等MS单组分的患病率均超过30%;(2)以中国建议的定义诊断MS的患病率(28.4%)高于wH0的MS诊断标准(20.2%);(3)WHO的MS诊断标准体质指数(BMI)界点过高;(4)微量白蛋白尿(MAU)阳性者的MS各组分发生率以及MS的患病率均较高。结论 糖代谢异常高危人群中根据中国建议定义MS的患病率较高;中国MS诊断标准中加入MAU组分,对MS的患病率影响不大。  相似文献   

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不同代谢综合征诊断标准对靶器官损害的检出   总被引:2,自引:0,他引:2  
目的探讨不同的代谢综合征(MS)诊断标准对靶器官损害的检出情况。方法分别采用世界卫生组织(WHO)、美国国家胆固醇教育计划成人治疗组(NCEP-ATPⅢ)和WHO亚太(体重指数采用亚太地区肥胖标准)、ATPⅢ亚太(腰围采用亚太地区肥胖标准)、仿WHO(体重指数采用中国肥胖标准)、仿ATPⅢ(腰围采用中国肥胖标准)代谢综合征(MS)诊断标准对1 363例临床住院高血压、糖尿病及高血压合并糖尿病患者进行诊断,并应用超声心动图、颈动脉超声和免疫比浊法检测MS患者的心肾血管的损害情况。结果采用6种诊断标准,女性的MS诊断率明显高于男性(P<0.01)。女性MS患者的左室肥厚发生率均明显高于男性(P<0.05)。采用不同的WHO标准,男性MS患者的颈动脉内膜中层厚度明显高于女性(P<0.05)。采用不同的ATPⅢ标准,女性MS患者的肌酐轻度升高发生率均明显高于男性(P<0.05)。结论不同MS诊断标准对MS不同的靶器官损害检出率有所差异,且受性别影响较大。  相似文献   

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目的比较中华医学会糖尿病学分会(CDS)、国际糖尿病联盟(IDF)、美国国家胆固醇教育计划成人治疗组(NCEP-ATPⅢ)的代谢综合征(MS)诊断标准在青中年和老年2型糖尿病患者中的应用。方法初发2型糖尿病患者1 279例进行MS诊断相关指标测定,按年龄分为青中年组(<60岁)946例和老年组(≥60岁)333例,计算不同标准的MS患病率。结果以CDS、IDF、NCEPATPⅢ为标准,青中年组MS患病率分别为61.7%、57.0%、60.5%,老年组分别为72.4%、69.7%、79.3%。青中年组以CDS为标准,IDF与CDS MS诊断符合率为57.4%,NCEP-ATPⅢ与CDS为60.1%。老年组IDF与CDS为78.8%,NCEP-ATPⅢ与CDS标准符合率为87.1%。结论在初发2型糖尿病人群中,为识别更多的心血管危险因素,对初诊青中年2型糖尿病患者可采用CDS标准诊断MS;而在老年患者,可采用NCEP-ATPⅢ标准诊断MS。  相似文献   

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A nocturnal surge of prolactin secretion occurs in the dark period preceding parturition in the rat. The aim of this study was to examine the role of the placenta in the control of this prolactin surge. Plasma prolactin and progesterone were measured by radioimmunoassay in serial blood samples collected after surgical removal of conceptuses during late pregnancy, and after intracerebroventricular (i.c.v.) injection of placental lactogen (PL) before the prolactin surge. In intact control animals, prolactin secretion remained low until a nocturnal surge of secretion occurred in the dark period preceding parturition, peaking at 269 +/- 51 (S.E.M.) micrograms/l at 03.00 h on day 21. Progesterone levels fell from greater than 200 nmol/l on day 19 to less than 40 nmol/l by 12.00 h on day 20 of pregnancy. PL levels during late pregnancy were modified by partial or complete removal of conceptuses at 10.00 h on day 19 of pregnancy. Removal of all but one or two conceptuses did not change the normal pattern of prolactin or progesterone secretion. Removal of all conceptuses, however, induced a large nocturnal surge of prolactin secretion, peaking at 211.7 +/- 78 micrograms/l at 03.00 h on day 20, 24 h earlier than the surge in intact animals. Progesterone levels after removal of all conceptuses fell to less than 40 nmol/l by 23.00 h on day 19, approximately 12 h before the decline in intact animals. Maintenance of increased progesterone levels after conceptus removal using silicone tubing implants significantly (P less than 0.05) reduced the peak of the premature prolactin surge to 79.7 +/- 18 micrograms/l at 05.00 h on day 20.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

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The extensive destruction of forebrain noradrenergic nerve terminals by the intraventricular injection of 250 μg of 6-hydroxy-dopamine prevents the subsequent development of DOCA-salt experimental hypertension in rats while the lesser destruction of noradrenergic nerve terminals produced by 90 μg of 6-hydroxydopa does not. The greatest difference in brain part noradrenaline levels between these two neurotoxins was in the septal area where noradrenaline was less than 15% of controls after 6-hydroxydopamine but was the same as controls after 6-hydroxydopa. The non-specific destruction of the lateral septal area by radiofrequency lesions prevented the subsequent development of DOCA-salt hypertension. The relatively selective destruction of catecholamine nerve terminals in the lateral septal area by the injection of 1 μg 6-hydroxydopamine in 1 μl vehicle also prevented the development of DOCA-salt hypertension. These data suggest that the lateral septal area may be the location of the forebrain catecholaminergic neural activity that is necessary for the development of DOCA-salt experimental hypertension in rats.  相似文献   

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Controversy continues to surround the value of drug treatment of hypertension in the elderly. Epidemiologic evidence implicates hypertension as a major risk factor in the precocious development of stroke and coronary heart disease in the elderly subject as clearly as it is implicated in the younger person. The hemodynamic and neuroendocrine profiles of the older patient with essential hypertension are similar to those of younger patients in the stable phase of the disease. However, the arterial ravages induced by many years of sustained hypertension render the circulation of the elderly subject more sensitive to pharmacologic intervention. The benefit-risk ratio of most antihypertensive drugs appears to be inversely related to age. Diuretics reduce the blood pressure at rest but have no influence on the increases in systolic pressure during normal activity; in addition, they carry potentially serious metabolic hazards in the elderly hypertensive patient. Centrally acting drugs likewise lower the blood pressure at rest without influencing the high systolic pressures induced by exercise. They also enhance the tendency to endogenous depression. Adrenergic-neurone blocking drugs and alpha-adrenoceptor antagonists are contraindicated because of the frequency of impaired cardiovascular reflexes in the elderly. The beta-blocking drugs can reduce the risk of coronary and cerebrovascular disease in the older patient with hypertension. They appear to be well tolerated, but because of their impaired metabolic handling in many elderly patients they should probably be used in smaller doses than those prescribed in younger patients. The influence of antihypertensive treatment on cardiovascular morbidity and mortality in the elderly hypertensive patient is not known.  相似文献   

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The control of arteriolar diameters in microvasculature has been in the focus of studies on mechanisms matching oxygen demand and supply at the tissue level. Functionally, important vascular elements include EC, VSMC, and RBC. Integration of these different cell types into functional units aimed at matching tissue oxygen supply with tissue oxygen demand is only achieved when all these cells can respond to the signals of tissue oxygen demand. Many vasoactive agents that serve as signals of tissue oxygen demand have their receptors on all these types of cells (VSMC, EC, and RBC) implying that there can be a coordinated regulation of their behavior by the tissue oxygen demand. Such functions of RBC as oxygen carrying by Hb, rheology, and release of vasoactive agents are considered. Several common extra‐ and intracellular signaling pathways that link tissue oxygen demand with control of VSMC contractility, EC permeability, and RBC functioning are discussed.  相似文献   

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