代谢综合征不同诊断标准的应用比较

目的比较CDS(2004)、IDF(2005)和NCEP-ATPⅢ(2005)建议的代谢综合征(MS)不同诊断标准计算的MS患病率的差异和3个标准间的一致性。方法采用随机整群抽样的方法,于2007～2008年对河南省某农村35～74岁居民16953人进行MS患病率的横断面调查,用前述的三个诊断标准计算MS的患病率,用κ检验比较3个标准的一致性。结果采用CDS(2004)、IDF(2005)和NCEP-ATPⅢ(2005)诊断标准计算的MS患病率分别为18.57%、34.52%、41.70%。ATPⅢ与IDF、ATPⅢ与CDS、IDF与CDS两两间的一致率分别为92.82%、75.97%和79.62%,Kappa值分别为0.85、0.46、0.49。以IDF为参照标准,绘制ROC曲线,ATPⅢ的曲线下面积为0.945,CDS的曲线下面积为0.720。结论3个诊断标准确定的MS患病率存在一定差异,ATPⅢ和IDF诊断的一致性较高。

Comparison of different diagnostic criteria for metabolic syndrome

Objective To compare the prevalence of metabolic syndrome(MS) and the agreement of different diagnostic criteria for MS proposed by CDS(2004),IDF(2005) and NCEP-ATPⅢ(2005).Methods A crosssectional study of MS included 16 953 participants aged 35-74 was conducted in rural Henan Province in 2007 and 2008.The prevalence of MS was calculated by the three criteria and Kappa statistics was used to compare the agreement of the three criteria.Results The prevalence rates of MS were 18.57%,34.52% and 41.70% based on CDS(2004),IDF(2005) and NCEP-ATPⅢ(2005) diagnostic criteria respectively.The agreement rates between ATPⅢ and IDF,ATPⅢ and CDS,IDF and CDS were 92.82%,75.97% and 79.62%,respectively,and the Kappa indices were 0.85,0.46 and 0.49 respectively.The areas under ROC curve were 0.945 for ATPⅢ and 0.720 for CDS when IDF was used as the reference.Conclusion There are some differences on the prevalence rates of MS diagnosed by the three criteria,and the consistency of ATPⅢ and IDF is higher.