国际糖尿病联盟与中国糖尿病学会关于代谢综合征诊断标准的比较分析

目的 评价、分析国际糖尿病联盟（IDF）和我国糖尿病学分会的代谢综合征（MS）诊断标准的一致性。方法 对北京石景山地区中老年人群流行病学调查中，无糖尿病者行口服75g葡萄糖耐量试验（OGTT），同时进行问卷调查和体检的1870例资料进行分析，按两个标准分别计算MS患病率。结果 （1）两种MS诊断标准具有较好的符合率（79．95％），将中国标准中的空腹血糖（FPG）调整至≥5．6mmol／L后，两者符合率增加（81．39％）。（2）体重指数≥25kg／m^2与男性腰围≥90cm或女性腰围≥80cm时符合率较好，女性符合率高达94．55％。（3）IDF与中国标准诊断MS者心肌梗死和／或脑卒中患病率及微量白蛋白尿的患病率相似，分别为19．87％和19．62％以及8．59％和8．55％，均显著高于无MS者的患病率（14．86％和15．21％以及4．28％和4．49％）。（4）中国标准诊断MS者中有63例并不存在肥胖或中心性肥胖，这些患者可能并不属于典型的代谢综合征。结论 我国建议MS诊断标准与IDF标准的一致性较好，两个标准都可用于中国人群。

Comparison of the diagnostic criteria of metabolic syndrome by International Diabetes Federation and that by Chinese Medical Association Diabetes Branch

OBJECTIVE: To compare the accordance between the diagnostic criteria of metabolic syndrome (MS) by International Diabetes Federation (IDF) and that by Chinese Medical Association (CMA) Diabetes Branch. METHODS: An epidemiological survey on diabetes mellitus (DM) was conducted among 2344 residents in Shijingshan community, Beijing, aged >or= 40. 1870 of these 2344 people, 901 males and 969 females, without DM underwent physical examination, laboratory tests, questionnaire survey and oral glucose tolerance test so as to screen the MS patients by both diagnostic criteria. The accordance of these 2 criteria was analyzed statistically by using the STATA7.0 software. RESULTS: The accordance rate of these 2 MS diagnostic criteria was 79.95%. If the criterion for fasting blood glucose in the China criteria was adjusted to 5.6 mmol/L, the accordance increased to 81.39%. 1091 persons were diagnosed as with central obesity according to the IDF criteria, 626 of which could be diagnosed as central obesity according to the China criteria with an accordance rate of 57.38%. Out of these 1091 persons 578 (92.3%) had the BMI >or= 25 kg/m(2). Out of the 779 persons that failed to be diagnosed as with central obesity 113 persons were diagnosed as with central obesity according to the China criteria. Fifty of these 113 persons had the BMI >or= 25 kg/m(2). 111 persons diagnosed as with MS did not have BMI abnormality. According to the IDF criteria, the morbidity of myocardial infarction (MI) and/or cerebral stroke in those with MS was 19.87%, significantly higher than in those without MS (14.86%, P = 0.004), and according to the China criteria, the morbidity of myocardial infarction (MI) and/or cerebral stroke in those with MS was 19.52%, significantly higher than in those without MS (15.21%, P = 0.013) as well. There was no significant difference in the morbidity of MI and cerebral stroke between the IDF criteria and China criteria (P = 0.092). According to the IDF criteria the morbidity of microalbuminuria in the MS patients was 8.59%, significantly higher than that in the persons without MS (4.28%, P = 0.000). According to the China criteria the morbidity of microalbuminuria in the MS patients was 8.55%, significantly higher than that in the persons without MS (4.49%, P = 0.000). There was no significant difference in the morbidity of microalbuminuria between these 2 criteria (P = 0.976). There were no significant difference in the morbidity of microalbuminuria in the persons with central obesity and those with the BMI >or= 25 kg/m(2) between these 2 criteria (P = 0.77). CONCLUSION: The MS diagnostic criteria of IDF and that of CMA Diabetes Branch are in good accordance.