国际糖尿病联盟关于代谢综合征定义的全球共识

一、供临床使用的代谢综合征全球定义1.国际糖尿病联盟(IDF)的代谢综合征新定义:根据IDF新定义,必须具备以下条件才能将某一个体定义为患有代谢综合征:中心性肥胖(欧洲男性腰围≥94cm,欧洲女性≥80cm,其他人种有各自特定的数值)加上以下4个因素中的任意2项,(1)甘油三酯(TG)水平     

2005: The International Diabetes Federation focuses on the diabetic foot

The International Diabetes Federation (IDF) has proclaimed 2005 to be the "Year of the Diabetic Foot." Together with the International Working Group on the Diabetic Foot, the IDF has launched a year-long campaign to raise awareness of the diabetic foot worldwide. In this article, both organizations are briefly described, an overview of the aims of the global awareness campaign is given, and the activities to promote World Diabetes Day in 2005 are outlined. Attention is also paid to present and future developments to improve the standards of diabetic foot care worldwide.     

Bariatric surgery for diabetes: the International Diabetes Federation takes a position

Type 2 diabetes (T2D) and obesity are both complex and chronic medical disorders, each with an escalating worldwide prevalence. When obesity is severe, and/or available medical therapies fail to control the diabetes, bariatric surgery becomes a cost-effective therapy for T2D. When there are other major comorbidities and cardiovascular risk, the option of bariatric surgery becomes even more worthy of consideration. National guidelines for bariatric surgery need to be developed and implemented for people with T2D. With this in mind, the International Diabetes Federation convened a multidisciplinary working group to develop a position statement. The key recommendations cover describing those eligible for surgery and who should be prioritized, incorporating bariatric surgery into T2D treatment algorithms, performing surgery in centers with multidisciplinary teams that are experienced in the management of both obesity and diabetes, and developing bariatric surgery registries and reporting standards.     

International Diabetes Federation: a consensus on Type 2 diabetes prevention.

AIMS: Early intervention and avoidance or delay of progression to Type 2 diabetes is of enormous benefit to patients in terms of increasing life expectancy and quality of life, and potentially in economic terms for society and health-care payers. To address the growing impact of Type 2 diabetes the International Diabetes Federation (IDF) Taskforce on Prevention and Epidemiology convened a consensus workshop in 2006. The primary goal of the workshop and this document was the prevention of Type 2 diabetes in both the developed and developing world. A second aim was to reduce the risk of cardiovascular disease in people who are identified as being at a higher risk of Type 2 diabetes. The IDF plan for prevention of Type 2 diabetes is based on controlling modifiable risk factors and can be divided into two target groups: People at high risk of developing Type 2 diabetes. The entire population. CONCLUSIONS: In planning national measures for the prevention of Type 2 diabetes, both groups should be targeted simultaneously with lifestyle modification the primary goal through a stepwise approach. In addition, it is important that all activities are tailored to the specific local situation. Further information on the prevention of diabetes can be found on the IDF website: http://www.idf.org/prevention.     

Diabetes Canada 2017

Ann M. Carracher, Payal H. Marathe, and Kelly L. Close are of Close Concerns ( http://www.closeconcerns.com ), a healthcare information company focused exclusively on diabetes and obesity care. Close Concerns publishes Closer Look, a periodical that brings together news and insights in these areas. Each month, the Journal of Diabetes includes this News feature, in which Carracher, Marathe, and Close review the latest developments relevant to researchers and clinicians.     

International Diabetes Federation guideline for management of postmeal glucose: a review of recommendations

Diabetes is a significant and growing concern, with over 246 million people around the world living with the disease and another 308 million with impaired glucose tolerance. Depending on the resources of different nations, intervention has generally focused on optimizing overall glycaemic control as assessed by glycated haemoglobin (HbA_1c) and fasting plasma glucose (FPG) values. Nevertheless, increasing evidence supports the importance of controlling all three members of the glucose triad, namely HbA_1c, FPG and postmeal glucose (PMG) in order to improve outcome in diabetes. As part of its global mission to promote diabetes care and prevention and to find a cure, the International Diabetes Federation (IDF) recently developed a guideline that reviews evidence to date on PMG and the development of diabetic complications. Based on an extensive database search of the literature, and guided by a Steering and Development Committee including experts from around the world, the IDF Guideline for Management of Postmeal Glucose offers recommendations for appropriate clinical management of PMG. These recommendations are intended to help clinicians and organizations in developing strategies for effective management of PMG in individuals with Type 1 and Type 2 diabetes. The following review highlights the recommendations of the guideline, the supporting evidence provided and the major conclusions drawn. The full guideline is available for download at http://www.idf.org .     

Prevalence of metabolic syndrome estimated by International Diabetes Federation criteria in a Hungarian population

Aims. In recent years, metabolic syndrome (MS) became a distinct pathological entity. MS is positively associated with cardiovascular mortality. The prevalence of MS is high and a continuing increase is expected. For this reason, all attempts to prevent or manage MS by interventions are extremely important. The new set of definition by International Diabetes Federation (IDF) standardizes criteria for the diagnosis of MS and facilitates its recognition. In a large sample (n = 13 383) of outpatients visiting their general practitioners, we determined the prevalence of risk factors of MS according to the earlier Adult Treatment Panel (ATP) III and the new IDF criteria. Methods and results. The age-standardized prevalence of MS was 14.9% in males and 8.6% in females (11.5% for all). The most prevalent factors were obesity (ATP III: 38.8% and IDF: 60%) and hypertriglyceridemia (34.1%). Hypertension dominated in men (28.7%), whereas in women obesity was the most prevalent factor (ATP III: 47.4% and IDF: 64%). Conclusion. The prevalence of MS depends on applied definition. The new IDF criteria offer the possibility of focusing on the importance of different components. The real comparison of prevalence among special populations has to be based on age-standardized data and the use of the same components. In our study, the dominance of obesity, hypertension and hypertriglyceridemia appears to be the major detrimental factors. The 11.5% general prevalence of MS in Hungarians, which means a 25-30% value in the middle-aged population, needs an urgent preventive approach with lifestyle changes.     

2种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代谢综合征(MS)诊断标准的一致性.方法 对心血管内科门诊和体检科年龄≥40岁的中老年人进行问卷调查.无糖尿病者行口服75 g葡萄糖耐量试验(OGTT),共1130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(72.4%),将中国标准中的空腹血糖(FPG)调整至≥5.6 mmol/L后,两者符合率增加(78.3%).2)体质量指数(BMI)≥25 kg/m2与男性腰围≥90 cm(女性腰围≥80 cm)时符合率较好,女性符合率高达91.0%.3)IDF与中国标准诊断MS者心肌梗死和(或)脑卒中患病率及尿微量白蛋白的患病率相似,均显著高于无MS者的患病率[IDF标准[心肌梗死和(或)脑卒中患病率:20.3%比无MS:14.5%,P<0.01;尿微量白蛋白患病率:7.9%比无MS,3.4%,P<0.01];中国标准[心肌梗死和(或)脑卒中患病率:21.3%比无MS:15.1%,P<0.01,尿微量白蛋白患病率:8.5%比无MS:4.2%,P<0.01].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.     

2种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代谢综合征(MS)诊断标准的一致性。方法对心血管内科门诊和体检科年龄≥40岁的中老年人进行问卷调查,无糖尿病者行口服75 g 葡萄糖耐量试验(OGTT),共1130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(72.4%),将中国标准中的空腹血糖(FPG)调整至≥5.6 mmol/L 后,两者符合率增加(78.3%)。2)体质量指数(BMI)≥25 kg/m~2与男性腰围≥90 cm(女性腰围≥80 cm)时符合率较好,女性符合率高达91.0%。3)IDF 与中国标准诊断 MS 者心肌梗死和(或)脑卒中患病率及尿微量白蛋白的患病率相似,均显著高于无 MS 者的患病率[IDF标准[心肌梗死和(或)脑卒中患病率:20.3%比无 MS:14.5%,P<0.01;尿微量白蛋白患病率:7.9%比无 MS:3.4%,P<0.01];中国标准[心肌梗死和(或)脑卒中患病率:21.3%比无 MS:15.1%,P<0.01;尿微量白蛋白患病率:8.5%比无 MS:4.2%,P<0.01]。结论我国建议 MS 诊断标准与 ...     

Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation.

AIMS: To establish a unified working diagnostic tool for the metabolic syndrome (MetS) that is convenient to use in clinical practice and that can be used world-wide so that data from different countries can be compared. An additional aim was to highlight areas where more research into the MetS is needed. PARTICIPANTS: The International Diabetes Federation (IDF) convened a workshop held 12-14 May 2004 in London, UK. The 21 participants included experts in the fields of diabetes, public health, epidemiology, lipidology, genetics, metabolism, nutrition and cardiology. There were participants from each of the five continents as well as from the World Health Organization (WHO) and the National Cholesterol Education Program-Third Adult Treatment Panel (ATP III). The workshop was sponsored by an educational grant from AstraZeneca Pharmaceuticals. CONSENSUS PROCESS: The consensus statement emerged following detailed discussions at the IDF workshop. After the workshop, a writing group produced a consensus statement which was reviewed and approved by all participants. CONCLUSIONS: The IDF has produced a new set of criteria for use both epidemiologically and in clinical practice world-wide with the aim of identifying people with the MetS to clarify the nature of the syndrome and to focus therapeutic strategies to reduce the long-term risk of cardiovascular disease. Guidance is included on how to compensate for differences in waist circumference and in regional adipose tissue distribution between different populations. The IDF has also produced recommendations for additional criteria that should be included when studying the MetS for research purposes. Finally, the IDF has identified areas where more studies are currently needed; these include research into the aetiology of the syndrome.     

Application of the International Diabetes Federation and American Diabetes Association criteria in the assessment of metabolic control after bariatric surgery

The International Diabetes Federation (IDF) and the American Diabetes Association (ADA) have introduced specific criteria to define the ‘optimization’ of the metabolic state and glycaemic ‘remission’ of type 2 diabetes mellitus (T2DM) after bariatric surgery, respectively. Our objective was to assess the percentage of patients achieving these criteria. Data were collected for body mass index, glycaemic markers, lipids, blood pressure, hypoglycaemia and medication usage from 396 morbidly obese T2DM patients who underwent bariatric surgery in two centres and followed up for 2 years. At year 1, 14% of patients achieved the IDF criteria and 38% the ADA criteria, whereas at 2 years 8 and 9% satisfied these criteria, respectively. A relatively low proportion of patients achieved optimization of the metabolic state and T2DM remission. These patients may potentially benefit from the combination of bariatric surgery and adjuvant medical therapy to achieve optimal metabolic outcomes.     

Waist circumference cutoff points for Chinese adults with metabolic syndrome defined by the International Diabetes Federation

Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344 Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P<0.05). 2)The prevalence of elevated TG, reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P<0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2 were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.