三种代谢综合征诊断标准的应用及评价

目的 比较代谢综合征(MS)的CDS(2004)、IDF(2005)、ATPⅢ(2005)三个诊断标准在社区人群中的应用并评价它们诊断的一致性.方法 分别计算三种标准的MS患病率及MS各组分的检出率,使用Kappa值比较诊断的一致性.结果 三种标准的MS患病率不同.CDS(2004) 标准中肥胖的检出率、IDF(2005)和ATPⅢ(2005)高血压的检出率最高.CDS(2004)与IDF(2005)、CDS(2004) 与ATPⅢ(2005) 和IDF(2005) 与ATPⅢ(2005) 诊断一致性的Kappa值分别是0.65、0.64和0.78,其中女性的CDS(2004)与IDF(2005)诊断一致性最高.结论 三种代谢综合征诊断标准的患病率、诊断一致性均不同;IDF(2005)和ATPⅢ(2005)标准使用腰围以及相应的截断值判断肥胖对中国人的适用性有待探讨.     

三种代谢综合征诊断标准在青中年和老年2型糖尿病患者中的应用对比

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。     

依据我国成人体重判定行业标准评价现行代谢综合征诊断标准在中老年人群中的应用

目的 :依据我国成人体重判定行业标准,评价现行代谢综合征(MS)3种诊断标准在合肥市中老年人群中的应用。方法:采用整群随机抽样方法,对合肥市某社区内40岁及以上常住居民进行问卷调查、体格检查和实验室检查。按照中华医学会糖尿病分会(CDS)诊断标准、国际糖尿病联盟(IDF)诊断标准和美国国家胆固醇教育计划成人治疗方案第3次报告(NCEP-ATPⅢ)分别计算MS的患病率,依据我国成人体重判定行业标准,修订现行CDS标准作为参考标准,评价上述3种标准及修订后的IDF和ATPⅢ在实际疾病筛查中的意义。结果:共调查2 860名居民,男1 093名(占38.22%),女1 767名(占61.78%),平均年龄(56.38±10.8)岁。按照CDS、IDF、ATPⅢ和参考标准,调查对象MS患病率分别为23.39%、34.55%、37.20%和26.71%,标化患病率分别为22.18%、33.73%、36.28%和25.33%。CDS与参考标准诊断时,男女间患病率无统计学差异,60~69岁年龄段MS患病率最高。IDF与ATPⅢ标准诊断时,50~59岁年龄段MS患病率最高,女性MS患病率高于男性。相同年龄段、相同性别人群均表现出CDS标准诊断MS患病率最低,ATPⅢ标准诊断MS患病率最高,差异有统计学意义。参照参考标准,现行CDS、IDF和ATPⅢ的灵敏度分别为87.57%、80.10%和84.29%,特异度分别为100.00%、82.06%和79.96%,阳性预测值分别为100.00%、61.94%和60.53%。修订后的IDF和ATPⅢ标准MS患病率分别为27.31%和32.76%,特异度分别为88.31%和84.40%,阳性预测值分别为68.63%和65.10%。结论:调查对象MS患病率较高,现行3种诊断标准中CDS标准诊断MS患病率最低,ATPⅢ标准诊断最高,参照成人体重判定修订现行标准,可提高CDS标准下MS患病率、IDF和ATPⅢ标准诊断的特异度和阳性预测值,在实际筛查工作中应结合调查对象的实际情况灵活选择诊断标准。     

三种代谢综合征定义在老年糖尿病人群中应用的比较

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。     

新疆汉族30～80岁人群代谢综合征流行病学调查及三种诊断标准的对比研究

目的通过流行病学调查,了解新疆汉族代谢综合征(MS)患病情况,比较美国国家胆固醇教育计划成年人治疗方案第三次报告(ATPⅢ)、国际糖尿病联盟(IDF)和中华医学会糖尿病学分会(CDS)建议的MS诊断标准在汉族人群中应用的差异。方法对新疆地区2656例汉族30～80岁居民进行横断面调查,根据3种诊断标准分别计算MS患病率,分析不同诊断标准下MS异常组份及危险因素聚集的检出情况,比较3种诊断标准在汉族人群中的一致性。结果 3种诊断标准患病率(标化患病率)分别为27.03%(27.18%)、22.40%(20.39%)和16.04%(16.02%)。3种标准对MS患者3个以上危险因素聚集的检出率分别为98.64%、97.9%和92.81%。3种诊断标准在汉人群中应用的一致性两两比较,ATPⅢ标准与IDF标准的一致性较好(一致率为0.9026,Youden指数为0.7928,Kappa值为0.7801),CDS标准与另外两种标准(ATPⅢ和IDF)的一致性不高。结论 3种MS诊断标准在新疆汉族人群中应用时,获得的患病率、危险组分聚集情况和一致性差异较大,IDF标准检出率最高,ATPⅢ标准对危险因素聚集检出率最高,且两者一致性较好,优于CDS标准。     

四种代谢综合征诊断标准在初发2型糖尿病人群中应用的比较

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.     

2型糖尿病家系一级亲人群代谢综合征患病情况及与肥胖相关指标的关系

Objective To compare the differences of metabolic syndrome (MS) prevalence by using four working definitions and their relationship with obesity-related indicators in first-degree relatives of type 2 diabetes mellitus pedigrees. Methods Totally, 2 372 first-degree relatives from 715 type 2 diabetic pedigrees were selected in this study. Complete laboratory data, including blood pressure, lipid profile and plasma glucose, were collected. The prevalence rates of MS and obesity of four definitions, as defined by National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATPⅢ) in 2005, International Diabetes Federation (IDF) in 2005,Chinese Diabetes Society (CDS) in 2004 aml Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG) in 2007,were analyzed. Results (1)The prevalence rates of MS were 45.40% ,38.74% ,25.08% and 39.29% aecording to four definitions respectively. The prevalence rates of MS were higher in females than in males by using ATPⅢ and IDF definitions (both P<0. 01). (2)The common comhinations of metabolic abnormality was dyslipidemia, hypertension, obesity and hyperglycemia by using four definitions,except in females by using CDS definition. (3)The prevalence rates of obesity were 58.18% ,58.18% ,33.90% and 42.96% acconling to the four definitions respectively. The prevalence rates of MS in obese subjects were 66.59% ,66.59% ,54.85% and 68.99% according to four definitions respectively. (4) Applying the cutoff point for abdominal obesity according to ATPⅢ, IDF and JCDCG definitions, the prevalence rates of abdominal obesity in subjects with body mass index (BMI) <25 kg/m2 were respectively 28.58% and 16.78%, being higher in females than in males(38.90% vs 15.02% ,21.01% vs 11.22% ,both P<0. 01). Conclusion (1)There is significant familial aggregation of MS and obesity,and the first-degree relatives of type 2 diabetic patients are high risk populations. (2) Waist circumference rather than BMI taken as a discriminating component of obesity in MS seems to be clinically more helpful to the early identification and prevention of MS.     

2型糖尿病家系一级亲人群代谢综合征患病情况及与肥胖相关指标的关系

Objective To compare the differences of metabolic syndrome (MS) prevalence by using four working definitions and their relationship with obesity-related indicators in first-degree relatives of type 2 diabetes mellitus pedigrees. Methods Totally, 2 372 first-degree relatives from 715 type 2 diabetic pedigrees were selected in this study. Complete laboratory data, including blood pressure, lipid profile and plasma glucose, were collected. The prevalence rates of MS and obesity of four definitions, as defined by National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATPⅢ) in 2005, International Diabetes Federation (IDF) in 2005,Chinese Diabetes Society (CDS) in 2004 aml Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG) in 2007,were analyzed. Results (1)The prevalence rates of MS were 45.40% ,38.74% ,25.08% and 39.29% aecording to four definitions respectively. The prevalence rates of MS were higher in females than in males by using ATPⅢ and IDF definitions (both P<0. 01). (2)The common comhinations of metabolic abnormality was dyslipidemia, hypertension, obesity and hyperglycemia by using four definitions,except in females by using CDS definition. (3)The prevalence rates of obesity were 58.18% ,58.18% ,33.90% and 42.96% acconling to the four definitions respectively. The prevalence rates of MS in obese subjects were 66.59% ,66.59% ,54.85% and 68.99% according to four definitions respectively. (4) Applying the cutoff point for abdominal obesity according to ATPⅢ, IDF and JCDCG definitions, the prevalence rates of abdominal obesity in subjects with body mass index (BMI) <25 kg/m2 were respectively 28.58% and 16.78%, being higher in females than in males(38.90% vs 15.02% ,21.01% vs 11.22% ,both P<0. 01). Conclusion (1)There is significant familial aggregation of MS and obesity,and the first-degree relatives of type 2 diabetic patients are high risk populations. (2) Waist circumference rather than BMI taken as a discriminating component of obesity in MS seems to be clinically more helpful to the early identification and prevention of MS.     

2型糖尿病家系一级亲人群代谢综合征患病情况及与肥胖相关指标的关系

Objective To compare the differences of metabolic syndrome (MS) prevalence by using four working definitions and their relationship with obesity-related indicators in first-degree relatives of type 2 diabetes mellitus pedigrees. Methods Totally, 2 372 first-degree relatives from 715 type 2 diabetic pedigrees were selected in this study. Complete laboratory data, including blood pressure, lipid profile and plasma glucose, were collected. The prevalence rates of MS and obesity of four definitions, as defined by National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATPⅢ) in 2005, International Diabetes Federation (IDF) in 2005,Chinese Diabetes Society (CDS) in 2004 aml Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG) in 2007,were analyzed. Results (1)The prevalence rates of MS were 45.40% ,38.74% ,25.08% and 39.29% aecording to four definitions respectively. The prevalence rates of MS were higher in females than in males by using ATPⅢ and IDF definitions (both P<0. 01). (2)The common comhinations of metabolic abnormality was dyslipidemia, hypertension, obesity and hyperglycemia by using four definitions,except in females by using CDS definition. (3)The prevalence rates of obesity were 58.18% ,58.18% ,33.90% and 42.96% acconling to the four definitions respectively. The prevalence rates of MS in obese subjects were 66.59% ,66.59% ,54.85% and 68.99% according to four definitions respectively. (4) Applying the cutoff point for abdominal obesity according to ATPⅢ, IDF and JCDCG definitions, the prevalence rates of abdominal obesity in subjects with body mass index (BMI) <25 kg/m2 were respectively 28.58% and 16.78%, being higher in females than in males(38.90% vs 15.02% ,21.01% vs 11.22% ,both P<0. 01). Conclusion (1)There is significant familial aggregation of MS and obesity,and the first-degree relatives of type 2 diabetic patients are high risk populations. (2) Waist circumference rather than BMI taken as a discriminating component of obesity in MS seems to be clinically more helpful to the early identification and prevention of MS.     

2型糖尿病家系一级亲人群代谢综合征患病情况及与肥胖相关指标的关系

Objective To compare the differences of metabolic syndrome (MS) prevalence by using four working definitions and their relationship with obesity-related indicators in first-degree relatives of type 2 diabetes mellitus pedigrees. Methods Totally, 2 372 first-degree relatives from 715 type 2 diabetic pedigrees were selected in this study. Complete laboratory data, including blood pressure, lipid profile and plasma glucose, were collected. The prevalence rates of MS and obesity of four definitions, as defined by National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATPⅢ) in 2005, International Diabetes Federation (IDF) in 2005,Chinese Diabetes Society (CDS) in 2004 aml Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG) in 2007,were analyzed. Results (1)The prevalence rates of MS were 45.40% ,38.74% ,25.08% and 39.29% aecording to four definitions respectively. The prevalence rates of MS were higher in females than in males by using ATPⅢ and IDF definitions (both P<0. 01). (2)The common comhinations of metabolic abnormality was dyslipidemia, hypertension, obesity and hyperglycemia by using four definitions,except in females by using CDS definition. (3)The prevalence rates of obesity were 58.18% ,58.18% ,33.90% and 42.96% acconling to the four definitions respectively. The prevalence rates of MS in obese subjects were 66.59% ,66.59% ,54.85% and 68.99% according to four definitions respectively. (4) Applying the cutoff point for abdominal obesity according to ATPⅢ, IDF and JCDCG definitions, the prevalence rates of abdominal obesity in subjects with body mass index (BMI) <25 kg/m2 were respectively 28.58% and 16.78%, being higher in females than in males(38.90% vs 15.02% ,21.01% vs 11.22% ,both P<0. 01). Conclusion (1)There is significant familial aggregation of MS and obesity,and the first-degree relatives of type 2 diabetic patients are high risk populations. (2) Waist circumference rather than BMI taken as a discriminating component of obesity in MS seems to be clinically more helpful to the early identification and prevention of MS.     

不同诊断标准下黑龙江省成人代谢综合征患病率调查

目的 了解不同诊断标准下黑龙江省成人代谢综合征(MS)的患病率,并比较其一致性.方法 采取多级分层整群随机抽样的原则,对黑龙江2875名20～74岁的居民进行流行病学调查.采用美国胆固醇教育计划成人治疗组第三次指南(NCEP-ATPⅢ)诊断标准、国际糖尿病联盟(IDF)诊断标准及中华医学会糖尿病学分会(CDS)诊断标准计算MS的患病率,并进行结果比较和一致性检验.结果 根据ATP Ⅲ、IDF、CDS这3种诊断标准,黑龙江省成人MS标化患病率分别为14.47%、21.92%和18.73%.ATP Ⅲ与CDS诊断标准判断MS患病率的一致性最好,符合率为87.58%;其次为ATP Ⅲ与IDF,符合率为84.97%;而CDS与IDF的符合率为82.50%.结论 黑龙江地区成人MS患病率已经达到较高水平,3种MS诊断标准存在较好的一致性.     

不同诊断标准下北京市成人代谢综合征患病率

目的了解不同诊断标准下北京市成人代谢综合征（MS）流行状况,比较不同诊断标准MS的患病率并进行一致性检验。方法采用分层整群随机抽样方法对16711名年龄18岁以上北京市常住居民进行问卷调查、体格检查和实验室检查。利用中华医学会糖尿病学分会诊断标准（CDS）、国际糖尿病联盟诊断标准（IDF）、美国国家胆固醇项目专家组诊断标准（ATPⅢ）分别计算MS的患病率,并将结果进行比较和一致性检验。结果根据CDS、IDF、ATPⅢ三种诊断标准,北京市成人MS标化患病率分别为12．7％、24．0o,4和15．3％。无论以何种诊断标准,MS患病率均呈现随年龄增加而逐步增加的趋势（P=0．000）。通过对分别用CDS、IDF、ATPⅢ诊断的患者进行比较分析,分别有83．0％和89．9％患者相一致。Kappa检验显示三种指标的符合率较高,Kappa系数分别为0．510（CDS和IDF）和0．634（CDS和ATPⅢ）。结论北京市代谢综合征患病率高于国内平均水平。三种代谢综合征诊断标准均可用于中国人群,但是其适用性及价值的评价需在前瞻及随访研究中进一步证实。     

国际糖尿病联盟与中华糖尿病学会关于代谢综合征定义的比较

221名存在代谢综合征（MS）风险者纳入研究。平均发现的MS组分数，国际糖尿病联盟（IDF）定义比中华糖尿病学会（CDS）定义略高（2．33us2．09，P〉0．05）。二者的诊断符合率为80％。女性的MS患病率，IDF定义（18／83）高于CDS定义（2／83）（P〈0．05）；但男性的MS诊断率，CDS定义（18／138）高于IDF定义（7／138）（P〈0．05）；血糖正常者诊断有MS的患病率，IDF定义（21／94，22％）高于CDS定义（10／97，10％）（P〈0．05）。CDS定义中有11例（12％）肥胖不达标者诊断MS。IDF不使用餐后血糖仅使MS漏诊6％。两种定义识别MS及其组分的能力基本相当；但与CDS定义相比，使用IDF定义能使患者群体发生以下几种漂移：从男性到女性，从糖代谢异常到脂代谢异常，从不肥胖到肥胖。     

四种代谢综合征诊断标准在贵阳市成人流行病学调查中的应用比较

目的 了解不同诊断标准下,贵阳市居民代谢综合征（MS）的患病率及四种诊断标准间的一致性,并探讨2009年国际多学会联合声明（JIS）标准的应用价值.方法 分析2009至2010年贵阳市糖尿病和代谢性疾病研究数据.分别用2004年中华医学会糖尿病学分会（CDS）、美国国家胆固醇教育计划成人治疗方案第三次报告（ATPⅢ）、2005年国际糖尿病联盟（IDF）及2009年JIS的MS标准,分析贵阳市社区居民总体及不同性别MS的患病率,并使用k值比较诊断结果的一致性.结果 贵阳市社区20岁及以上成人共1 512人（男性634人,女性878人）中,MS的标化患病率分别为21.7％（CDS标准）、29.1％（IDF标准）、40.3％（ATPⅢ标准）和43.6％ （JIS标准）.IDF标准下女性MS患病率高于男性（31.0％比26.2％,P＜0.01）,而JIS标准下男性患病率高于女性（45.1％比38.8％,P＜0.01）.ATPⅢ标准和JIS标准的诊断一致性最好（k=0.94,P＜0.05）,其次为IDF标准与ATPⅢ标准k值为0.78（P＜0.05）.结论 不同的诊断标准下,贵阳市成人MS的患病率均较高,JIS标准与ATPⅢ标准的诊断一致性最好.     

不同代谢综合征诊断标准与中老年人心脑血管病患病率分析

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.     

Relationship between nonalcoholic fatty liver disease and metabolic syndrome

OBJECTIVE: The aim of this study was to investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) in subjects who underwent a routine health checkup. We intended to establish a clinical association between NAFLD and MS as well as to compare the diagnostic criteria of MS based on the definitions set forth by the International Diabetes Federation (IDF), the US National Cholesterol Education Program Adult Treatment Panel III (2001) (NCEP/ATP‐III) and the Metabolic Syndrome Study Group of Chinese Diabetes Society (CDS). METHODS: Weight, height, waist circumference, hip circumference, percentage of body fat, blood pressure and ultrasound of liver were performed on subjects undergoing routine health checkup. Serum triglyceride, total cholesterol, high density lipoprotein cholesterol and fasting plasma glucose level were measured. RESULTS: A total of 2394 subjects were included in this analysis and 437 had NAFLD. The prevalence of MS in the whole sample according to IDF, NCEP/ATP‐III and CDS definitions was 11.11%, 8.48% and 5.30%, respectively. The total degree of agreement between IDF, NCEP/ATP‐III and CDS definition was 87.76%. The prevalence of MS in NAFLD subjects is much higher than that in non‐NAFLD subjects. The prevalence of NAFLD in MS subjects is also much higher than that in non‐MS subjects. CONCLUSION: The prevalence of MS varied depending on the diagnostic criteria used. NAFLD was strongly associated with the MS, although it remains unknown whether NAFLD is a cause or effect of MS.     

广东省成人代谢综合征流行特征及其不同诊断标准的对比研究

目的了解广东省18岁及以上人群代谢综合征（MS）的患病情况,比较2004年中华医学会糖尿病学分会（CDS）标准、2007年中国成人血脂异常防治指南制订联合委员会（JCDCG）标准和2009年国际联合暂定声明（JIS）标准在广东省18岁及以上人群中应用的差异。方法采用多阶段分层整群抽样方法抽取广东省6个监测县（区、市）18岁及以上居民中的3591人为研究对象,采用统一制定的调查表进行问卷调查,同时进行体格检查及血生化检测。两两比较采用t检验,率的比较采用ｘ2检验。结果采用CDS（2004）、JCDCG（2007）和JIS（2009）标准计算的MS患病率（标化患病率）分别为21．1％（19．0％,756例）、28．6％（25．4％,1026例）和44．5％（40．6％,1599例）;3种标准诊断为MS者中存在3个及以上危险因素聚集的比例分别为97．5％（737例）、98．4％（1010例）和100．0％（1599例）;CDS与JIS、JCDCG与JIS、JCDCG与CDS两两问的一致率（Kappa值）分别为74．8％（0．46,2688例）、82．1％（0．63,2950例）和87．8％（0．68,3153例）。以JIS为参照标准,绘制ROC曲线,CDS的曲线下面积为0．719,JCDCG的曲线下面积为0．802。结论广东省18岁及以上居民MS患病率已经达到较高水平,建议加强MS高危人群的综合防治力度。三种MS诊断标准中,JIS标准诊断MS的患病率、灵敏度和危险因素聚集的检出率最高。     

不同代谢综合征定义在广州地区中老年人群中应用的比较

目的比较国际糖尿病联盟(IDF)与中华糖尿病学会(CDS)关于代谢综合征(MS)的定义在广州地区中老年人群中诊断的符合率及差异。方法于2004年对年龄≥35岁的广州造船厂(广船)1270名工人及广州番禺大石(大石)4个自然村农民2082人进行调查,调查内容包括问卷及病史调查,身高、体重、腰围、血压测量,血液生化指标检测等。除掉资料不完整者,用于分析的分别为广船1266人,大石1658人。按照IDF对MS的定义及CDS对MS的定义分别计算不同人群MS患病率。结果 (1)共有40.5%的个体满足两种诊断标准,仅符合IDF定义的为34.6%,仅符合CDS定义的为24.9%,两者对MS诊断符合率达到87%(城市87.3%,农村87.1%),Kapple值为0.501(P0.001)。(2)不论用IDF定义或CDS定义,城市或农村MS患病率水平大致相同,分别为城市15.5%(IDF定义)和14.6%(CDS定义),农村16.6%(IDF定义)和13.8%(CDS定义)。但是在IDF定义中,因为腰围未达标,尽管有其他3项指标达到标准也未诊断为MS的人数城市105人,农村160人。(3)男性MS患病率CDS定义(16.1%)高于IDF定义(12.3%);女性则IDF定义比CDS定义高(分别为20.1%和12.0%)。(4)按年龄不同分为40岁、40～49岁、50～59岁、60～69岁和≥70岁共5个年龄组,两种定义MS患病率均随年龄增长而增高,但70岁以后MS患病率则是下降趋势,最高患病率出现在60～69岁年龄组。结论用现有的诊断标准,IDF和CDS对MS患病率的检出基本一致,只是男性对CDS定义较敏感,而女性对IDF定义更敏感;老年人是MS的重点防治对象。