中国社区老年人群代谢综合征诊断应用3种标准的对比研究

目的比较3种标准在我国社区老年人群中对MS诊断的一致性,为比较和验证各种MS诊断标准的应用价值提供依据。方法采用多阶段分层抽样方法在5座城市共调查6 295名年龄≥60周岁的社区居民,使用统一的流行病学调查表进行问卷调查,并进行体格检查、血生化标本的收集和测定。分别应用国际糖尿病联盟（IDF）、美国国家胆固醇教育计划成年人治疗方案第三次报告（NCEP-ATPⅢ）、中华医学会糖尿病学会分会（CDS,修订）的3种诊断标准计算该人群MS的患病率,研究3种标准在中国老年人群中应用的一致性。结果分别应用IDF、NCEP-ATPⅢ和CDS修订标准判定我国社区60岁以上老年人MS患病率分别为21.2%、38.6%、25.5%。按照IDF或NCEP-ATPⅢ诊断标准计算的MS患病率女性高于男性,差异有统计学意义（P〈0.01）。按照CDS的诊断标准（修订）计算不同性别人群MS患病率差异无统计学意义（P〉0.05）。NCEP-ATPⅢ与CDS诊断标准（修订）一致率最高,为87.0%,Kappa值为0.71。结论在社区卫生工作中对MS进行诊断和防控时,选择不同的标准将在一定程度上影响对疾病流行程度的评估。

Comparative study on the three diagnosis criteria of metabolic syndrome in Chinese elderly population

Objective To compare the consistency of the three diagnosis criteria of metabolic syndrome（MS） in Chinese elderly population and to provide the base for verifying the values of different MS diagnosis criteria. Methods Cluster sampling method was used to select 6 295 senior residents（≥60 years old） from 5 cities of China as the subjects. The unified questionnaire,physical examination and blood biochemical test were used in present investigation. The MS criteria from IDF, NCEP-ATP Ⅲ and CDS were utilized to diagnose the patients with MS, and the morbidities of MS were calculated. The consistency of the three diagnosis criteria used for Chinese elderly population was studied. Results The MS morbidities diagnosed by three criteria from IDF, NCEP-ATPⅢ and CDS were 21.2%,38.6% and 25.5%, respectively. When the diagnosis criteria from IDF and NCEP-ATPⅢ were used in diagnosis, female MS morbidity was significantly higher than male MS morbidity（ P〈0.01）. When the revised diagnosis criterion from CDS was used in diagnosis, there was no significant difference of MS morbidity between females and males（P0.05）. The consistency between the diagnosis criterion from NCEP-ATP Ⅲ and the revised diagnosis criterion from CDS was the best（87.0%）, Kappa value was 0.71. Conclusion When the MS is diagnosed and prevented in communities, the different diagnosis criteria can influence the evaluation of MS prevalence at some extent.