三种标准在无锡市社区人群中诊断代谢综合征相关代谢异常状态的比较

目的了解国际糖尿病联盟(IDF)诊断标准、中华糖尿病学会(CDS)诊断标准及美国国家胆固醇教育计划成人治疗指南(NCEP-ATPⅢ)的诊断标准在无锡人群的适用性及异同。方法采用整群抽样方法抽取无锡市社区20岁以上人群10 833人进行现况调查。分别采用三种标准诊断MS的患病率和一致性。计量资料采用t检验,计数资料采用χ2检验,一致性检验采用Kappa检验,P<0.05为差异有统计学意义。结果无锡市社区人群IDF、ATPⅢ和CDS的MS标化患病率分别为27.33%、35.78%和20.33%。IDF标准诊断的MS患病率女性(20.90%)高于男性(17.03%)(P<0.05),ATPⅢ标准男女没有差异(P>0.05),而CDS标准男性(15.76%)高于女性(12.02%)(P<0.05)。以IDF与ATPⅢ符合率较高为91.46%,Kappa值为0.81。结论从预防疾病的角度出发,采用ATPⅢ标准更易早期发现心血管病、糖尿病风险。

Comparison of three standards in the diagnosis of metabolic syndrome related metabolic disorder in Wuxi

Objective To compare the sensitivity and applicability of three diagnostic standards proposed by International Diabetes Federation （IDF） 2005, Chinese Diabetes Society （CDS） 2004 and The Third Report of the National Cholesterol Education Program （NCEP） Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in adults （ATP III ） 2005 in the diagnosis of metabolic syndrome （MS） in Wuxi community. Methods Cluster sampling method was used to select 10833 residents aged over 20 years in Wuxi. The prevalence of MS were determined based on the above three diagnostic standards. T-test, chi-square test and Kappa test were used for quantitative data, qualitative data and consistency analysis. Results The age standardized prevalence of MS were 27.33%, 35. 780% and 20.33% determined based on the criteria of IDF, NCEP-ATPUI and CDS among residents in Wuxi. The prevalence was higher in female （20.90%） than in male （17.03%） based on IDF criteria （P〈0.05）, while under the criteria of CDS, it was higher in male （15.76%） than in female （12.02%） （P〈0.05） . However, the difference was not significant based on ATP UI criteria. 1DF and ATPIU criteria had a higher consistency of 91.46% with a kappa coefficient of 0.81.Conclusions For the purpose of chronic disease control, metabolic syndrome defined by ATPIII criteria is a good indicator for the early recognition for the risk of cardiovascular disease and type 2 diabetes.