代谢综合征不同诊断标准在公安民警中的应用研究

目的调查天津市公安民警代谢综合征(MS)患病率,探讨和比较4种MS诊断标准用于该人群MS诊断时其患病率一致性和应用差异。方法以2007年3月～2008年3月在天津市公安医院接受健康体检的10944名公安民警(男性9886例,女性1058例)为研究对象,分别应用ATPⅢ、修订的NCEP-ATPⅢ、CDS和IDF4种MS标准诊断MS,比较其患病率和一致性。结果经IDF、CDS、ATPⅢ和修订的NCEP-ATPⅢ标准诊断的MS年龄标化患病率分别为18.60%,10.57%,9.97%和20.31%。4种诊断标准检出的男性MS患病率高于女性(P0.001)。男女MS患病率均不表现为增龄趋势。CDS标准对MS各异常组分检出率均较高,应用IDF标准诊断为非MS人群中,12.4%的个体有3个以上危险因素聚集。4种诊断标准合并的一致率为79.36%,其中修订的NCEP-ATPⅢ与IDF标准的一致率最高(κ=0.94)。结论4种诊断标准诊断的公安民警MS患病率明显偏高,55～65岁男性人群与65～75岁女性人群为MS高危人群,CDS标准较适合公安民警人群,CDS标准中肥胖判定建议采用腰围指标,且空腹血糖切点值宜降至5.6mmol/L。IDF与修订的NCEP-ATPⅢ标准一致性最好。

Comparison and application of four diagnostic criteria for metabolic syndrome in police

Objective To explore the prevalence of metabolic syndrome（MS）and to compare the differences of four diagnostic criteria for MS among the police in Tianjin.Methods A survey was conducted among 10 944 participants（policemen 9 886,police women 1 058）,who went to the Tianjin Police Hospital for physical examination from March,2007 to March,2008.The MS was diagnosed according to the NCEP-ATPⅢ,the revised NCEP-ATPⅢ,the CDS and the IDF criteria,respectively.The results of MS prevalence rates by four criteria were analyzed.Results The age-adjusted MS prevalences were 18.60%,10.57%,9.97% and 20.31% respectively by the IDF,CDS,ATPⅢ and revised NCEP-ATPⅢ criteria.The MS prevalence was higher in man than that in women（P0.001）.There was no confirmed association between prevalences of MS and aging either in policemen or policewomen.The MS cases diagnosed by CDS criterion had the highest rate of aggregation of MS risk factors among the four criteria,while 12.4% of non-MS cases defined by IDF criterion presented at least 3 MS risk factors.79.36% of the participants got same results of MS diagnosis with all the four criteria.The IDF and revised NCEP-ATPⅢ had the highest agreement（κ=0.94）in MS diagnosis.Conclusion The prevalence of MS was high among police in Tianjin and high-risk groups included 55-65 years old policemen and 65-75 years old policewomen.The CDS was the most suitable criteria for MS diagnosis among police with waist circumference for obesity evaluation and cut-off value of fasting plasma glucose as 5.6 mmol.The IDF and revised NCEP-ATPⅢ had the most similar results of MS diagnosis.