代谢综合征不同诊断标准在老年人群的比较研究

目的 在老年人群中对代谢综合征(MS)的不同诊断标准(WHO、IDF和CDS标准)进行比较分析.方法 对1996～2005年连续10年在解放军总医院院查体的2 456例北京老年人进行MS相关指标的检查,比较WHO、IDF和CDS三种诊断标准的差异,以及老年人中MS各组分的发生情况.结果 使用WHO、IDF和CDS诊断标准,总人群MS的患病率分别是27.2%、27.0%、42.6%,Kappa检验显示IDF和CDS两种诊断标准的符合率为79.0%;其中有腰围资料的1 759例患者使用WHO、IDF和CDS标准诊断MS的患病率分别是32.3%、37.8%、53.8%,Kappa检验显示IDF和CDS两种诊断标准的符合率为76.5%.使用WHO、IDF和CDS标准诊断中心性肥胖的诊断率分别是35.9%、49.6%、52.2%,高血压的诊断率分别是61.6%、72.4%、61.6%,糖代谢异常的诊断率分别是24.9%、40.5%、24.9%.本组MS最常见的代谢异常组合为血压、血糖及血脂紊乱.结论 尽管IDF和CDS两种诊断标准的符合率较高,但在老年人群中使用CDS标准诊断MS的比例高于WHO和IDF标准.要重视对老年人群腰围的检查,老年男性人群CDS标准中腰围从85cm调整到90cm可能更为合理,但还需要进行大规模的流行病学研究进一步确认.

Comparison on diagnostic criteria for metabolic syndrome in the senile people

Objectives To compare the value of different criteria (WHO, IDF and CDS criteria) on the diagnosis of metabolic syndrome (MS) in the elderly people. Methods 2 456 elderly patients admitted to General Hospital of PLA for routine physical examination during 1996 to 2005 were involved in present study. The value of different criteria (WHO, IDF and CDS criteria) on the diagnosis of metabolic syndrome (MS) was compared. Results The incidences of MS in the involved patients were 27.2%, 27.0% and 42.6%, respectively, according to WHO, IDF and CDS criteria. The diagnostic coincidence of CDS and IDF criteria was 79.0%. For the 1759 cases with the waistline data, the incidences of MS were 32.3%, 37.8% and 53.8%, respectively, according to the above three criteria. The diagnostic coincidence of CDS and IDF criteria was 76.5 %. According to the criteria of WHO, IDF and CDS, central obesity was detectable in a rate of 35.9%, 49.6% and 52.2%, respectively. Hypertension was diagnosed in a rate of 61.6%, 72.4% and 61.6%, and abnormal glucose metabolism was found in a rate of 24.9%, 40.5% and 24.9%, respectively. The most common clinical symptom complex of MS was hypertension, impaired glucose tolerance and abnormal lipid metabolism. Conclusions A higher coincidence exists between CDS and IDF criteria for MS, but the incidence of MS is higher in CDS criterion compared to WHO and IDF criteria. It is indicated that more attention should be paid on the measurement of the waistline in the elderly people. It seems more appropriate that the waistline data in CDS criterion should be modified from 85cm to 90cm for the elderly people, however, this should be verified by more epidemiological investigation.