Objective To compare the application of three diagnostic criteria of metabolic syndrome (MS). Methods Three diagnostic criteria were based on the International Diabetes Federation formulation in 2005 (IDF2005), the Third Report of the National Cholesterol Education Program Export Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults[ATPⅢ(revised)] in 2005 (NCEP2005) and Chinese Medical Association Diabetes Branch in 2004 (CDS2004). Total 1363 subjects who underwent health check-up were enrolled in the study. The MS components including body mass index (BMI) and waist circumference (WC) were measured. MS was diagnosed by IDF2005, ATPⅢ2005 and CDS2004 criteria respectively; the total prevalence and consistency of MS with three criteria were compared. Results The total prevalence of MS for men were 6.69％, 1t.6％ and 12.4％ based on IDF2005, ATPⅢ2005 and CDS2004 criteria respectively; that for women was 4.32％ 、4.9％ 、2.31％, respectively;according to the IDF (test) the MS prevalence in men was 13.9％. Consistency analysis: diagnostic consistent rate over 90％, For IDF and ATPⅢ were highly consistent, for others were moderate consistent. WC and BMI were highly correlated: male r = 0.816,female r = 0.745. Consistency analysis: male WC ≥90cm, WC ≥85cm with BMI ≥25 diagnostic consistent rates were 80.71％ and 85.14％ respectively, Kappa value 0.440 and 0.634; for female WC≥80cm with BMI ≥25 consistent rate was 90.77％, Kappa value 0.558. Conclusion The diagnosis of MS using IDF2005, ATPⅢ2005 and CDS2004 standards had difference in men. The diagnostic rate using IDF2005 standard is Iow, if the cut-off point of WC in men set as 85cm, it may be close to that using other two standards. The consensus for diagnosis of MS of 3 criteria is moderate. The WC and BMI are closely correlated.%目的 比较2005年国际糖尿病联盟(IDF 2005)、2005年美国心脏协会(ANA)制定的美国胆固醇教育计划成人治疗专家组第三次报告修订版(ATP Ⅲ 2005)和2004年中华医学会糖尿病分会(CDS 2004)制定的的三个代谢综合征(MS)诊断标准应用上的异同,探讨将IDF标准中的男性腰围(WC)切点下调至85 cm[IDF(test)]后的应用价值;并分析WC与BMI的关系.方法 采用现况调查方法,对健康体检人群(1363例)进行MS各组分测量、检验、计算和记录;分别用IDF 2005、ATP Ⅲ 2005、CDS 2004标准及IDF(test)诊断MS,比较MS总患病率,分析诊断标准的一致性;同时分析WC与BMI的相关性和一致性.结果 (1)根据IDF 2005、ATPⅢ2005、CDS 2004标准确定的男性MS总患病率分别为6.69%、11.60%、12.40%,三者差异有显著统计学意义;女性分别为4.32%、4.90%、2.31%,差异则无统计学意义;根据IDF(test)标准诊断的男性MS总患病率为13.9%,与ATPⅢ2005、CDS 2004标准的差异无统计学意义;40岁以下MS患病率较低,40岁以上患病率增高,60岁以上达高峰;一致性分析诊断一致率达90%以上,女性IDF2005和ATPⅢ2005标准呈高度一致,其余均呈中度一致.(2)WC与BMI呈高度正相关性;一致性分析结果显示:男性WC≥90cm或≥85cm与BMI≥25的诊断一致率分别为80.71%、85.14%,女性WC≥80cm与BMI≥25的诊断一致率为90.77%.结论 (1)IDF 2005、ATPⅢ 2005、CDS 2004的三种标准诊断男性MS患病率存在差异,IDF 2005标准患病率较低,将IDF标准中男性WC切点下调至85 cm,可明显提高MS的诊断率,并与其他两个标准非常接近,而女性则无显著差异;IDF标准中男性WC切点过高,不利于M S防治.三个标准诊断MS能达到中度一致;中老年人群是MS的主要患病人群.(2)WC与BMI间关系密切,但两者不完全代表同一肥胖人群.
展开▼
