不同代谢综合征诊断标准对靶器官损害的检出  

Evaluation of target organ damage using different diagnostic criteria for metabolic syndrome in diabetes mellitus and hypertension patients

作　　者：张刚[1] 倪银星[1] 赵志钢[1] 李茜[1] 刘浩宇[1] 祝之明[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所高血压内分泌科,重庆400042

出　　处：《中华老年心脑血管病杂志》2005年第6期363-366,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金资助(39725013)

摘　　要：目的探讨不同的代谢综合征(MS)诊断标准对靶器官损害的检出情况。方法分别采用世界卫生组织(WHO)、美国国家胆固醇教育计划成人治疗组(NCEP-ATPⅢ)和WHO亚太(体重指数采用亚太地区肥胖标准)、ATPⅢ亚太(腰围采用亚太地区肥胖标准)、仿WHO(体重指数采用中国肥胖标准)、仿ATPⅢ(腰围采用中国肥胖标准)代谢综合征(MS)诊断标准对1 363例临床住院高血压、糖尿病及高血压合并糖尿病患者进行诊断,并应用超声心动图、颈动脉超声和免疫比浊法检测MS患者的心肾血管的损害情况。结果采用6种诊断标准,女性的MS诊断率明显高于男性(P<0.01)。女性MS患者的左室肥厚发生率均明显高于男性(P<0.05)。采用不同的WHO标准,男性MS患者的颈动脉内膜中层厚度明显高于女性(P<0.05)。采用不同的ATPⅢ标准,女性MS患者的肌酐轻度升高发生率均明显高于男性(P<0.05)。结论不同MS诊断标准对MS不同的靶器官损害检出率有所差异,且受性别影响较大。Objective To evaluate the target organ damage （TOD） using different diagnostic criteria for the metabolic syndrome （MS） in patients with type 2 diabetes mellitus（T2DM）, essential hypertension（EH）, and hypertensive diabetes. Methods Totally 1 363 patients with type 2 T2DM, EH, and hypertensive diabetes were included. WHO, WHO Asian, mimic WHO, ATP m, ATP m Asian and mimic ATP m criteria for MS were used in present study. Color Doppler ultmsonography was used to measure the left ventricular hypertrophy and carotid intima-media thickness （IMT）. Urinary albumin excretion rate（UAER） and high normal serum creatinine levels were used to evaluate the renal damage. Results The diagnostic rate of MS was significantly higher in women than in men when application of above mentioned six diagnostic criteria （ P 〈 0.01 ）. The incidence of LVH was significantly higher in women than in men when application of above mentioned six diagnostic criteria （ P 〈 0.05）. The incidence of increased IMT was significantly higher in men than in women when application of different WHO criteria （ P 〈 0.05）. The incidence of mild high creatinine level was significantly higher in women than in men when application of different ATPm criteria （ P 〈 0.05）. Conclusion The incidence of TOD in patients with MS is different with different diagnostic criteria of MS, which is affected by gender.

关 键 词：代谢疾病 诊断 高血压 糖尿病 肥胖症 

分 类 号：R589[医药卫生—内分泌]