代谢综合征多元医学参考值标准的应用  

The application of multivariate reference value criterion for metabolic syndrome

作　　者：易德青[1] 张庆英[1] 皮富华[2] 陈彬[1] 李一鸣[3] 程本坤[3] 

机构地区：[1]汕头大学医学院预防医学教研室,515041 [2]汕头大学医学院体育教研室,515041 [3]汕头大学医学院第一附属医院预防感染科

出　　处：《中国医药》2011年第5期544-546,共3页China Medicine

基　　金：广东省医学科学技术研究基金（WSTJJ20091220510102196610016129）;广东省汕头市重点科技计划项目（2009）;汕头大学医学院基础与临床科研基金（2010）

摘　　要：目的探讨多指标组合指标法制定的代谢综合征（MS）多元医学参考值标准的应用。方法以2008年6月至12月在汕头大学医学院第一附属医院行健康体检的居民为研究对象，收集体检相关数据，随机抽取资料完备的1204例，分别采用多元医学参考值标准、2007年《中国成人血脂异常防治指南》（防治指南）以及2005年美国国家胆固醇教育计划成人治疗组第三次报告修订版（ATPⅢ）制定的MS诊断标准计算该人群MS的患病率，分析各定义下诊断MS的差异和一致性。结果应用多元参考值、防治指南和ATPⅢ三种标准计算人群MS的标化患病率分别为9．9％、9．3％和14．8％（P〈0．01）；男性患病率（分别为10．5％、11．O％和15．1％）高于女性（分别为8．7％、5．8％和13．1％，P〈0．01）。多元参考值标准下该人群血压异常率为32．6％，低于防治指南和ATPⅢ标准的检出率（均为45．1％）；在诊断为MS的人群中，多元参考值对肥胖的检出率最高（78．7％）。多元参考值与防治指南以及ATPⅢ的检出结果一致性较好，Kappa系数分别为0．759和0．715（P〈0．01）。结论多元参考值标准分别提出了适合男性和女性MS的诊断标准，对MS各指标检出率有其特点，适用于该地区人群MS的诊断。Objective To investigate the application of the reference value criterion for metabolic syndrome （MS） established by the multivariate combination indicatrixes method. Methods The data of participants was collected in the chronic disease monitoring site built by the First Afflicted Hospita1 of Shantou University Medical Col- lege from June to December in 2008. One thousand two hundred and four people were randomly selected to calculate the prevalence rates of MS and its components according to these three criterions proposed by the multivariate combination indieatrixes method, guidelines of dyslipidemia of Chinese adult in 2007, and the Third Report of National Cholesterol Education Program-Adult Treatment Panel 11I （NCEP-ATP 1112005 ） in 2005, and to compare the differ- enees and agreement rates betweenthese criterions. Results According to multivariate reference value, guidelines and ATP III, the age-adjusted MS prevalence rates were 9.9%, 9.3% and 14.8% respectively（P 〈0.01）, and the prevalence rate in male was more than that in female（ P 〈 0.01 ）. The prevalence rate of abnormal blood pres- sure according to multivariate reference value was 32.6%, which was less than the value of guideline and ATPⅢ（45.1%）. Among the MS patients, the detection ratio of obesity diaguosticed by multivariate reference value was 78.7% , which was the highest. The diagnostic agreement rate between multivariate and guidelines, multivariate and ATP Iil （ 2005 ） was high and the Kappa value was 0.759 and 0.715 respectively （ P 〈 0.01 ）. Conclusions The multivariate reference criterion for MS about male and female has been set up. The multivariate reference value criterion for MS is adaptable for enrolled population.

关 键 词：代谢综合征 诊断标准 组合指标法 一致率 KAPPA值 

分 类 号：R589[医药卫生—内分泌]