广东省成人代谢综合征流行特征及其不同诊断标准的对比研究  

Epidemiological survey and comparison of three different metabolic syndrome diagnostic criteria among adult residents in Guangdong province

作　　者：宋秀玲[1] 许燕君[1] 许晓君[1] 蔡秋茂[1] 夏亮[1] 徐浩锋[1] 孟瑞琳[1] 莫景富[2] 

机构地区：[1]广东省疾病预防控制中心慢性非传染性疾病预防控制所,广州511430 [2]汕头大学医学院公共卫生硕士教育中心

出　　处：《中华糖尿病杂志》2013年第12期728-733,共6页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的了解广东省18岁及以上人群代谢综合征（MS）的患病情况，比较2004年中华医学会糖尿病学分会（CDS）标准、2007年中国成人血脂异常防治指南制订联合委员会（JCDCG）标准和2009年国际联合暂定声明（JIS）标准在广东省18岁及以上人群中应用的差异。方法采用多阶段分层整群抽样方法抽取广东省6个监测县（区、市）18岁及以上居民中的3591人为研究对象，采用统一制定的调查表进行问卷调查，同时进行体格检查及血生化检测。两两比较采用t检验，率的比较采用ｘ2检验。结果采用CDS（2004）、JCDCG（2007）和JIS（2009）标准计算的MS患病率（标化患病率）分别为21．1％（19．0％，756例）、28．6％（25．4％，1026例）和44．5％（40．6％，1599例）；3种标准诊断为MS者中存在3个及以上危险因素聚集的比例分别为97．5％（737例）、98．4％（1010例）和100．0％（1599例）；CDS与JIS、JCDCG与JIS、JCDCG与CDS两两问的一致率（Kappa值）分别为74．8％（0．46，2688例）、82．1％（0．63，2950例）和87．8％（0．68，3153例）。以JIS为参照标准，绘制ROC曲线，CDS的曲线下面积为0．719，JCDCG的曲线下面积为0．802。结论广东省18岁及以上居民MS患病率已经达到较高水平，建议加强MS高危人群的综合防治力度。三种MS诊断标准中，JIS标准诊断MS的患病率、灵敏度和危险因素聚集的检出率最高。Objective To investigate the prevalence of metabolic syndrome （MS）among residents who are more than 18 years old in Guangdong province and to compare the differences of the three diagnostic criteria used for MS. The three diagnostic criteria were from Chinese Medical Association Diabetes Branch （ CDS）, Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults （JCDCG） and international Joint Interim Statement （JIS）. Methods Using multi-stage stratified cluster sampling method, 3591 inhabitants who were more than 18 years old and from 6 counties in Guangdong Province were enrolled. Questionnaire survey, medical examination and biochemical analyses were conducted in the residents. Data analyses of two groups were performed using t test. Comparision of rate were used by X2 test. Results According to the three definitions （CDS, JCDCG and JIS）, the prevalence （ standardized prevalence rate） of MS was 21.1% （756 cases, 19.0% ） , 28.6% （ 1026 case,25.4% ） and 44. 5% （1599 cases,40. 6% ）, respectively. The prevalence rate of subjects who had at least 3 risk factors among all the subjects with MS was 97. 5% （737 cases）, 98. 4% （1010 cases）and 100. 0% （1599 cases）, respectively. The agreement rate （Kappa index） between CDS and JIS, JCDCG and JIS, JCDCG and CDS was 74. 8% （2688 cases, 0.46）, 82.1% （2950 cases, 0.63） and 87.8% （3153 cases, 0.68）, respectively. The area under receiver operator characteristic （ROC） curve was 0. 719 for CDS and 0. 802 for JCDCG when JIS was used as the reference. Conclusion The prevalence of MS has been in a high level among residents who are more than 18 years old in Guangdong province, the strengthen measures should be taken to prevent the people with higher MS risk. JIS definition can screen out the highest prevalence,sensitivity of MS and risk factors aggregation among three definitions.

关 键 词：代谢综合征 诊断标准 患病率 一致率 KAPPA值 

分 类 号：R589[医药卫生—内分泌]