三种代谢综合征诊断标准在杭州市企业职工人群中的应用比较  

Comparative analysis of three criteria in the diagnosis of metabolic syndrome among employees in Hangzhou

作　　者：刘庆敏[1] 马先富[1] 任艳军[1] 吕筠[2] 李立明[2] 

机构地区：[1]杭州市疾病预防控制中心,浙江杭州310021 [2]北京大学公共卫生学院流行病与卫生统计学系

出　　处：《中国预防医学杂志》2015年第11期865-870,共6页Chinese Preventive Medicine

基　　金：社区健康干预(CIH)项目

摘　　要：目的了解美国国家胆固醇教育计划成年人治疗方案第三次报告（ATPⅢ）、国际糖尿病联盟（IDF）及中华医学会糖尿病学分会（CDS）三种标准诊断下杭州市企业职工代谢综合征（MS）患病特点及人群分布,探讨三种诊断方法的筛检一致性及适用性。方法对杭州市三城区的12家企事业单位1 946名在职职工进行体检指标检测;应用SPSS 16.0软件进行分析;率及构成比间比较采用Pearson检验,定量变量均数间比较采用ANOVA检验,线性趋势采用Cochran Armitage趋势检验,无序分类变量一致性检验采用KAPPA检验,以P〈0.05为差异有统计学意义。结果IDF与ATPⅢ标准诊断的组分中：腰围（WC）、血压（BP）、空腹血糖（FPG）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）的异常率分别为15.62%、21.53%、18.24%、17.52%、55.14%;CDS标准诊断的各组分中：体质指数（BMI）、BP、FPG、血脂代谢异常率分别为19.12%、11.20%、8.12%、37.10%。采用IDF、ATPⅢ、CDS标准诊断代谢综合征标化患病率分别为12.16%、16.97%、6.16%,其中ATPⅢ（χ^2=11.490,P=0.001）、CDS（χ^2=19.865,P〈0.05）诊断标准中男性患病率高于女性,三种诊断标准中男性（趋势χ^2=35.999-70.000,P〈0.05）、女性（趋势χ^2=16.785-54.992,P〈0.05）及总的（趋势χ^2=57.227-127.010,P〈0.05）患病率均随着年龄的增加呈增长趋势。IDF与ATPⅢ诊断标准的符合率为95.48%（KAPPA=0.799,P〈0.05）;IDF与CDS诊断标准的符合率为91.93%（KAPPA=0.447,P〈0.05）;CDS与ATPⅢ诊断标准的符合率为89.16%（KAPPA=0.419,P〈0.05）。结论本着预防为主及提高灵敏度的原则,建议采用ATPⅢ为诊断企业职工代谢综合征的推荐方法。Objective To compare the coincidence of three criteria in the diagnosis of metabolic syndrome among employees in Hangzhou. Methods Three diagnostic criteria including the US National Cholesterol Education Program Adult Treatment Programs Third Report（ATP Ⅲ）,the International Diabetes Federation（IDF）and the Chinese Medical Association Diabetes Society（CDS）were applied for the diagnosis of metabolic syndrome among 1 946 employees randomly selected from 12 enterprises and institutions in Hangzhou.A standardized self-administered questionnaire survey was conducted,physical examinations were performed and blood samples were also collected.SPSS 16.0software was used for data statistical analysis.Pearson test was used to compare rate and constituent ratio.ANOVA test was used to analyze the quantitative variables.Cochran Armitage and KAPPA test were used to analyze linear trend and consistency.P〈0.05 was defined as statistically significant. Results According to IDF and ATPⅢ diagnostic criteria,abnormal rates of waist circumference,high blood pressure,high blood sugar,triglycerides,high-density lipoprotein were15.62%,21.53%,18.24%,17.52% and 55.14%.Meanwhile,based on CDS diagnostic criteria,the abnormal rates of BMI,hypertension,hyperglycemia,dyslipidemia were 19.12%,11.20%,8.12%,37.10%,respectively.The standardized incidence rates of metabolic syndrome were 12.16%,16.97% and 6.16% according to the criteria of IDF,ATP Ⅲ and CDS.The incidence rate was higher among male subjects than females based on ATP Ⅲ（χ^2=11.490,P=0.001）and CDS（χ^2=19.865,P〈0.05）.Both of total and sub-gender prevalence of metabolic syndrome increased along with age.The coincidence rates of IDF and ATP Ⅲ,IDF and CDS,CDS and ATP Ⅲ diagnostic criteria were 95.48%,91.93% and 89.16%,respectively,with the Kappa values of 0.799（P〈0.05）,0.447（P〈0.05）and 0.419（P〈0.05）. Conclusions The diagnostic criteria of ATP Ⅲis recommended to be used for the diagnosis of metabolic syndrome among employees from enter

关 键 词：诊断方法 企业职工 代谢综合征 比较 

分 类 号：R589[医药卫生—内分泌]