Santos Ana-Cristina, Barros Henrique
Department of Hygiene and Epidemiology, University of Porto Medical School, 4200-319 Porto, Portugal.
Diab Vasc Dis Res. 2007 Dec;4(4):320-7. doi: 10.3132/dvdr.2007.059.
This study compared the prevalence of metabolic syndrome (MS) according to World Health Organization (WHO), National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATP III), International Diabetes Federation (IDF) and American Heart Association/ National Heart, Lung and Blood Institute (AHA/NHLBI) definitions, to evaluate how well the different classifications agreed. The study also compared their 10-year predicted risk of coronary heart disease (CHD) with the Framingham risk score (FRS). Some 886 women and 547 men aged 18-92 years were included in the study. Demographic and personal medical history data were obtained at interview. Four operational definitions of MS were used (those of the WHO, NCEP-ATP III, AHA/NHLBI and IDF). The prevalence of metabolic syndrome was found to be 26.4% (WHO criteria), 24.0% (NCEP-ATP III criteria), 41.9% (IDF criteria) and 37.2% (AHA/NHLBI criteria). According to the definition used, central obesity ranged from 41.9% to 75.1% and high blood pressure from 52.9% to 65.8%. Agreement between classifications ranged from 75.2% (kappa=0.47) to 90.4% (kappa=0.80) and was lower in males. The 10-year predicted risk of CHD by FRS was similar between the different definitions. IDF and AHA/NHLBI definitions resulted in a higher prevalence of MS than the NCEP-ATP III or WHO definition. Overall, however, good agreement was found between definitions, and the predicted 10-year of CHD risk was similar.
本研究根据世界卫生组织（WHO）、美国国家胆固醇教育计划成人治疗专家组第三次报告（NCEP-ATP III）、国际糖尿病联盟（IDF）以及美国心脏协会/美国国立心肺血液研究所（AHA/NHLBI）的定义，比较了代谢综合征（MS）的患病率，以评估不同分类之间的一致性程度。该研究还将它们预测的冠心病（CHD）10年风险与弗雷明汉风险评分（FRS）进行了比较。研究纳入了约886名年龄在18至92岁之间的女性和547名男性。通过访谈获取了人口统计学和个人病史数据。采用了代谢综合征的四种操作性定义（WHO、NCEP-ATP III、AHA/NHLBI和IDF的定义）。结果发现，代谢综合征的患病率分别为26.4%（WHO标准）、24.0%（NCEP-ATP III标准）、41.9%（IDF标准）和37.2%（AHA/NHLBI标准）。根据所使用的定义，中心性肥胖的比例在41.9%至75.1%之间，高血压的比例在52.9%至65.8%之间。不同分类之间的一致性范围为75.2%（kappa=0.47）至90.4%（kappa=0.80），男性中的一致性较低。不同定义下，FRS预测的冠心病10年风险相似。与NCEP-ATP III或WHO定义相比，IDF和AHA/NHLBI定义导致代谢综合征的患病率更高。然而，总体而言，各定义之间存在良好的一致性，且预测的冠心病10年风险相似。
