Ucar Edip, Huzmeli Can, Guven Oguz, Savas Nazan, Gullu Murat, Asilyoruk Sema, Kuvandik Ceren, Temizkan Aysegul, Kuvandik Guven
Department of Internal Medicine, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey.
Ren Fail. 2009;31(3):221-8. doi: 10.1080/08860220802669883.
Objective. Patients with chronic renal failure (CRF) have an increased risk of death from cardiovascular diseases. The metabolic syndrome is a common risk factor for cardiovascular diseases. In the present study, it was aimed to evaluate the frequency of metabolic syndrome using the National Cholesterol Education Program Adults Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF) definitions in patients with end-stage CRF undergoing hemodialysis (HD). Materials and Methods. A total of 222 cases undergoing HD were enrolled in the study. After obtaining medical history and physical examination, blood samples were collected from each patient for the measurements of fasting blood glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides. Results. Among HD patients evaluated according to both IDF and NCEP-ATP III definitions, the diagnosis of metabolic syndrome was confirmed by IDF in 56.5% of those fulfilling the criteria for NCEP-ATP III. Similarly, 86% of the undiagnosed patients according to NCEP-ATP III were confirmed by IDF definitions. The sensitivity and positive predictive value of NCEP-ATP III for metabolic syndrome were 81.25% and 64.8%, respectively. The area under the Receiver Operating Characteristic (ROC) curve for NECP-ATP III and IDF was 0.730. False-positive rate and probability ratio for NECP-ATP III were 0.352 and 2.49, respectively. In other words, among the patients who were diagnosed with metabolic syndrome according to NCEP-ATP III definitions, the proportion of subjects whose diagnosis was confirmed by IDF definitions was 2.49-fold higher than those with unconfirmed diagnosis. Conclusion. It is logical to evaluate patients with CRF for metabolic syndrome and cardiovascular risk factors at the time of diagnosis and regularly thereafter due to the high ratio of metabolic syndrome in this population.
目的。慢性肾衰竭（CRF）患者死于心血管疾病的风险增加。代谢综合征是心血管疾病的常见危险因素。在本研究中，旨在使用美国国家胆固醇教育计划成人治疗小组第三次报告（NCEP-ATP III）和国际糖尿病联盟（IDF）的定义，评估接受血液透析（HD）的终末期CRF患者中代谢综合征的发生率。材料与方法。本研究共纳入222例接受HD治疗的患者。在获取病史和进行体格检查后，采集每位患者的血样，以测量空腹血糖、总胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇和甘油三酯。结果。在根据IDF和NCEP-ATP III定义评估的HD患者中，IDF确认56.5%符合NCEP-ATP III标准的患者患有代谢综合征。同样，根据NCEP-ATP III未诊断出的患者中，86%被IDF定义确诊。NCEP-ATP III对代谢综合征的敏感性和阳性预测值分别为81.25%和64.8%。NECP-ATP III和IDF的受试者工作特征（ROC）曲线下面积为0.730。NCEP-ATP III的假阳性率和概率比分别为0.352和2.49。换句话说，根据NCEP-ATP III定义被诊断为代谢综合征的患者中，经IDF定义确诊的受试者比例比未确诊的受试者高2.49倍。结论。鉴于该人群中代谢综合征的比例较高，在CRF患者诊断时及之后定期评估其代谢综合征和心血管危险因素是合理的。
