Yokoyama Hirokazu, Hirose Hiroshi, Kawabe Hiroshi, Saito Ikuo
Health Center, Keio University, Tokyo, Japan.
J Atheroscler Thromb. 2009 Apr;16(2):113-20. doi: 10.5551/jat.e609. Epub 2009 Apr 30.
To verify the clinical diagnostic criteria for metabolic syndrome (MetS-Criteria) for Japanese (Japanese-Criteria) from the viewpoint of reference intervals (RIs) of metabolic factors.
In healthy subjects selected from 1,379 males and 1,528 females aged 20-65 years, generation-and gender-specific RIs of metabolic factors were determined. Then, from the upper or lower limits of the RIs, new MetS-Criteria were tentatively set (New-Criteria).
RIs of some metabolic factors were associated with gender- and/or generation-specific differences. In both genders, the New-Criteria for subjects in their 40s and over (older adults) were comparable to the Japanese-Criteria, whereas the New-Criteria for these in their 30s and less (younger adults) were not. Levels of cut-off values in the New-Criteria for younger adults were mostly between those of the Japanese-Criteria and recently established MetS-Criteria for adolescents. The prevalence of metabolic syndrome estimated by the Japanese-Criteria and the New-Criteria well corresponded in older adults but significantly differed in younger adults.
MetS-Criteria prepared on gender- and generation-specific bases may be necessary. The Japanese-Criteria, which may still have room for minor changes, seem to be valid at least for older adults; however, new MetS-Criteria should be established for younger adults.
从代谢因子的参考区间（RIs）角度验证日本人群的代谢综合征临床诊断标准（日本标准）。
在从1379名年龄在20 - 65岁的男性和1528名年龄在20 - 65岁的女性中选取的健康受试者中，确定代谢因子的代际和性别特异性参考区间。然后，根据参考区间的上限或下限，初步设定新的代谢综合征标准（新标准）。
一些代谢因子的参考区间存在性别和/或代际差异。在两个性别中，40岁及以上（老年人）受试者的新标准与日本标准相当，而30岁及以下（年轻人）受试者的新标准则不然。年轻人新标准中的临界值水平大多介于日本标准和最近制定的青少年代谢综合征标准之间。日本标准和新标准估计的代谢综合征患病率在老年人中吻合良好，但在年轻人中差异显著。
可能有必要制定基于性别和代际的代谢综合征标准。日本标准可能仍有微调空间，至少对老年人似乎是有效的；然而，应为年轻人制定新的代谢综合征标准。
