Moebus Susanne, Hanisch Jens Ulrich, Neuhäuser Markus, Aidelsburger Pamela, Wasem Jürgen, Jöckel Karl-Heinz
Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University of Duisburg-Essen, Essen, Germany.
Ger Med Sci. 2006 Oct 9;4:Doc07.
Metabolic Syndrome (MetSyn) describes a cluster of metabolic disorders and is considered a risk factor for development of cardiovascular disease. Although a high prevalence is commonly assumed in Germany data about the degree of its occurrence in the population and in subgroups are still missing. The aim of this study was to assess the prevalence of the MetSyn according to the NCEP ATP-III (National Cholesterol Education Program Adult Treatment Panel III) criteria in persons aged >or=18 years attending a general practitioner in Germany. Here we describe in detail the methods used and the feasibility of determining the MetSyn in a primary health care setting.
The German-wide cross-sectional study was performed during two weeks in October 2005. Blood samples were analyzed in a central laboratory. Waist circumference and blood pressure were assessed, data on smoking, life style, fasting status, socio-demographic characteristics and core information from non-participants collected. Quality control procedures included telephone-monitoring and random on-site visits. In order to achieve a maximal number of fasting blood samples with a minimal need for follow-up appointments a stepwise approach was developed. Basic descriptive statistics were calculated, the Taylor expansion method used to estimate standard errors needed for calculation of confidence intervals for clustered observations.
In total, 1511 randomly selected general practices from 397 out of 438 German cities and administrative districts enrolled 35,869 patients (age range: 18-99, women 61.1%). More than 50,000 blood samples were taken. Fasting blood samples were available for 49% of the participants. Of the participating patients 99.3% returned questionnaires to the GP, only 12% were not filled out completely. The overall prevalence of the MetSyn (NCEP/ATP III 2001) was found to be 19.8%, with men showing higher prevalence rates than women (22.7% respective 18.0%).
This study was designed to provide data as robust as possible within the confines of an epidemiological study. Judging by the low degree of missing data and the high data quality, the feasibility for this kind of a research setting (short evaluation period, practitioners as data assessment sites) was found to be very good. The results will help to gain a more comprehensive insight into the prevalence of MetSyn for patients in primary health care in Germany.
代谢综合征（MetSyn）描述了一组代谢紊乱情况，被认为是心血管疾病发生的一个风险因素。尽管通常认为德国该病患病率较高，但关于其在人群及亚组中的发病程度的数据仍然缺失。本研究的目的是根据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）标准，评估德国年龄≥18岁且就诊于全科医生的人群中代谢综合征的患病率。在此，我们详细描述所使用的方法以及在初级卫生保健环境中确定代谢综合征的可行性。
这项全德范围的横断面研究于2005年10月进行了两周。血样在一个中央实验室进行分析。测量了腰围和血压，收集了关于吸烟、生活方式、空腹状态、社会人口学特征的数据以及未参与者的核心信息。质量控制程序包括电话监测和随机现场访视。为了在尽量减少后续预约需求的情况下获得最大数量的空腹血样，制定了一种逐步推进的方法。计算了基本描述性统计量，采用泰勒展开法估计聚类观察值计算置信区间所需的标准误差。
总共从德国438个城市和行政区中的397个随机选取了1511家全科诊所，纳入了35869名患者（年龄范围：18 - 99岁，女性占61.1%）。采集了超过50000份血样。49%的参与者有空腹血样。参与研究的患者中99.3%向全科医生返还了问卷，只有12%未完全填写。发现代谢综合征（NCEP/ATP III 2001）的总体患病率为19.8%，男性患病率高于女性（分别为22.7%和18.0%）。
本研究旨在在流行病学研究的范围内提供尽可能可靠的数据。从低缺失数据程度和高数据质量来看，发现这种研究环境（短评估期，从业者作为数据评估地点）的可行性非常好。这些结果将有助于更全面地了解德国初级卫生保健中患者代谢综合征的患病率。
