Rodríguez Bernardino Angel, García Polavieja Pepa, Reviriego Fernández Jesús, Serrano Ríos Manuel
Departamento de Investigación Clínica, Lilly España, Madrid, Spain.
Endocrinol Nutr. 2010 Feb;57(2):60-70. doi: 10.1016/j.endonu.2009.12.002. Epub 2010 Feb 12.
To determine the prevalence of metabolic syndrome, the degree of consistency among World Health Organization (WHO), The Third Report National Cholesterol Education Program (NCEP-ATP III) and the International Diabetes Federation (IDF) diagnostic criteria and the relationship with cardiovascular risk in a Spanish population of patients with type 2 diabetes.
This descriptive, epidemiologic, multicenter and cross-sectional study included 1259 patients with type 2 diabetes. The primary variable was diagnosis of metabolic syndrome according to WHO, NCEP-ATP III and IDF criteria.
The prevalence of metabolic syndrome was 71.5% (WHO), 78.2% (NCEP-ATP III), and 89.5% (IDF). The prevalence of metabolic syndrome was higher in sedentary diabetic patients (WHO=79.3%, NCEP-ATP III=86.2%, and IDF=93.9) than in those who exercised moderately (WHO=61.4%, NCEP-ATP III=73.2%, and IDF=85.5%, [p<0.001]). The percentage of patients with metabolic syndrome and moderate/high cardiovascular risk was 38.9% (WHO), 33.6% (NCEP-ATP III), and 30.1%, (IDF). Consistency among WHO, NCEP-ATP III and IDF criteria was low. Only comparison of WHO vs NCEP-ATP III criteria was acceptable (k=0.52 [0.46-0.58]).
The prevalence of metabolic syndrome in patients with type 2 diabetes in Spain is high, even when the low consistency among WHO, NCEP-ATP III and IDF criteria is considered. A standard definition of metabolic syndrome, according to routine clinical practice, is needed. Cardiovascular risk is greater when OMS and NCEP-ATP III criteria are used for the diagnosis of metabolic syndrome compared with IDF criteria.
确定代谢综合征的患病率、世界卫生组织(WHO)、美国国家胆固醇教育计划第三次报告(NCEP-ATP III)和国际糖尿病联盟(IDF)诊断标准之间的一致性程度,以及与西班牙2型糖尿病患者心血管风险的关系。
这项描述性、流行病学、多中心横断面研究纳入了1259例2型糖尿病患者。主要变量是根据WHO、NCEP-ATP III和IDF标准诊断代谢综合征。
代谢综合征的患病率分别为71.5%(WHO)、78.2%(NCEP-ATP III)和89.5%(IDF)。久坐不动的糖尿病患者代谢综合征的患病率(WHO=79.3%,NCEP-ATP III=86.2%,IDF=93.9%)高于适度运动的患者(WHO=61.4%,NCEP-ATP III=73.2%,IDF=85.5%,[p<0.001])。患有代谢综合征且有中度/高度心血管风险的患者百分比分别为38.9%(WHO)、33.6%(NCEP-ATP III)和30.1%(IDF)。WHO、NCEP-ATP III和IDF标准之间的一致性较低。仅WHO与NCEP-ATP III标准的比较可接受(k=0.52[0.46-0.58])。
即使考虑到WHO、NCEP-ATP III和IDF标准之间的低一致性,西班牙2型糖尿病患者中代谢综合征的患病率仍很高。需要根据常规临床实践制定代谢综合征的标准定义。与IDF标准相比,使用WHO和NCEP-ATP III标准诊断代谢综合征时心血管风险更高。