Universidade Federal de Viçosa, MG, Brasil.
Arq Bras Cardiol. 2010 Sep;95(3):346-53. doi: 10.1590/s0066-782x2010005000100. Epub 2010 Jul 30.
The criteria for best defining the metabolic syndrome (MS), especially in the elderly population, are still little known, and the understanding is increasingly necessary.
Compare the four MS definition proposals, two official ones (National Cholesterol Education Program's Adult Treatment Panel III/NCEP-ATPIII and International Diabetes Federation/IDF) and two proposed definitions (Metabolic Syndrome - National Cholesterol Education Program's Adult Treatment Panel III - modified/MS-ATPM and Metabolic Syndrome - International Diabetes Federation - modified/MS-IDFM), derived from the changes in the official criteria.
A total of 113 women (60-83 years old) participated in this study; they were submitted to anthropometric, blood pressure, lipid profile, fasting glycemia tests and answered questions related to life style habits and health conditions. Statistical analyses were performed using the chi-square test and Kappa coefficient determination.
The frequency of the high pressure levels was similar in the two official definitions (54.8%), with a reduction in the two proposed definitions (33.6%). The homeostasis change of the glucose was higher as per the IDF and MS-IDFM (30.1%). The hypertriglyceridemia and the low levels of HDL-c were similar in all the definitions (35.4%). In relation to the abdominal obesity, the higher occurrence was registered by the IDF criteria (88.5%). The presence of the metabolic syndrome presented higher and lower frequencies as per the IDF proposal (45.1%) and MS-IDFM (22.1%), respectively. Higher agreement was found between the modified definition MS-ATPM with NCEP-ATPIII and MS-IDFM (Kappa: 0.79 and 0.77; p < 0.00001).
The MS-ATPM proposal was found more adequate for the MS detection in the evaluated elderly women.
代谢综合征(MS)的最佳定义标准,尤其是在老年人群中,仍知之甚少,因此对其的理解也变得越来越重要。
比较四种 MS 定义建议,两种官方建议(国家胆固醇教育计划成人治疗专家组第三版/NCEP-ATPIII 和国际糖尿病联合会/IDF)和两种建议定义(改良的代谢综合征-国家胆固醇教育计划成人治疗专家组第三版/MS-ATPM 和改良的代谢综合征-国际糖尿病联合会/MS-IDFM),这些定义是根据官方标准的变化而来。
共有 113 名女性(60-83 岁)参与了这项研究;她们接受了人体测量、血压、血脂谱、空腹血糖检测,并回答了与生活方式习惯和健康状况相关的问题。统计分析采用卡方检验和 Kappa 系数确定。
两种官方定义的高血压水平发生率相似(54.8%),而两种建议定义的发生率有所降低(33.6%)。根据 IDF 和 MS-IDFM,葡萄糖的稳态变化更高(30.1%)。所有定义的高三酰甘油血症和低水平高密度脂蛋白胆固醇(HDL-c)相似(35.4%)。在腹部肥胖方面,IDF 标准的发生率更高(88.5%)。代谢综合征的存在根据 IDF 建议(45.1%)和 MS-IDFM(22.1%)分别呈现出较高和较低的频率。改良定义 MS-ATPM 与 NCEP-ATPIII 和 MS-IDFM 之间的一致性更高(Kappa:0.79 和 0.77;p<0.00001)。
在评估的老年女性中,MS-ATPM 建议更适合用于检测 MS。