Centre de Recherche Public Santé (CRP-Santé), Centre d'Etudes en Santé, Grand-Duchy of Luxembourg.
BMC Public Health. 2011 Jan 4;11(1):4. doi: 10.1186/1471-2458-11-4.
The prevalence of the metabolic syndrome (MS) has been determined in many countries worldwide but never in Luxembourg. This research aimed to 1) establish the gender- and age-specific prevalence of MS and its components in the general adult population of Luxembourg, according to the most recent Joint Interim Statement (JIS) definition, by using both the high and low cut-off points to define abdominal obesity, and 2) compare and assess the degree of agreement with the Revised National Cholesterol Education Programme-Adult Treatment Panel III (R-ATPIII) and the International Diabetes Federation (IDF) definitions.
A representative stratified random sample of 1349 European subjects, aged 18-69 years, participated to ORISCAV-LUX survey. Logistic regression and odds ratios (OR) were used to study MS prevalence with respect to gender and age. The Framingham risk score (FRS) to predict the 10-year coronary heart disease (CHD) risk was calculated to compare the proportion of MS cases below or above 20%, according to both high and low waist circumference (WC) thresholds. Cohen's kappa coefficient (κ) was utilized to measure the degree of agreement between MS definitions.
The prevalence of the MS defined by the JIS was 28.0% and 24.7% when using the low (94/80) and the high (102/88) WC cut-off points, respectively. The prevalence was significantly higher in men than in women (OR = 2.6 and 2.3 for the low and high WC thresholds), as were all components of the MS except abdominal obesity measured by both thresholds. It also increased with age (OR values in age categories ranging from 2.7 to 28 when compared to the younger subjects for low WC and from 3.3 to 31 for the high WC cut-offs). The 10-year predicted risk of CHD by FRS did not depend on the threshold used. Globally, excellent agreement was observed between the three definitions of MS (κ= 0.89), in particular between JIS and IDF (κ = 0.93). Agreement was significantly higher in women than in men, and differed between age groups.
Regardless of the definition used, the adult population of Luxembourg reveals a high MS prevalence. Our findings contribute to build evidence regarding the definitive construct of the MS, to help selecting the waist circumference thresholds for Europid populations, and to support the need to revise the guidelines for abdominal obesity levels.
代谢综合征（MS）的流行情况在世界许多国家都已经确定，但卢森堡从未进行过相关研究。本研究旨在：1）根据最近的联合临时声明（JIS）定义，使用高和低两种腰围截断值来定义腹型肥胖，确定卢森堡普通成年人群中 MS 及其各组分的性别和年龄特异性流行率；2）比较和评估与修订后的国家胆固醇教育计划-成人治疗专家组 III（R-ATPIII）和国际糖尿病联合会（IDF）定义的吻合程度。
一项代表性的分层随机抽样研究，共纳入 1349 名年龄在 18-69 岁的欧洲人，参与 ORISCAV-LUX 调查。使用逻辑回归和比值比（OR）研究了 MS 患病率与性别和年龄的关系。计算 Framingham 风险评分（FRS），以比较根据高和低腰围（WC）阈值，MS 病例中处于或低于 20%的比例。使用 Cohen's kappa 系数（κ）评估 MS 定义的吻合程度。
使用 JIS 定义时，MS 的流行率分别为低（94/80）和高（102/88）WC 截断值时的 28.0%和 24.7%。男性的 MS 患病率明显高于女性（低 WC 和高 WC 截断值时的 OR 分别为 2.6 和 2.3），除了两种 WC 截断值测量的腹型肥胖外，MS 的所有组分患病率均较高。患病率还随年龄增加而增加（与年轻组相比，低 WC 时的 OR 值范围为 2.7 至 28，高 WC 时为 3.3 至 31）。FRS 预测的 10 年 CHD 风险不依赖于使用的阈值。总体而言，三种 MS 定义之间存在极好的一致性（κ=0.89），尤其是 JIS 和 IDF 之间（κ=0.93）。女性的一致性明显高于男性，并且在不同年龄组之间存在差异。
无论使用何种定义，卢森堡成年人群中 MS 的患病率都很高。我们的研究结果为明确 MS 的构建提供了证据，有助于为 Europid 人群选择腰围截断值，并支持修订腹型肥胖水平的指南。
