Bee Ying Tan, Haresh Kumar Kantilal, Rajibans Singh
Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, 53300 Kuala Lumpur Malaysia.
Malays J Nutr. 2008 Mar;14(1):65-77. Epub 2008 Mar 15.
The World Health Organization (WHO), National Cholesterol Education Program Adults Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) have proposed different criteria to diagnose metabolic syndrome (MetS). However, there is no single definition to accurately diagnose MetS. The objective of this study is to estimate the prevalence of MetS using WHO, NCEP ATP III and IDF in the Malaysian community, and to determine the concordance between these definitions for MetS. 109 men and women aged > 30 years participated in the study, and the prevalence of MetS was determined according to the three definitions. Weight, height, body mass index (BMI), waist-hip circumference, blood pressure, blood lipid profile and plasma fasting glucose were measured. In order to determine the concordance between IDF and the other two definitions, the kappa index (κ-test) was used. The prevalence of MetS (95% confidence interval) was 22.9% (22.8-23.1) by IDF definition, 16.5% (16.3-16.9) by NCEP ATP III definition and 6.4% (6.2-6.6) by modified WHO definition. The sensitivity and specificity of IDF against NCEP ATP III were 88.9% and 90.1% respectively, IDF against WHO definition were 85.7% and 81.4%. The κ statistics for the agreement of the IDF definition was 68.3 ± 0.1 with the NCEP ATP III, and 30.5 ± 0.1 with the modified WHO definition. The prevalence of the MetS among respondents using the IDF definition was highest, followed by NCEP ATP III, and finally modified WHO definition. There was a good concordance between the IDF and NCEP ATP III definitions, and a low concordance between IDF and modified WHO definitions.
世界卫生组织（WHO）、美国国家胆固醇教育计划成人治疗组第三次报告（NCEP ATP III）以及国际糖尿病联盟（IDF）提出了不同的代谢综合征（MetS）诊断标准。然而，目前尚无能够准确诊断MetS的单一标准。本研究的目的是采用WHO、NCEP ATP III和IDF标准评估马来西亚社区人群中MetS的患病率，并确定这些MetS定义之间的一致性。109名年龄大于30岁的男性和女性参与了本研究，并依据这三种定义确定了MetS的患病率。测量了体重、身高、体重指数（BMI）、腰臀围、血压、血脂谱以及空腹血糖。为了确定IDF与其他两种定义之间的一致性，采用了kappa指数（κ检验）。根据IDF定义，MetS的患病率（95%置信区间）为22.9%（22.8 - 23.1）；根据NCEP ATP III定义为16.5%（16.3 - 16.9）；根据修改后的WHO定义为6.4%（6.2 - 6.6）。IDF相对于NCEP ATP III的灵敏度和特异度分别为88.9%和9,0.1%，IDF相对于WHO定义的灵敏度和特异度分别为85.7%和81.4%。IDF定义与NCEP ATP III的κ统计值为68.3 ± 0.1，与修改后的WHO定义的κ统计值为30.5 ± 0.1。采用IDF定义的受访者中MetS的患病率最高，其次是NCEP ATP III，最后是修改后的WHO定义。IDF与NCEP ATP III定义之间具有良好的一致性，而IDF与修改后的WHO定义之间的一致性较低。
