Ahmed Asma, Khan Talha Ehsan, Yasmeen Tahira, Awan Safia, Islam Najmul
Department of Endocrinilogy, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2012 Jun;62(6):569-74.
To determine the frequency of metabolic syndrome in type 2 diabetes according to three commonly used operational definitions {World Health Organization (WHO), National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) and International Diabetes Federation( IDF)}. To evaluate the agreement between these classifications in the Pakistani cohort.
Data was collected retrospectively of 210 patients with type 2 diabetes visiting outpatient clinics of one of the large tertiary care hospitals at Karachi, Pakistan between June 2008 to November 2008.
The prevalence of metabolic syndrome was found to be 81.4% (WHO), 86.7 % (IDF) and 91.9 % (NCEP ATPIII). The degree of agreement (kappa statistic) was found to be highest among IDF & NCEP ATPIII (0.728) as compared to (0.436 & 0.417) between WHO & ATP and WHO & IDF respectively. The most significant predictors for metabolic syndrome were found out to be female gender OR= 8.74 95% CI 1.51-50.53, low HDL cholesterol levels OR = 0.89 95% CI 0.84-0.94 and high systolic blood pressure OR= 1.06 95% CI 1.009-1.11.
Our study results suggested that NCEP ATPIII and IDF are the most reliable criteria for diagnosing metabolic syndrome in type 2 diabetic patients, with NECP capturing more patients in comparison to IDF definition. The alarmingly high frequency of metabolic syndrome in type 2 diabetes found in this study suggests that primary prevention strategies should be initiated earlier and early in this ethnic group and our health care system should be geared up to cope with this deadly quartet.
根据三种常用的操作定义{世界卫生组织（WHO）、美国国家胆固醇教育计划成人治疗小组（NCEP ATP III）和国际糖尿病联盟（IDF）}来确定2型糖尿病患者中代谢综合征的发生率。评估这些分类在巴基斯坦队列中的一致性。
回顾性收集2008年6月至2008年11月期间在巴基斯坦卡拉奇一家大型三级护理医院门诊就诊的210例2型糖尿病患者的数据。
代谢综合征的患病率分别为81.4%（WHO）、86.7%（IDF）和91.9%（NCEP ATPIII）。发现IDF和NCEP ATPIII之间的一致性程度（kappa统计量）最高（0.728），而WHO与ATP以及WHO与IDF之间的一致性程度分别为（0.436和0.417）。发现代谢综合征最显著的预测因素为女性，比值比（OR）=8.74，95%置信区间（CI）为1.51 - 50.53；高密度脂蛋白胆固醇水平低，OR = 0.89，95%CI为0.84 - 0.94；收缩压高，OR = 1.06，95%CI为1.009 - 1.11。
我们的研究结果表明，NCEP ATPIII和IDF是诊断2型糖尿病患者代谢综合征最可靠的标准，与IDF定义相比，NECP纳入的患者更多。本研究中2型糖尿病患者代谢综合征的高得惊人的发生率表明，应在该种族群体中尽早启动一级预防策略，我们的医疗保健系统应做好准备应对这一致命四重奏。
