Mora García Gustavo, Salguedo Madrid Germán, Ruíz Díaz María, Ramos Clason Enrique, Alario Bello Angelo, Fortich Alvaro, Mazenett Enrique, Gómez Camargo Doris, Gómez Alegría Claudio
Laboratorio de Investigaciones, Universidad de Cartagena, Cartagena, España.
Rev Esp Salud Publica. 2012 May-Jun;86(3):301-11. doi: 10.1590/S1135-57272012000300009.
During last decade the metabolic syndrome has been defined by five different guidelines. Discrepancies in such definitions could influence syndrome predictive ability over cardiovascular diseases. The aim of this study was to determine the degree of agreement between these five guidelines, in population from Cartagena (Colombia).
A cross sectional study was conducted in adults from urban zone. Sample size was estimated based on 2005 DANE census, which included 670 individuals. The prevalence of metabolic syndrome was determined through the WHO (World Health Organization), AHA/NHLBI (American Heart Association/National Heart Lung and Blood Institute), ATP III (Adult Treatment Panel III), IDF (International Diabetes Federation) and JIS (Joint Interim Statement) guidelines. Frequencies obtained were compared through Cohen's kappa index.
According to JIS, IDF, ATPIII, AHA/NHBLI and WHO guidelines, metabolic syndrome prevalence was 36.3% [32.6 - 39.9], 35.1%, 30.3%, 24.2% and 4.9%. Agreement between JIS and IDF was 0.893, while index for these two guidelines with AHA/NHLBI was 0.778 y 0.750, respectively. ATPIII had a lower agreement with JIS and IDF (0.711 and 0.645, respectively), however with AHA/NHLBI agreement was 0.863. WHO presented a agreement with the others guidelines between 0.14 and 0.16.
Significant agreement was found between the four most recent guidelines. Abdominal obesity cut-off points might support differences agreement differences.
在过去十年中,代谢综合征由五种不同的指南进行定义。这些定义上的差异可能会影响该综合征对心血管疾病的预测能力。本研究的目的是确定这五种指南在来自卡塔赫纳(哥伦比亚)的人群中的一致程度。
对城市地区的成年人进行了一项横断面研究。样本量是根据2005年国家统计局(DANE)的人口普查估算的,共纳入670人。通过世界卫生组织(WHO)、美国心脏协会/美国国立心肺血液研究所(AHA/NHLBI)、成人治疗小组第三次报告(ATP III)、国际糖尿病联盟(IDF)和联合临时声明(JIS)指南来确定代谢综合征的患病率。通过科恩kappa指数对所得频率进行比较。
根据JIS、IDF、ATPIII、AHA/NHBLI和WHO指南,代谢综合征的患病率分别为36.3%[32.6 - 39.9]、35.1%、30.3%、24.2%和4.9%。JIS和IDF之间的一致性为0.893,而这两个指南与AHA/NHLBI的一致性指数分别为0.778和0.750。ATPIII与JIS和IDF的一致性较低(分别为0.711和0.645),不过与AHA/NHLBI的一致性为0.863。WHO与其他指南的一致性在0.14至0.16之间。
在四个最新指南之间发现了显著的一致性。腹部肥胖的切点可能是导致一致性差异的原因。