Hu Zhefang, Zhang Ronghua, Huang Lichun, Zhou Biao, He Denghua, Ding Gangqiang
Epidemiology and Health Statistics,Medical School of Ningbo University, Ningbo 315211, China.
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Zhonghua Yu Fang Yi Xue Za Zhi. 2014 Jun;48(6):507-11.
To compare the applicative effect of four diagnostic criteria of metabolic syndrome (MS) among the urban adult population of Zhejiang Province.
According to multi-stage stratified and proportional to size, cluster, random sampling principle, 3 417 adults population at urban areas were extracted by random number method from 320 families of Shangcheng and Jianggan community in Hangzhou,Jiangdong community in Ningbo and Wucheng community in Jinhua in 2009 and 2010 respectively, which excluded pregnant, wet nurse, children, and those who were at least 18 years of age. Height, weight, waist, blood pressure, fasting plasma glucose (FBG) , 2-hour postprandial blood glucose (2h-PBG), TG and HDL-C of all the subjects were measured by standard method. MS was diagnosed and compared according to four diagnostic criteria:Chinese Medical Association Diabetic Society (CDS), Joint Committee for Developing Chinese Guidelines (JCDCG), American National Cholesterol Education Program Adult Treatment PaneI II in 2005 (ATPIII) and International Diabetes Federation (IDF), respectively.
The high prevalence of MS diagnosed by the criteria of ATPIII was 21.6% (737/3 417) , while the lowest prevalence diagnosed by CDS was 9.8% (335/3 417), the result of consistency check demonstrated the MS diagnostic criteria of ATPIII and IDF, ATPIII and JCDCG were in strong and the same accordance with the concordance rate, Kappa value was 0.75, while the consistency of the criteria of ATP III and CDS were in relatively weak agreement, Kappa value was 0.53; the detection result of MS abnormal components showed the highest proportion of having ≥ 3 risk factors was presented by ATPIII among subjects diagnosed as MS (100.0%) , meanwhile, the lowest proportion of having ≥ 3 risk factors was also found by ATPIII among those MS-free (0.8%) .
The criteria of ATPIII may have more sensitivity when screening MS and its abnormal components.However, it's limited to extrapolate the results from the cross-sectional survey to the total population.
比较代谢综合征（MS）的四种诊断标准在浙江省城市成年人群中的应用效果。
按照多阶段分层、按比例大小整群随机抽样原则，于2009年和2010年分别采用随机数字法从杭州市上城区和江干区、宁波市江东区、金华市婺城区的320个家庭中抽取3417名城区成年人群，排除孕妇、乳母、儿童以及年龄未满18岁者。采用标准方法测量所有研究对象的身高、体重、腰围、血压、空腹血糖（FBG）、餐后2小时血糖（2h-PBG）、甘油三酯（TG）和高密度脂蛋白胆固醇（HDL-C）。分别依据中华医学会糖尿病学分会（CDS）、中国糖尿病防治指南联合委员会（JCDCG）、2005年美国国家胆固醇教育计划成人治疗组第三次报告（ATPIII）以及国际糖尿病联盟（IDF）这四种诊断标准对MS进行诊断并比较。
依据ATPIII标准诊断的MS患病率最高，为21.6%（737/3417），而依据CDS标准诊断的患病率最低，为9.8%（335/3417）；一致性检验结果显示，ATPIII与IDF、ATPIII与JCDCG的MS诊断标准一致性较强且符合率相同，Kappa值为0.75，而ATPIII与CDS标准的一致性相对较弱，Kappa值为0.53；MS异常组分检测结果显示，在诊断为MS的人群中，ATPIII标准呈现出≥3个危险因素的比例最高（达100.0%），同时在未患MS的人群中，ATPIII标准呈现出≥3个危险因素的比例最低（为0.8%）。
ATPIII标准在筛查MS及其异常组分时可能具有更高的敏感性。然而，将横断面调查结果外推至总体人群存在局限性。
