Herrera-Enriquez Karela, Narvaez-Guerra Offdan
Department of Preventive Medicine, Integral Occupational Medicine Center CEMOIN, Arequipa, Peru.
Department of Preventive Medicine, Integral Occupational Medicine Center CEMOIN, Arequipa, Peru.
Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S359-S364. doi: 10.1016/j.dsx.2017.03.016. Epub 2017 Mar 6.
There is no consensus as to which Metabolic Syndrome (MetS) definition to use for South-American populations. The aim of this study is to compare the prevalence of MetS and abdominal obesity using different criteria in Andean adults aged 40 and older living permanently at high altitude.
We conducted a cross-sectional study in Chivay (Andean highlands). 237 participants were included. Anthropometric measurements, glucose and lipid assessments were done in all subjects. Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria for MetS were used. Abdominal obesity prevalence was determined using the American Diabetes Association (ADA), IDF, and PREVENCION Study criteria. Cohen's Kappa coefficient (κ) was analyzed to assess agreement level between different criteria. Multiple regression analyses were performed to find predictors for waist circumference.
MetS was identified in 28.7% (95%CI=23.8-33.5) using ATPIII criteria, and 37.9% (95%CI=32.7-43.0) using IDF criteria, with higher prevalence in women. The κ statistics for agreement between both criteria was 0.775 (95%CI=0.690-0.859). Abdominal obesity prevalence according to ADA, IDF, and PREVENCION criteria was 35.9% (95%CI=29.7-42.0), 75.9% (95%CI=70.5-81.4), and 42.6% (95%CI=36.3-49.0), respectively. Agreement between ADA and PREVENCION criteria was highest (κ=0.859, 95%CI=0.792-0.925). The strongest predictors for higher waist circumference values were triglycerides and BMI in women, and systolic blood pressure, triglycerides, fasting plasma glucose, and HDL-cholesterol in men.
MetS according to ATP III and IDF criteria was highly prevalent. IDF criteria identified a larger number of subjects with MetS. Different abdominal obesity criteria tended to show variation when applied to our sample population.
对于南美洲人群应采用哪种代谢综合征（MetS）定义尚无共识。本研究的目的是比较在高海拔地区长期居住的40岁及以上安第斯成年人中，使用不同标准时MetS和腹型肥胖的患病率。
我们在奇瓦伊（安第斯高地）进行了一项横断面研究。纳入了237名参与者。对所有受试者进行了人体测量、血糖和血脂评估。使用成人治疗小组第三次报告（ATPIII）和国际糖尿病联盟（IDF）的MetS标准。使用美国糖尿病协会（ADA）、IDF和预防研究标准确定腹型肥胖患病率。分析科恩卡方系数（κ）以评估不同标准之间的一致性水平。进行多元回归分析以找出腰围的预测因素。
使用ATPIII标准时，MetS的患病率为28.7%（95%置信区间=23.8-33.5），使用IDF标准时为37.9%（95%置信区间=32.7-43.0），女性患病率更高。两种标准之间一致性的κ统计量为0.775（95%置信区间=0.690-0.859）。根据ADA、IDF和预防标准，腹型肥胖患病率分别为35.9%（95%置信区间=29.7-42.0）、75.9%（95%置信区间=70.5-81.4）和42.6%（95%置信区间=36.3-49.0）。ADA和预防标准之间的一致性最高（κ=0.859，95%置信区间=0.792-0.925）。女性腰围值较高的最强预测因素是甘油三酯和体重指数，男性是收缩压、甘油三酯、空腹血糖和高密度脂蛋白胆固醇。
根据ATP III和IDF标准，MetS的患病率很高。IDF标准识别出更多患有MetS的受试者。当应用于我们的样本人群时，不同的腹型肥胖标准往往会显示出差异。
