Porchia Leonardo M, Lara-Solis Beatriz, Torres-Rasgado Enrique, Gonzalez-Mejia M Elba, Ruiz-Vivanco Guadalupe, Pérez-Fuentes Ricardo
Independent researcher and consultant. Laboratorio de Investigación en Fisiopatología de Enfermedades Crónicas, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico.
Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.
Rev Panam Salud Publica. 2019 Jan 25;43:e9. doi: 10.26633/RPSP.2019.9. eCollection 2019.
To determine the reliability of a non-laboratorial questionnaire, the (ESF-I) for identifying Metabolic Syndrome among a population in central Mexico.
Clinical and biochemical parameters were collected for 232 participants from 1 June 2012 - 31 August 2013. Three definitions of Metabolic Syndrome (Harmonizing, National Cholesterol Education Program Expert Panel and Adult Treatment Panel III [ATPIII], and International Diabetes Federation [IDF]) were used to allocate subjects to either the normal or Metabolic Syndrome positive (MetS+) group. The predictability of the questionnaire was determined by the Area-Under-the-Receiver-Operating Characteristic curve (AUC). Youden's index was calculated and the highest score was considered the optimal cutoff value. Cohen´s kappa (κ) was calculated to determine the level of agreement between the ESF-I questionnaire (max score: 15 based on 15 items) and Metabolic Syndrome.
From 53.8% - 60.7% of the participants were determined to be MetS+. The average questionnaire score was significantly higher in the MetS+ group for each definition (4.0 vs. 8.0, P < 0.05). The ESF-I questionnaire was predictive for the Harmonizing definition (AUC = 0.841, 95%CI: 0.790 - 0.892), the ATPIII definition (AUC = 0.827, 95%CI: 0.774 - 0.880), and the IDF definition (AUC = 0.836, 95%CI: 0.785 - 0.887). A cutoff value of 7 was determined for each definition; therefore, the cohort was re-categorized based on questionnaire results. There was a strong agreement between the ESF-I questionnaire and MetS (Harmonizing: accuracy = 77.6%, κ = 0.554; ATPIII: accuracy = 74.1%, κ = 0.489; IDF: accuracy = 74.6%, κ = 0.495, < 0.001).
The ESF-I questionnaire can identify MetS+ patients, and therefore, lead to earlier diagnoses, reduced number of consultations, and lower costs with easier application.
确定一种非实验室问卷（ESF-I）在墨西哥中部人群中识别代谢综合征的可靠性。
收集了2012年6月1日至2013年8月31日期间232名参与者的临床和生化参数。采用三种代谢综合征定义（协调定义、美国国家胆固醇教育计划专家小组和成人治疗小组第三次报告[ATPIII]以及国际糖尿病联盟[IDF]）将受试者分为正常组或代谢综合征阳性（MetS+）组。通过受试者工作特征曲线下面积（AUC）确定问卷的预测能力。计算约登指数，最高分数被视为最佳截断值。计算科恩kappa（κ）系数以确定ESF-I问卷（基于15个项目，最高分数为15分）与代谢综合征之间的一致性水平。
53.8% - 60.7%的参与者被确定为MetS+。对于每种定义，MetS+组的问卷平均得分显著更高（4.0对8.0，P < 0.05）。ESF-I问卷对协调定义（AUC = 0.841，95%CI：0.790 - 0.892）、ATPIII定义（AUC = 0.827，95%CI：0.774 - 0.880）和IDF定义（AUC = 0.836，95%CI：0.785 - 0.887）具有预测性。为每种定义确定的截断值为7；因此，根据问卷结果对队列进行了重新分类。ESF-I问卷与MetS之间存在高度一致性（协调定义：准确性 = 77.6%，κ = 0.554；ATPIII：准确性 = 74.1%，κ = 0.489；IDF：准确性 = 74.6%，κ = 0.495，P < 0.001）。
ESF-I问卷能够识别MetS+患者，因此可实现更早诊断、减少就诊次数并降低成本，且应用更简便。
