Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
BMJ Open. 2020 Apr 6;10(4):e035216. doi: 10.1136/bmjopen-2019-035216.
In this study, we aimed to estimate the prevalence of metabolic syndrome (MetS) among Chinese adults, describe the disease components and compare utility of the existing international criteria and Chinese diagnostic criteria.
DESIGN, SETTING AND PARTICIPANTS: A retrospective database analysis was conducted for one hospital in Zhejiang province, China. We analysed data (collected in 2017) from a total of 64 902 participants (37 500 males and 27 402 females), aged between 18 and 97 years, and who met the eligibility criteria.
We employed three criteria for MetS proposed by the International Diabetes Federation (IDF) in 2005, the 2009 Joint Scientific Statement (harmonising criteria) and the China Diabetes Society (CDS) in 2013 to detect prevalence of MetS. Specifically, we analysed waist circumference, blood pressure, fasting plasma glucose, plasma triglycerides and plasma high-density lipoprotein cholesterol.
We found an estimated age-adjusted MetS prevalence of 20.4% using IDF 2005, 30.0% based on harmonising criteria 2009 and 16.3% under the CDS 2013. This prevalence was higher in males, older adults and increased body mass index. Analysis of agreements among the criteria were 87.2% (IDF and CDS), 87.1% (IDF and harmonising criteria) and 81.6% (CDS and harmonising criteria), while their kappa coefficients were 0.641, 0.708 and 0.572 for IDF versus CDS, IDF versus harmonising criteria and CDS versus harmonising criteria, respectively. The most prevalent MetS component was abdominal obesity (50.1%), followed by dyslipidaemia (49.5%) and hypertension (46.8%) using harmonising criteria.
These findings revealed moderate agreement among the three criteria with utility in Chinese clinical settings. The harmonising criteria 2009 performed better in early identification of MetS in the Chinese population.
本研究旨在估计中国成年人代谢综合征（MetS）的患病率，描述疾病组分，并比较现有国际标准和中国诊断标准的适用性。
设计、地点和参与者：对中国浙江省的一家医院进行了回顾性数据库分析。我们分析了符合入选标准的共 64902 名参与者（37500 名男性和 27402 名女性）的数据（于 2017 年收集），年龄在 18 至 97 岁之间。
我们采用了国际糖尿病联盟（IDF）2005 年、2009 年联合科学声明（协调标准）和中国糖尿病学会（CDS）2013 年提出的三种 MetS 标准来检测患病率。具体而言，我们分析了腰围、血压、空腹血糖、血浆甘油三酯和血浆高密度脂蛋白胆固醇。
我们发现，采用 IDF 2005 标准时，年龄校正后的 MetS 患病率估计为 20.4%，采用协调标准 2009 时为 30.0%，采用 CDS 2013 时为 16.3%。这种患病率在男性、老年人和体重指数较高的人群中更高。标准之间的一致性分析结果分别为 87.2%（IDF 和 CDS）、87.1%（IDF 和协调标准）和 81.6%（CDS 和协调标准），而 IDF 与 CDS、IDF 与协调标准和 CDS 与协调标准的kappa 系数分别为 0.641、0.708 和 0.572。采用协调标准时，最常见的 MetS 组分是腹型肥胖（50.1%），其次是血脂异常（49.5%）和高血压（46.8%）。
这些发现表明，三种标准之间具有中等程度的一致性，在中国临床环境中具有一定的实用性。协调标准 2009 在识别中国人群中的 MetS 方面表现更好。
