基于人群的回顾性研究：使用五种不同定义在中国比较代谢综合征的患病率和特征。
Comparison of metabolic syndrome prevalence and characteristics using five different definitions in China: a population-based retrospective study.
机构信息
Department of Graduate School, Wannan Medical College, Wuhu, Anhui, China.
Student Health Center, Wannan Medical College, Wuhu, Anhui, China.
出版信息
Front Public Health. 2024 Feb 19;12:1333910. doi: 10.3389/fpubh.2024.1333910. eCollection 2024.
BACKGROUND
Metabolic syndrome (MetS) is on the rise in developing countries and is characterized by a series of indications of metabolic disturbance. However, the prevalence of MetS varies under different definitions. The study aimed to compare five definitions of MetS in the China adult population, to explore their prevalence, characteristics and agreement.
METHODS
The data for the retrospective study came from the China Health and Retirement Longitudinal Study (CHARLS), consisting of 9,588 participants (≥45). MetS definitions from International Diabetes Federation (IDF) (2006), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2005), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2001), Chinese Diabetes society (CDS) (2004) and the World Health Organization (WHO) (1999). We used binary and multivariable logistic analysis to explore factors connected with MetS.
RESULTS
The five definitions of MetS led to different prevalence of MetS:34.52% by IDF (2006), 38.63% by ATP (2005), 25.94% by ATP (2001), 26.31% by CDS (2004), 21.57% by WHO (1999). According to the definition of IDF (2006) (22.32% vs. 45.06%), ATPIII (2005) definition (27.99% vs. 47.82%), ATPIII (2001) definition (15.37% vs. 35.07%), CDS (2004) definition (19.96% vs. 31.80%), and WHO (1999) definition (17.44% vs. 25.14%), the prevalence of MetS in men was low but in women was high. The agreement between the five definitions for men was good except for the IDF (2006) definition and ATPIII (2001) definition (kappa = 0.51), with kappa values from 0.64 to 0.85. For women, the agreement between the five definitions was good ranging from 0.67 to 0.95, however, except for the definition of CDS (2004) and the definition of IDF (2006) (kappa = 0.44), the definition of WHO (1999) and the definition of IDF (2006) (kappa = 0.55), and the definition of WHO (1999) and the definition of ATPIII (2005) (kappa = 0.54). Binary logistic analysis indicated that although the impact and relevance varied by sex and definition, age, education, marital status, current residence, current smoking, alcohol using, taking activities and number of chronic diseases were factors connected to MetS.
CONCLUSION
the prevalence and characteristics of the five definitions of MetS are different in the Chinese population. Therefore, it is vital to use the same definition for a country to diagnose MetS. On the other side, a lower prevalence in men than in women and the consistency of five MetS definitions are good in men but relatively poor in women.
背景
代谢综合征（MetS）在发展中国家呈上升趋势，其特征是一系列代谢紊乱的迹象。然而，不同的定义下 MetS 的患病率也不同。本研究旨在比较中国成年人群中五种 MetS 定义，探讨其患病率、特征和一致性。
方法
本回顾性研究的数据来自中国健康与退休纵向研究（CHARLS），共纳入 9588 名（≥45 岁）参与者。MetS 定义来自国际糖尿病联合会（IDF）（2006 年）、美国国家胆固醇教育计划成人治疗专家组第三版（ATPIII）（2005 年）、美国国家胆固醇教育计划成人治疗专家组第三版（ATPIII）（2001 年）、中国糖尿病学会（CDS）（2004 年）和世界卫生组织（WHO）（1999 年）。我们使用二项和多变量逻辑分析来探讨与 MetS 相关的因素。
结果
五种 MetS 定义导致不同的 MetS 患病率：IDF（2006 年）定义为 34.52%，ATP（2005 年）定义为 38.63%，ATP（2001 年）定义为 25.94%，CDS（2004 年）定义为 26.31%，WHO（1999 年）定义为 21.57%。根据 IDF（2006 年）（22.32%比 45.06%）和 ATPIII（2005 年）定义（27.99%比 47.82%），ATPIII（2001 年）定义（15.37%比 35.07%），CDS（2004 年）定义（19.96%比 31.80%）和 WHO（1999 年）定义（17.44%比 25.14%），男性的 MetS 患病率较低，而女性的患病率较高。除 IDF（2006 年）定义和 ATPIII（2001 年）定义（kappa=0.51）外，五种定义之间的一致性在男性中较好，kappa 值在 0.64 至 0.85 之间。对于女性，五种定义之间的一致性较好，范围为 0.67 至 0.95，但是除了 CDS（2004 年）定义和 IDF（2006 年）定义（kappa=0.44），WHO（1999 年）定义和 IDF（2006 年）定义（kappa=0.55），以及 WHO（1999 年）定义和 ATPIII（2005 年）定义（kappa=0.54）外。二项逻辑分析表明，尽管影响和相关性因性别和定义而异，但年龄、教育程度、婚姻状况、当前居住地、当前吸烟、饮酒、活动量和慢性病数量是与 MetS 相关的因素。
结论
中国人群中五种 MetS 定义的患病率和特征不同。因此，对于诊断 MetS ，使用同一国家的定义非常重要。另一方面，男性的患病率低于女性，五种 MetS 定义在男性中的一致性较好，但在女性中相对较差。
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