甘肃兰州地区代谢综合征流行病学调查及不同诊断标准的对比研究

摘要

Objective To study the prevalence of metabolic syndrome (MS) among urban inhabitant aged 20~74 years in Lanzhou, and compare the differences among different diagnostic criteria for metabolic syndrome. Methods A stratified, cluster and random sampling design was used to select participants who were 20~74 years old living in their local residence for at least 5 years from 2013 to 2014. All subjects completed a questionnaires survey , immediately following a physical examina-tion and laboratory test. The prevalence of MS among the urban adult population of Lanzhou city was assessed according to dif-ferent diagnostic criteria,namely Joint Committee for Developing Chinese Guidelines(JCDCG),the International Diabetes Feder-ation (IDF),the American Heart Association (AHA) revision of the project group national cholesterol Ⅲ (ATPⅢ),the interna-tional society for more than a joint statement (JIS). The difference and consistency of four diagnostic criteria for MS were com-pared. Results The prevalence and standardized prevalence of MS were 22.0%(16.3%),34.0%(30.9%),37.4%(34.1%)and 37.7%(34.3%),respectively, according to the JCDCG,IDF,ATPⅢ,JIS. The highest consistency of JIS,ATPⅢand IDF for the diagnosis of MS was 99.7% and 96.6%,respectively, with their kappa value being 0.99 and 0.93, respectively. Conclusion The MS prevalence in Lanzhou city is high. There are differences MS detection of four kinds of diagnostic criteria among resi-dents of Lanzhou city, and JIS is better than other criteria in screening for MS and abnormal composition effect.%目的：调查甘肃兰州地区20~74岁城市居民代谢综合征（metabolic syndrome，MS）流行状况，并分析比较不同诊断标准下MS检出率差异与一致性。方法采用分层整群随机抽样的方法，于2013~2014年在兰州地区抽取20~74岁5年以上的常住城市居民2996名，并进行问卷调查、体格检查和生化检查。分别采用中国成人血脂异常防治指南制订联合会（JCDCG）、国际糖尿病联盟（IDF）、美国心脏病学会（AHA）修订版的美国国家胆固醇项目专家组（ATPⅢ）及国际多学会联合声明（JIS）诊断标准，评估兰州城市居民MS及其各组分检出率，并使用Kappa值比较不同标准间一致性。结果根据JCDCG、IDF、ATPⅢ、JIS 诊断标准，MS 患病率（标化患病率）分别为22.0%（16.3%）、34.0%（30.9%）、37.4%（34.1%）、37.7%（34.3%），差异有统计学意义（χ2=221.03，P＜0.05）。不同标准两两一致性比较，其中ATPⅢ与JIS、IDF一致性较好，一致率分别为99.7%、96.6%；Kappa值分别为0.99、0.93。结论兰州地区城市居民MS患病率较高，不同标准对兰州地区城市居民MS检出率有差异，其中以JIS标准对MS及异常组分检出率最高。