摘要目的 利用4种代谢综合征(MS)诊断标准对浙江省城市地区18岁以上人群进行诊断,并分析比较4种诊断标准MS检出率情况.方法 按照多阶段分层与人口成比例(PPS)的整群随机抽样原则,分别于2009年和2010年采用随机数字法在杭州市下城区、江干区,宁波市江东区,金华市婺城区抽取了320户家庭的18周岁以上非孕妇和非乳母人群共计3 417名.采用标准方法测量其身高、体重、腰围、血压、FBG、餐后2h血糖(2h-PBG)、TG和HDL-C,分别用中华医学会糖尿病学分会(CDS)标准、中国成人血脂异常防治指南制订联合会(JCDCG)标准、2005年美国国家胆固醇教育计划成人治疗方案第三次报告(ATPⅢ)标准、国际糖尿病联盟(IDF)标准对3 417名研究对象进行MS诊断,分析比较4种诊断标准下MS检出率情况.结果 ATPⅢ标准MS检出率最高,为21.6％ (737/3417),CDS标准最低,为9.8％ (335/3 417),JCDCG标准MS检出率为15.0％ (513/3 417),IDF标准MS检出率为18.5％ (632/3 417),4种诊断标准MS检出率差异有统计学意义(x2=192.1,P＜0.05);ATPⅢ标准与IDF标准、JCDCG标准一致性较高,一致率分别为96.9％、92.9％,Kappa值均为0.75;MS异常组分检出结果表明,MS人群中ATPⅢ标准检出≥3个危险因素聚集比例最高,为100.0％,非MS人群中ATPⅢ检出≥3个危险因素聚集比例最低,为0.8％.结论 4种诊断标准对浙江省城市地区18岁以上人群MS检出情况有差异,其中以ATPⅢ标准筛检MS及其异常组分效果较好.

abstractsObjective To compare the applicative effect of four diagnostic criteria of metabolic syndrome(MS) among the urban adult population of Zhejiang Province.Methods According to multi-stage stratified and proportional to size,cluster,random sampling principle,3 417 adults population at urban areas were extracted by random number method from 320 families of Shangcheng and Jianggan community in Hangzhou,Jiangdong community in Ningbo and Wucheng community in Jinhua in 2009 and 2010 respectively,which excluded pregnant,wet nurse,children,and those who were at least 18 years of age.Height,weight,waist,blood pressure,fasting plasma glucose (FBG),2-hour postprandial blood glucose (2h-PBG),TG and HDL-C of all the subjects were measured by standard method.MS was diagnosed and compared according to four diagnostic criteria:Chinese Medical Association Diabetic Society (CDS),Joint Committee for Developing Chinese Guidelines (JCDCG),American National Cholesterol Education Program Adult Treatment Pane Ⅲ in 2005 (ATP Ⅲ) and International Diabetes Federation (IDF),respectively.Results The high prevalence of MS diagnosed by the criteria of ATPⅢ was 21.6％ (737/3 417),while the lowest prevalence diagnosed by CDS was 9.8％ (335/3 417),the result of consistency check demonstrated the MS diagnostic criteria of ATPⅢ and IDF,ATPⅢ and JCDCG were in strong and the same accordance with the concordance rate,Kappa value was 0.75,while the consistency of the criteria of ATP Ⅲ and CDS were in relatively weak agreement,Kappa value was 0.53 ; the detection result of MS abnormal components showed the highest proportion of having ≥ 3 risk factors was presented by ATP Ⅲ among subjects diagnosed as MS (100.0％),meanwhile,the lowest proportion of having ≥3 risk factors was also found by ATP Ⅲ among those MS-free(0.8％).Conclusions The criteria of ATPⅢ may have more sensitivity when screening MS and its abnormal components.However,it's limited to extrapolate the results from the cross-sectional survey to the total population.