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目的比较三种代谢综合征(MS)诊断标准在内蒙古锡林郭勒盟人群中应用的差异。方法2006年9月—2007年3月,对在内蒙古锡林郭勒盟医院体检的企事业单位20岁以上职工进行流行病学调查(1060人),分别采用国际糖尿病联盟(IDF,2005)、美国国家胆固醇教育计划成人组第三次报告(NCEP-ATPⅢ,2005)和中华医学会糖尿病分会(CDS,2004)标准计算MS患病率,比较三种标准在锡盟人群应用中的一致性和差异。结果IDF、ATPⅢ和CDS三种标准下,锡盟人群MS标化患病率分别为25.0%,27.9%和22.5%。IDF与ATPⅢ诊断一致性最高,Kappa值为0.929,IDF与CDS、ATPⅢ与CDS的Kappa值分别为0.726,0.763,基本一致。与ATPⅢ比较,IDF、CDS诊断的非MS人群中分别有4.3%和10.8%的人具有3种及以上代谢异常组分。蒙古族男性腰围90cm,女性BMI≥25kg/m2时,灵敏度及特异度较好,ROC曲线距离最短,预测MS危险因素聚集的能力相对最好;而汉族则以男性BMI≥25kg/m2、女性腰围80cm时相对最好。结论三种MS诊断标准中,ATPⅢ标准对MS及危险因素聚集个体的检出率最高,最适合心脑血管病高危人群的筛查。IDF与ATPⅢ的腰围标准较适合锡盟蒙古族男性,而CDS的标准较适合汉族男性,提示肥胖评价指标应联合采用腰围和BMI。
Objective To compare the differences of three metabolic syndrome (MS) diagnostic criteria in the Xilin Gol League in Inner Mongolia. Methods From September 2006 to March 2007, the epidemiological survey (1060) of workers above 20 years old in enterprises and institutions in Xilinguole Hospital of Inner Mongolia was conducted, and the data were collected by International Diabetes Federation (IDF, 2005), National Cholesterol The third report of the Adult Education Program (NCEP-ATP III, 2005) and the Diabetes Branch of the Chinese Medical Association (CDS, 2004) were used to calculate the prevalence of MS and to compare the consistency and differences of the three criteria in the application of the Ximeng population. Results Under the three standards of IDF, ATP Ⅲ and CDS, the prevalence of MS in the Ximeng population were 25.0%, 27.9% and 22.5% respectively. IDF and ATP Ⅲ had the highest diagnostic concordance with Kappa value of 0.929. The Kappa values of IDF and CDS, ATP Ⅲ and CDS were 0.726 and 0.763, respectively, which were basically the same. Compared with ATPⅢ, 4.3% and 10.8% of IDF and CDS diagnosed non-MS patients had three or more metabolic abnormalities. Mongolian men waist circumference 90cm, female BMI ≥ 25kg / m2, the sensitivity and specificity of the ROC curve is the shortest, the ability to predict the risk of MS aggregation is relatively the best; while the Han men BMI ≥ 25kg / m2, waist circumference 80cm when the relative best. Conclusion Among the three MS diagnostic criteria, the ATP Ⅲ standard has the highest detection rate for MS and aggregated individuals with risk factors, and is most suitable for screening high-risk groups of cardiovascular and cerebrovascular diseases. IDF and ATP III waist circumference standards are more suitable for the Mongolian ethnic group in Ximeng, while the CDS standard is more suitable for Han men, suggesting that obesity evaluation should be combined with waist circumference and BMI.