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目的比较3种标准在我国社区老年人群中对MS诊断的一致性,为比较和验证各种MS诊断标准的应用价值提供依据。方法采用多阶段分层抽样方法在5座城市共调查6 295名年龄≥60周岁的社区居民,使用统一的流行病学调查表进行问卷调查,并进行体格检查、血生化标本的收集和测定。分别应用国际糖尿病联盟(IDF)、美国国家胆固醇教育计划成年人治疗方案第三次报告(NCEP-ATPⅢ)、中华医学会糖尿病学会分会(CDS,修订)的3种诊断标准计算该人群MS的患病率,研究3种标准在中国老年人群中应用的一致性。结果分别应用IDF、NCEP-ATPⅢ和CDS修订标准判定我国社区60岁以上老年人MS患病率分别为21.2%、38.6%、25.5%。按照IDF或NCEP-ATPⅢ诊断标准计算的MS患病率女性高于男性,差异有统计学意义(P<0.01)。按照CDS的诊断标准(修订)计算不同性别人群MS患病率差异无统计学意义(P>0.05)。NCEP-ATPⅢ与CDS诊断标准(修订)一致率最高,为87.0%,Kappa值为0.71。结论在社区卫生工作中对MS进行诊断和防控时,选择不同的标准将在一定程度上影响对疾病流行程度的评估。
Objective To compare the consistency of three kinds of criteria in diagnosing MS among the community elders in our country and provide the basis for comparing and verifying the application value of various MS diagnostic criteria. Methods A total of 6 295 community residents aged 60 years and older were surveyed in five cities by using multistage stratified sampling method. Questionnaires were conducted using a unified epidemiological questionnaire and physical examination and blood biochemical samples were collected and measured. The prevalence of MS in this population was calculated using the three diagnostic criteria of the International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Program Third Report (NCEP-ATP III), and Chinese Medical Association Diabetes Association Branch (CDS) The prevalence of these three criteria was examined for consistency among Chinese elderly population. Results Using IDF, NCEP-ATPⅢ and CDS revised standards respectively, the prevalence of MS in our community over the age of 60 was 21.2%, 38.6% and 25.5% respectively. According to IDF or NCEP-ATPⅢ diagnostic criteria, the prevalence of MS was higher in females than in males, with significant difference (P <0.01). According to the diagnostic criteria of CDS (revised), there was no significant difference in the prevalence of MS between different sex groups (P> 0.05). NCEP-ATPⅢ and CDS diagnostic criteria (revised) the highest agreement rate of 87.0%, Kappa value of 0.71. Conclusion In the diagnosis and prevention and control of MS in community health work, choosing different standards will affect the evaluation of the prevalence of the disease to a certain extent.