CAJ | 학술논문

目的了解广东省18岁及以上人群代谢综合征(MS)的患病情况,比较2004年中华医学会糖尿病学分会(CDS)标准、2007年中国成人血脂异常防治指南制订联合委员会(JCDCG)标准和2009年国际联合暂定声明(JIS)标准在广东省18岁及以上人群中应用的差异.方法采用多阶段分层整群抽样方法抽取广东省6个监测县(区、市)18岁及以上居民中的3591人为研究对象,采用统一制定的调查表进行问卷调查,同时进行体格检查及血生化检测.两两比较采用t检验,率的比较采用X2检验.结果采用CDS(2004)、JCDCG(2007)和JIS(2009)标准计算的MS患病率(标化患病率)分别为21.1％(19.0％,756例)、28.6％(25.4％,1026例)和44.5％(40.6％,1599例);3种标准诊断为MS者中存在3个及以上危险因素聚集的比例分别为97.5％(737例)、98.4％(1010例)和100.0％(1599例);CDS与JIS、JCDCG与JIS、JCDCG与CDS两两间的一致率(Kappa值)分别为74.8％(0.46,2688例)、82.1％(0.63,2950例)和87.8％(0.68,3153例).以JIS为参照标准,绘制ROC曲线,CDS的曲线下面积为0.719,JCDCG的曲线下面积为0.802.结论广东省18岁及以上居民MS患病率已经达到较高水平,建议加强MS高危人群的综合防治力度.三种MS诊断标准中,JIS标准诊断MS的患病率、灵敏度和危险因素聚集的检出率最高.
목적 료해광동성18세급이상인군대사종합정(MS)적환병정황,비교2004년중화의학회당뇨병학분회(CDS)표준、2007년중국성인혈지이상방치지남제정연합위원회(JCDCG)표준화2009년국제연합잠정성명(JIS)표준재광동성18세급이상인군중응용적차이.방법 채용다계단분층정군추양방법추취광동성6개감측현(구、시)18세급이상거민중적3591인위연구대상,채용통일제정적조사표진행문권조사,동시진행체격검사급혈생화검측.량량비교채용t검험,솔적비교채용X2검험.결과 채용CDS(2004)、JCDCG(2007)화JIS(2009)표준계산적MS환병솔(표화환병솔)분별위21.1％(19.0％,756례)、28.6％(25.4％,1026례)화44.5％(40.6％,1599례);3충표준진단위MS자중존재3개급이상위험인소취집적비례분별위97.5％(737례)、98.4％(1010례)화100.0％(1599례);CDS여JIS、JCDCG여JIS、JCDCG여CDS량량간적일치솔(Kappa치)분별위74.8％(0.46,2688례)、82.1％(0.63,2950례)화87.8％(0.68,3153례).이JIS위삼조표준,회제ROC곡선,CDS적곡선하면적위0.719,JCDCG적곡선하면적위0.802.결론 광동성18세급이상거민MS환병솔이경체도교고수평,건의가강MS고위인군적종합방치력도.삼충MS진단표준중,JIS표준진단MS적환병솔、령민도화위험인소취집적검출솔최고.
Objective To investigate the prevalence of metabolic syndrome(MS) among residents who are more than 18 years old in Guangdong province and to compare the differences of the three diagnostic criteria used for MS.The three diagnostic criteria were from Chinese Medical Association Diabetes Branch (CDS),Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG) and international Joint Interim Statement (JIS).Methods Using multi-stage stratified cluster sampling method,3591 inhabitants who were more than 18 years old and from 6 counties in Guangdong Province were enrolled.Questionnaire survey,medical examination and biochemical analyses were conducted in the residents.Data analyses of two groups were performed using t test.Comparision of rate were used by X2 test.Results According to the three definitions (CDS,JCDCG and JIS),the prevalence (standardized prevalence rate) of MS was 21.1％ (756 cases,19.0％),28.6％ (1026 case,25.4％) and 44.5％ (1599 cases,40.6％),respectively.The prevalence rate of subjects who had at least 3 risk factors among all the subjects with MS was 97.5％ (737 cases),98.4％ (1010 cases) and 100.0％ (1599 cases),espectively.The agreement rate (Kappa index) between CDS and JIS,JCDCG and JIS,JCDCG and CDS was 74.8％ (2688 cases,0.46),82.1％ (2950 cases,0.63) and 87.8％ (3153 cases,0.68),respectively.The area under receiver operator characteristic (ROC) curve was 0.719 for CDS and 0.802 for JCDCG when JIS was used as the reference.Conclusion The prevalence of MS has been in a high level among residents who are more than 18 years old in Guangdong province,the strengthen measures should be taken to prevent the people with higher MS risk.JIS definition can screen out the highest prevalence,sensitivity of MS and risk factors aggregation among three definitions.