不同诊断标准下北京市成人代谢综合征患病率

目的了解不同诊断标准下北京市成人代谢综合征（MS）流行状况，比较不同诊断标准MS的患病率并进行一致性检验。方法采用分层整群随机抽样方法对16711名年龄18岁以上北京市常住居民进行问卷调查、体格检查和实验室检查。利用中华医学会糖尿病学分会诊断标准（CDS）、国际糖尿病联盟诊断标准（IDF）、美国国家胆固醇项目专家组诊断标准（ATPⅢ）分别计算MS的患病率，并将结果进行比较和一致性检验。结果根据CDS、IDF、ATPⅢ三种诊断标准，北京市成人MS标化患病率分别为12．7％、24．0o,4和15．3％。无论以何种诊断标准，MS患病率均呈现随年龄增加而逐步增加的趋势（P=0．000）。通过对分别用CDS、IDF、ATPⅢ诊断的患者进行比较分析，分别有83．0％和89．9％患者相一致。Kappa检验显示三种指标的符合率较高，Kappa系数分别为0．510（CDS和IDF）和0．634（CDS和ATPⅢ）。结论北京市代谢综合征患病率高于国内平均水平。三种代谢综合征诊断标准均可用于中国人群，但是其适用性及价值的评价需在前瞻及随访研究中进一步证实。

Comparison of the prevalence of metabolic syndrome under different definitions in Beijing adults

Objective To compare the prevalences of metabolic syndrome under different definitions and find the appropriate diagnostic definition for Chinese adults. Methods 16711 residents aged〉 18 years were selected by multiple-stages and random cluster sampling among 18 districts and interviewed with questionnaire, physician check and laboratory test. The different prevalences under CDS, IDF, and ATPⅢ definitions respectively were calculated and the results were compared by Kappa test. Results The adjusted prevalences of metabolic syndrome under CDS, IDF, and ATPⅢ definitions were 12. 7%, 24.0% and 15.3% respectively. All definitions showed the prevalence of metabolic syndrome was increased with age （P=0. 000）. The 83.0% concordance of metabolic syndrome cases was found between CDS and IDF definitions, and 89.9% between CDS and ATPⅢ. Kappa test showed that the agreement among three definitions was high with Kappa coefficient of 0. 510 between CDS and IDF, and 0. 634 between CDS and ATPⅢ. Conclusions The prevalence of metabolic syndrome in Beijing adults is higher than the average prevalence in China. All the three definitions can be used for Chinese, the evaluation is still needed in future by cohort study and follow up study.