文献类型：期刊文献

中文题名：高血压患者不同代谢综合征诊断标准比较

英文题名：Comparison on metabolic syndrome diagnosis with different criteria among hypertension patients

作者：张磊[1];李永春[2];王馨[3];王增武[3];张慧英[4];胡继宏[5,6]

第一作者：张磊

机构：[1]兰州大学第二临床医学院,甘肃兰州730000;[2]兰州大学第一临床医学院;[3]北京阜外心血管病医院心血管病防治中心;[4]宁夏医科大学公共卫生学院预防医学教研室;[5]宁夏医科大学公共卫生学院流行病与卫生统计教研室;[6]甘肃中医学院基础课部预防医学教研室

第一机构：兰州大学第二临床医学院,甘肃兰州730000

年份：2013

卷号：29

期号：11

起止页码：1596

中文期刊名：中国公共卫生

外文期刊名：Chinese Journal of Public Health

收录：CSTPCD;;北大核心:【北大核心2011】；CSCD:【CSCD_E2013_2014】；

基金：卫生部行业基金项目(200902001)

语种：中文

中文关键词：代谢综合征(MS);高血压患者;诊断标准

外文关键词：metabolic syndrome ; hypertension patient; diagnostic criteria

摘要：目的比较美国国家胆固醇教育计划成人组第三次报告(NECP/ATPⅢ)、国际糖尿病联盟(IDF)以及中华医学会糖尿病学分会(CDS)代谢综合征(MS)诊断标准在高血压患者中应用的异同。方法采用整群随机抽样方法对在宁夏回族自治区银川市24家社区卫生服务站抽取的2 994例高血压患者分别应用NECP/ATPⅢ、IDF和CDS标准进行MS的诊断,比较MS的检出率及诊断的一致性,并分析不同性别、年龄及代谢异常构成的分布特点。结果高血压患者采用NECP/ATPⅢ、IDF和CDS诊断标准MS的检出率分别为37.4%、47.0%、38.6%,3种诊断标准MS检出率两两比较差异均有统计学意义(P<0.001);CDS诊断标准男性MS的检出率(42.1%)高于女性(36.4%),NECP/ATPⅢ和IDF诊断标准男性MS的检出率(25.8%和39.9%)均低于女性(44.6%和51.5%),差异均有统计学意义(P<0.001);高血压患者3种诊断标准MS的检出率均随着年龄增长而呈增高趋势(P<0.05);NECP/ATPⅢ和CDS诊断标准一致性最高(Kappa=0.514,P<0.001);NECP/ATPⅢ、IDF和CDS诊断标准在高血压伴1种代谢异常中高血压伴血脂异常检出率均最高,分别为46.5%、23.9%、22.2%,在高血压伴2种代谢异常中高血压伴肥胖和血脂异常检出率最高,分别为11.2%、34.3%、25.3%,在高血压伴肥胖、血脂异常和糖尿病3种代谢异常中检出率分别为2.5%、11.1%、5.4%。结论高血压患者中MS普遍存在;IDF诊断标准在高血压患者中MS的检出率相对较高。
Objective To compare different criteria established by National Cholesterol Education Program＇s Adult Treatment Panel Ⅲ（NCEP/ATP Ⅲ）,International Diabetes Federation（IDF）,and Chinese Diabetes Society（CDS） for diagnosis of metabolic syndrome（MS） among hypertension patients.Methods Totally 2 994 hypertention patients were recruited from 24 communities in Yinchuan city,Ningxia Hui Autonomous Region with cluster random sampling.The prevalences of MS diagnosed with the 3 crieria were analyzed.Results The overall prevalence of MS was 37.4%,47.0%,and 38.6% according to NCEP/ATP Ⅲ,IDF,and CDS criteria,respectively（ATP vs CDS：=454.19,ATP vs IDF：=457.99,IDF vs CDS：=793.07,P〈0.001 for all） among the patients.In contrast to CDS definition,the prevalence of MS in males diagnosed with NCEP/ATP Ⅲ and IDF was significantly lower than those in females（P〈0.001）.The prevalence of the MS was higher in men（42.1%） than in women（36.4%） using CDS definition but this gender difference was reversed when using the NCEP/ATP Ⅲ（25.8% for males vs 44.6% for females） and the IDF（39.9% for males vs 51.5% for females） criteria.Different criteria resulted in the same increased prevalence of MS with age（P〈0.05）.Consistency in MS diagnosis with NCEP/ATP Ⅲ and CDS was higher in the patients of different gender and age（Kappa=0.514,P〈0.001）.In the hypertension patients with one metabolic disorder,the comorbidity rate of hypertension with dyslipidemia was the highest based on the criteria of NECP/ATP Ⅲ（46.5%）,IDF（23.9%）,and CDS（22.2%）.In the hypertension patients with two metabolic disorders,the comorbidity rate of hypertension with obesity and dyslipidemia was the highest based on the 3 different criteria（11.2% for NECP/ATP Ⅲ,34.3% for IDF,and 25.3% for CDS）.The comorbidity rates of hypertension with obesity,dyslipidemia and diabetes mellitus based on NCEP/ATP Ⅲ,IDF and CDS criteria were 2.5%,11.1% and 5.4%,respectively.Conclusion The MS is highly prevalent among hypertension patients.Compared with NCEP/ATP Ⅲ and CDS criteria,the diagnostic rate of MS by IDF criteria is higher.