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目的调查天津市公安民警代谢综合征(MS)患病率,探讨和比较4种MS诊断标准用于该人群MS诊断时其患病率一致性和应用差异。方法以2007年3月～2008年3月在天津市公安医院接受健康体检的10944名公安民警(男性9886例,女性1058例)为研究对象,分别应用ATPⅢ、修订的NCEP-ATPⅢ、CDS和IDF4种MS标准诊断MS,比较其患病率和一致性。结果经IDF、CDS、ATPⅢ和修订的NCEP-ATPⅢ标准诊断的MS年龄标化患病率分别为18.60%,10.57%,9.97%和20.31%。4种诊断标准检出的男性MS患病率高于女性(P<0.001)。男女MS患病率均不表现为增龄趋势。CDS标准对MS各异常组分检出率均较高,应用IDF标准诊断为非MS人群中,12.4%的个体有3个以上危险因素聚集。4种诊断标准合并的一致率为79.36%,其中修订的NCEP-ATPⅢ与IDF标准的一致率最高(κ=0.94)。结论4种诊断标准诊断的公安民警MS患病率明显偏高,55～65岁男性人群与65～75岁女性人群为MS高危人群,CDS标准较适合公安民警人群,CDS标准中肥胖判定建议采用腰围指标,且空腹血糖切点值宜降至5.6mmol/L。IDF与修订的NCEP-ATPⅢ标准一致性最好。
Objective To investigate the prevalence of metabolic syndrome (MS) in public security police in Tianjin and to explore and compare the diagnostic criteria of four kinds of MS for the consistency and application of MS prevalence in this population. Methods From October 2007 to March 2008, 10944 public security police (9886 males and 1058 females) were enrolled in the Tianjin Public Security Hospital. The subjects were treated with ATP Ⅲ, modified NCEP-ATP Ⅲ, CDS and IDF4 MS standard diagnostic MS, compared with the prevalence and consistency. Results The standardized age of MS diagnosed by IDF, CDS, ATP Ⅲ and revised NCEP-ATP Ⅲ standard were 18.60%, 10.57%, 9.97% and 20.31% respectively. The prevalence of MS among the four diagnostic criteria was higher in men than in women (P <0.001). The prevalence of MS in both men and women did not show an increasing trend. CDS standard detection rate of MS abnormalities were high, using IDF standard diagnosis of non-MS population, 12.4% of individuals with more than three risk factors. The concordance rates of the four diagnostic criteria were 79.36%, of which the revised NCEP-ATPⅢ and IDF standards had the highest agreement (κ = 0.94). Conclusions The prevalence of MS in public security police diagnosed by four diagnostic criteria is obviously higher. The 55-65-year-old male population and the 65-75-year-old female population are MS high-risk population. The CDS standard is more suitable for police civil police population. Waist circumference index, and point of fasting blood glucose cut point should be reduced to 5.6mmol / L. IDF and the revised NCEP-ATP Ⅲ standard the best consistency.