Abstract:

Objective To investigate the epidemiological characteristics of metabolic syndrome(MS)in adults of Jiangsu Province and compare the consistency and difference of the five diagnostic criteria for MS, and to explore the optimum cut-off points of waist circumference or body mass index(BMI)for forecasting other components and risk factors aggregation of MS in adults of Jiangsu Province. Methods A total of 8 400 residents aged 18 and older from Jiangsu Province were selected by multistage cluster randomly sampling method in 2010.Medical examination and face to face questionnaire survey were conducted to collect the health information for respondents.The prevalence and epidemiological characteristics of MS were calculated and described, diagnosed according to five diagnostic criteria, issued by the Chinese Medical Association Diabetes Branch(CDS)in 2004, Adult Treatment Panel Ⅲ of National Cholesterol Education Program(NCEP-ATP Ⅲ)in 2005, International Diabetes Federation(IDF)in 2005, Joint committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults(JCDDCG)in 2007 and International Joint Interim Statement(JIS)in 2009, respectively.The distribution of MS components and risk factors aggregation were analyzed, and the agreement rate and Kappa values of different diagnostic criteria were calculated to compare the consistency and difference of the five diagnostic criteria.Receiver operating characteristic(ROC)curve was conducted to forecast other components and risk factors aggregation of MS with cut-off points of waist circumference or BMI. Results The crude prevalence(standardized prevalence rate)of MS in the respondents was respectively 18.4%(15.1%)for CDS criterion, 37.3%(31.0%) for ATPⅢ criterion, 29.5%(24.6%)for IDF criterion, 22.8%(19.4%)for JCDCG criterion and 38.9%(32.7%)for JIS criterion.There were statistically significant differences of the distribution of the prevalence of MS diagnosed by different criteria between different sex, age, education level, occupation, parents in hypertension and diabetes group(P<0.05).The proportions of at least three risk factors among the subjects with MS diagnosed by CDS, ATPⅢ, IDF, JCDCG and JIS criteria were respectively 97.2%, 96.7%, 97.2%, 98.7% and 100%. The agreement rates(Kappa value) were respectively 95.93%(0.91), 91.91%(0.82)and 88.89%(0.76) between ATP Ⅲ and JIS, ATP Ⅲ and IDF, IDF and JIS.The agreement rate and Kappa value of other pairs were among 78%-82% and 0.40-0.74, respectively.The sensitivity, specificity and shortest distance of receiver operating characteristic(ROC)curve for forecasting risk factors aggregation of MS were respectively 88.29%, 74.54%, 0.28 in male and 85.97%, 70.07%, 0.33 in female when waist circumference was 85 cm in male and 80 cm in female. Conclusion The prevalence of MS is higher in the adults of Jiangsu Province.Among the five diagnostic criteria for MS, there is bigger difference in applicability for the adults of Jiangsu and a best consistency between the ATPⅢ and JIS.The optimum cut-off points of waist circumference for the adults in Jiangsu Province are respectively 85 cm for male and 80 cm for female.

Key words: metabolic syndrome, diagnostic criteria, prevalence rate, consistency, surveillance