Prevalence And Comparison Of Different Diagnostic Criteria Of Metabolic Syndrome Among Adult Inhabitants In Jiangxi Province

Objective:To explore the prevalence status and its influential factors of metabolic syndrome(MS)of adult inhabitants in Jiangxi Province,compare the three MS diagnostic criteria and analyze their applicability,in order to provide practical reference for prevention and control of MS for adult inhabitants in Jiangxi Province.Methods:A total of 5997 inhabitants aged 18 and older from 10 disease surveillance points in Jiangxi Province were selected by multistage stratified cluster random sampling methods.The survey included questionnaire survey,physical examination and laboratory tests.We selected three criteria,i.e.,those of the International Diabetes Federation(IDF,2005),the National Cholesterol Education Program Adult Treatment PanelⅢ(ATPⅢ,2005),and the Chinese Diabetes Society(CDS,2004).The three criteria were calculated the prevalence rates of MS and its components of adult inhabitants in Jiangxi Province.It also included comparing the authenticity and consistency of the three.Using the ROC curve distance to explore the MS risk factors clusters situation by cut-points of adult waist circumference(WC)and body mass index(BMI)in Jiangxi Province.Result:(1)The crude(age-adjusted)prevalence rate of MS was 11.71%(9.95%)among adult inhabitants in Jiangxi Province.The crude(age-adjusted)prevalence rates of MS were 13.06%(12.31%)in male,10.78%(8.50%)in female.The prevalence rate of male was higher than that of women(P<0.050).There was an upward trend in the prevalence rate of MS as age increased(P<0.001).From the distribution of marital status,no matter male,female or the whole population,the prevalence rate of MS was the highest among separation/divorce/widowed,followed by married/cohabitation and unmarried,this difference was statistically significant(P<0.050).In the whole population,there was a statistically significant difference in the prevalence rate of MS between static behavioral time(P=0.018),and the highest prevalence rate of MS was(12.67%)at 3~5 hours per day in static behavior time.(2)The detection rates of overweight or obese,hyperglycemia,hypertension and dyslipidemia were 28.28%,22.59%,27.79%and 25.57%respectively.The prevalence rates of different components in male were higher than those in the female(P<0.050).The prevalence rates of hypertension in rural population were higher than those in the urban population(P<0.050).(3)Multiple logistic stepwise regression analysis showed that the MS risk factors were age more than 45 years,marital status was married/cohabitation/separation/divorce/widowed and static behavioral time was more than 3-hour per day,and the protective factor was female.(4)The standardized prevalence rate of MS was 19.85%,24.77%and 9.95%according to the IDF,ATPⅢ(2005)and CDS criteria,respectively.The order of the prevalence rates of the different components of MS according to the IDF and ATPⅢ(2005)criteria from high to low were as follows:hypertension>central obesity>reduced high-density lipoprotein cholesterol(HDL-C)>hyperglycemia>elevated triglyceride(TG).Beside,using the CDS criterion,the prevalence rates of different components were:overweight or obesity>hypertension>dyslipidemia>hyperglycemia.(5)The results showed the IDF criterion sensitivity was 79.40%(male 69.36%,female 85.94%)and the specificity was 99.98%(male 100%,female 99.96%)in the diagnosis of MS,and the CDS criterion sensitivity was 38.86%(male 48.48%,female33.55%),the specificity was 98.86%(male 98.28%,female 99.30%)in the diagnosis of MS referring to the ATPⅢ(2005)criterion.The Youden’s index in IDF criterion was higher than which in CDS criterion(0.79 for IDF vs.0.38 for CDS).The highest consistency rate was between the IDF and ATPⅢ(2005)criteria(94.21%),followed by the IDF and CDS criteria(84.51%)and the ATPⅢ(2005)and CDS criteria(82.04%),and the kappa values was 0.85,0.46 and 0.46,respectively.(6)Compliance with at least three conditions in the ATP Ⅲ(2005)criterion was MS risk factor aggregation.Considering Jiangxi Province inhabitants(male/female),the ability of predicting MS risk factors clusters was superior when the cut-off point was 24/24kg/m~2 using BMI indicator,otherwise when the cut-off point was 87/80cm using WC indicator.The male population who using the obesity index of CDS criterion was more conducive to predict of MS risk factor aggregation,while the obesity index of IDF criterion was more suitable for prediction of MS risk factor aggregation in female.Among the 18~59 years old male group,BMI was superior to WC in predicting clusters of risk factors for MS;while in the 60 years and above male group and all-age female group,WC was superior to BMI.Conclusion:(1)There was a high prevalence rate of MS in the adult inhabitants of Jiangxi Province.The influential factors of MS were gender,age,marital status and static behavioral time.It was suggested that the government departments should pay more attention and move forward the MS prevention and control gateway,vigorously advocate a healthy lifestyle,so as to reduce the incidence and mortality of MS and cardiovascular disease.(2)Considering Jiangxi Province inhabitants(male/female),the ability of predicting MS risk factors clusters was superior when the cut-off point was24/24kg/m~2 using BMI indicator,otherwise when the cut-off point was 87/80cm using WC indicator.WC was superior to BMI in the identification of MS.Obesity indicators of different criteria had different ability to predict clusters of risk factors for MS in different gender and age groups.(3)The applicability of the three criteria of IDF,ATPⅢ(2005)and CDS was different.The choice of the appropriate criteria should be based on the purpose of work,actual conditions of the site and characteristics of the study object.