OBJECTIVETo compare and evaluate clinical applications of two definitions of metabolic syndrome in children and adolescents, which was developed by Pediatric Academy of Chinese Medical Association in 2012 (Chinese definition) and by International Diabetes Federation in 2007 (IDF definition), respectively.

METHODS593 obese children and adolescents aged 10 ≊16 y from July 2006 to December 2012 were enrolled in the study. The diagnostic concordance of two definitions for metabolic syndrome and individual components was estimated, and their sensitivity and specificity for detecting insulin resistance and early macrovascular complications were compared.

RESULTSThe concordance between two definitions for diagnosing metabolic syndrome was good (kappa=0.626); as for detecting the individual components, the Kappa concordance index were 1.000, 0.803, 0.780, 0.734 and 0.594 for hypertriglyceridemia, hyperglycemia, cholesterol abnormality and hypertension, respectively. The incidence of insulin resistance and early macrovascular complications, detected by the two definitions, were both increased with increasing number of abnormal components. The sensitivity and specificity for detecting insulin resistance in children with metabolic syndrome were 54.5% and 65.7% by Chinese definition, and 36.1% and 83.1% by IDF definition; while the sensitivity and specificity for detecting early macrovascular complications were 58.3% and 55.8% by Chinese definition, and 37.3% and 70.8% by IDF definition. After adjusting for age and sex, compared to the obese children and adolescents without metabolic syndrome, the odds ratios of insulin resistance and early macrovascular complications were 2.166 (P<0.001) and 1.771(P=0.008) for children with metabolic syndrome diagnosed by Chinese definition, and the odds ratio of insulin resistance and early macrovascular complications were 2.618 (P<0.001) and 1.357 (P=0.190) by IDF definition.

CONCLUSIONThe concordance between Chinese and IDF definitions for diagnosing metabolic syndrome in Chinese obese children and adolescents is good. Compared to IDF definition, Chinese definition is more sensitive for hypertension, hyperglycemia and hypercholesterolemia, thus it can more effectively detect insulin resistance and early macrovascular complication.

Adolescent ; Child ; Female ; Humans ; Insulin Resistance ; Male ; Metabolic Syndrome ; classification ; complications ; diagnosis ; Obesity ; complications ; Sensitivity and Specificity

Objective:To explore the effects of health education based on reinforcement theory combined with empowerment theory in patients with chronic obstructive pulmonary disease (COPD) .Methods:From January 2018 to January 2021, convenience sampling was used to select 80 COPD patients admitted to the Respiratory Department of Lishui Hospital of Traditional Chinese Medicine as the subject. Patients were randomly divided into a control group and an observation group with 40 cases each in a 1∶1 ratio using the random number table. The control group received routine health education and psychological intervention, while the observation group was treated with health education based on reinforcement theory combined with empowerment theory. The pulmonary rehabilitation compliance, Short Form of the Profile of Mood States (POMS-SF) and Health-Promoting Lifestyle Profile (HPLP) scores before and after intervention were compared between two groups.Results:After intervention, the total score and all dimension scores of pulmonary rehabilitation compliance in both groups were higher than those before intervention, and the observation group scored higher than the control group, with statistically significant differences ( P<0.05). After intervention, the energy-vitality scores of the two groups were higher than those before intervention, the observation group scored higher than the control group, and the scores of other dimensions were lower than those before intervention, the observation group scored lower than the control group, and the differences were statistically significant ( P<0.05). After intervention, the scores of HPLP in all dimensions in both groups were higher than those before intervention, and the observation group scored higher than the control group, with statistically significant differences ( P<0.05) . Conclusions:Health education based on reinforcement theory combined with empowerment theory for COPD patients can enhance their rehabilitation compliance, effectively improve their mental state, and promote the development of healthy behaviors.

Evoked Potentials ; Social Isolation ; Attention ; Humans