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청소년에서 인슐린저항성, 아디포사이토카인, 심폐체력 및 운동 후 심박수 회복과의 연관성

The Association of Insulin Resistance, Adipocytokine, Cardiovascular Fitness and Heart Rate Recovery after Exercise in Adolescent

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[서론] 본 연구는 청소년에서 인슐린저항성, 아디포사이토카인, 심폐체력 및 운동 후 심박수 회복과의 연관성에 대한 것이다. [방법] 연구대상자는 C 지역 남자 중학생 30명이며, 이 중 연령별 체질량지수(BMI) 백분위수 95이상에 해당하는 비만군(n=15)과 정상군(n=15)으로 구분하여 신체계측, 혈압 측정, 혈액 검사 및 운동부하 검사를 실시하였다. [결과] 1. 인슐린(p<.05), 인슐린저항성(p<.05), 허리둘레(p<.001), 유리지방산(p<.05), 중성지방(p<.05), 수축기 혈압(p<.01) 및 이완기 혈압(p<.05)은 비만군이 정상군에 비해 유의하게 높게 나타났지만, 공복 혈당과 HDL-C는 집단 간 유의한 차이가 나타나지 않았다. 2. 렙틴(p<.01)과 CRP(p<.05)은 비만군이 정상군에 비해 유의하게 높게 나타났지만 IL-6과 TNF-α는 집단 간 유의한 차이가 나타나지 않았다. 3. VO2max는 비만군이 정상군에 비해 유의하게 낮게 나타났으며(p<.01), 운동 후 심박수 회복은 비만군이 정상군에 비해 유의하게 느리게 나타났다(p<.001). 4. 인슐린저항성은 BMI(p<.001), 체지방율(p<.001), 허리둘레(p<.01), 수축기 혈압(p<.05), 이완기 혈압(p<.01), 중성지방(p<.05), 인슐린(p<.001), 렙틴(p<.001), IL-6(p<.01) 및 CRP(p<.01)에서 유의한 양의 상관관계가 나타났으며 VO2max(p<.05)와 운동 후 심박수 회복(p<.05)간에는 유의한 음의 상관관계가 나타났다. 5. VO2max는 BMI(p<.001), 체지방율(p<.001), 허리둘레(p<.01), 수축기 혈압(p<.01), 이완기 혈압(p<.011), 공복 혈당(p<.05), 렙틴(p<.01), TNF-α(p<.05) 및 안정시 심박수(p<.05)에서 유의한 음의 상관관계가 나타났으며 운동 후 심박수 회복(p<.05)과는 유의한 양의 상관관계가 나타났다. 6. 운동 후 심박수 회복은 BMI(p<.001), 체지방율(p<.001), 허리둘레(p<.05), 수축기 혈압(p<.05), 이완기 혈압, (p<.01), 인슐린(p<.05) 및 렙틴(p<.05)에서 유의한 음의 상관관계가 나타났다. [결론] 청소년에서 인슐린저항성은 렙틴, IL-6과 CRP, 심폐체력 및 운동 후 심박수 회복 간에 연관이 있는 것으로 나타났다.

Abstract

[INTRODUCTION] The purpose of this study was to association of insulin resistance, adipocytokine, cardiovascular fitness and heart rate recovery after exercise in adolescent. [METHOD] The subjects were composed of obesity group(n=15), and normal group(n=15) in middle school. The body mass index(BMI), %fat, waist circumference(WC), insulin, systolic blood pressure(SBP), and diastolic blood pressure(DBP) were evaluated. The HOMA index were used as the insulin resistance, and insulin, fasting glucose, triglyceride(TG), HDL-C, adipocytokine(leptin, IL-6, TNF-α), C-reactive proteins(CRP) were measured. Exercise stress testing were performed according to the Bruce protocol. Heart Rate Recovery(HRR) were assessed by measuring the reduction of heart rate for 1 minutes after cessation of exercise. [RESULT] 1. The insulin(p<.05), HOMA-IR(p<.05), WC(p<.001), free fatty acids(p<.05), TG(p<.01), SBP(p<.01), and DBP(p<.05) were significantly increased in obesity group compared to normal group, however fasting glucose, HDL-C was not significant different between groups. 2. The leptin(p<.01), and CRP(p<.05) were significantly increased in obesity group compared to normal group, however IL-6 and, TNF-α was not significant different between groups. 3. The VO2max were significantly decreased in obesity group compared to normal group(p<.01) and HRR were significantly delayer in obesity group compared to normal group(p<.001). 4. In correlation analysis showed that the insulin resistance were positively correlated with BMI(p<.001), %fat(p<.001), WC(p<.01), TG(p<.05), SBP(p<.05), DBP(p<.01), insulin(p<.001), leptin(p<.001), IL-6(p<.01), CRP(p<.01), and positively correlated with VO2max(p<.05), HRR(p<.05). 5. In correlation analysis showed that the VO2max were negatively correlated with BMI(p<.001), %fat(p<.01), WC(p<.01), SBP(p<.01), DBP(p<.001) fasting glucose(p<.05), leptin(p<.01), TNF-a(p<.05), resting heart rate(p<.05), and positively correlated with HRR(p<.05). 6. In correlation analysis showed that the HRR were negatively correlated with BMI(p<.001), %fat(p<.01), WC(p<.05), SBP(p<.05), DBP(p<.01), insulin(p<.05), and leptin(p<.05). [CONCLUSION] Insulin resistance was significantly associated with leptin, CRP, cardiovascular fitness and HRR in adolescent.

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