한국인 여성에서 체성분과 혈청 지질 및 골밀도와의 상관관계
The Relationship between Body Composition, Serum Lipid Profile and Bone Mineral Density in Korean Women
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초록
목적: 본 연구는 국내 여성의 체성분을 측정하여 각 체성분의 변화와 혈청지질 및 골밀도와 어떤 상관관계가 있는지 파악하고자 하였다. 방법: 2005년 8월부터 2006년 3월까지 건국대학교병원 산부인과에 내원한 여성 중 당뇨, 갑상선 질환 혹은 대사성 골질환이 없으며 호르몬 대체 요법이나 지질 및 골대사에 영향을 미치는 약물을 복용한 기왕력이 없는 190명을 대상으로 하여 체성분분석기 InBody 3.0을 이용하여 체중(weight), 체질량지수(BMI), 체지방량(fat mass), 제지방량(fat free mass)을 측정하였으며, Hologic QDR 1500(USA) 이중 에너지 방사선 흡수계측법(DXA, dual energy X-ray absorptiometry)을 사용하여 요추, 대퇴골 경부의 골밀도를 측정하였다. 혈청 지질은 금식 후 약 5cc 채혈하여 총콜레스테롤, 중성지방, 저밀도 지단백콜레스테롤과 고밀도 지단백 콜레스테롤을 측정하였다. 결과: 190명의 여성을 연령에 따라 5개 군으로 나누었으며, 각 군은 각 군별 평균 체질량지수, 체지방지수, 제지방 지수에서 각 군별로 유의한 차이가 있었다. 혈중 지질에서 총 콜레스테롤, 중성지방, 저밀도 지단백 콜레스테롤에서 각 군별로 점차로 증가하였으며, 고밀도 지단백 콜레스테롤은 점차로 감소하였으며, 유의한 차이가 있었다. 골밀도에서 요추부, 대퇴골 경부의 골밀도 또한 나이가 듦에 따라 감소하여 유의한 차이를 보였다. Pearson상관관계에 의하면 혈중 지질은 체질량지수, 체지방지수, 제지방지수와 모두 연관성이 있지만 대퇴골 경부 골밀도는 체질량지수와 제지방지수와 상관관계가 있으며, 요추 골밀도는 제지방지수와 상관관계가 있었다. 결론: 연령에 따라 체질량지수, 체지방지수, 제지방지수 모두 혈중지질을 변화시킬 수 있으며, 체지방보다는 제지방이 골밀도 증가에 영향을 줄 수 있다. 이에 기초대사량과 신체활동을 증가시켜 체지방 감소와 제지방 증가로 인하여 골다공증과 심혈관질환 예방에 도움이 될 것으로 사료된다.
Abstract
Objectives: To assess the correlation of body composition with serum lipid profile and bone mineral density(BMD) in Korean women. Methods: Between August 2005 and March 2006, we retrospectively reviewed 190 women who did not take any drugs affecting lipid or bone metabolism. The women were classified into 5 groups according to age and menopausal state. We analyzed the relationship between body composition and serum lipid profile and BMD; differences were determined by ANOVA test, Pearson correlation, and multiple linear regression. Results: Body composition(i.e., BMI, fat mass, and lean body mass), BMD, and lipid profile were significantly different among the five groups. Based on multiple linear regression, age was a predictor of spine and femur neck BMD(P<0.001). Conclusion: Different levels of BMI and fat mass index with age can affect serum lipid levels. Lean body mass rather than fat mass can exert an effect on BMD. Therefore, we speculate that increased physical activity may have a positive effect in preventing osteoporosis and cardiovascular events by lowering body fat and increasing lean body mass.
참고문헌 (38)
- Ley CJ, "Sex-and menopause-associated changes in body-fat distribution", Am J Nutr, 55, pp.950~954 (1992)
- Florence AT, "Relative influence of age and menopause on total age and regional body composition changes in postmenopausal women", Am J Obstet Gynecol, 175, pp.1594~1600 (1996)
- Poehlman ET, "Menopause-associated changes in plasma lipids, insulin-like growth factor I and blood pressure: a longitudinal study", Eur J Clin Invest, 27, pp.322~326 (1997)
- Seeman E, "Sexual dimorphism in skeletal size, density and strength", J Clin Endocrinol Metab, 86, pp.4676~4684 (2001)
- 이성근, "체성분 분석", 대한비만학회지, 10, pp.261~270 (2001)
- Ferrara A, "Total, LDL, and HDL cholesterol decrease with age in older men and women. The Rancho Bernardo study 1984-1994", Circulation, 96, pp.37~43 (1994)
- Sattar N, "Associations of indices of adiposity with atherogenic lipoprotein subfractions", Int J obes, 22, pp.432~439 (1998)
- Eberle E, "Weight change and change of total cholesterol and high-densitylipoprotein cholesterol. Results of the MONICA Augsburg cohort study", Ann Epidemiol, 1, pp.487~492 (1991)
- Folsom AR, "Body mass, fat distribution and cardiovascular risk factors in a lean population of south China", J Clin Epidemiol, 47, pp.173~181 (1994)
- Nancy EL, "Epidemiology, etiology and diagnosis of osteoporosis", Am J Obstet Gynecol, 196, pp.S3~S11 (2006)
- Edelstein SL, "Relation between body size and bone mineral density in elderly men and women", Am J Epidemiol, 138, pp.160~169 (1993)
- Reid IR, "Determinants of total body and regional bone mineral density in normal postmenopausal women - a key role for fat mass", J Clin Endocrinol Metab, 75, pp.45~51 (1992)
- Blum M, "Leptin, body composition and bone mineral density in premenopausal women", Calcif Tissue Int, 73, pp.27~32 (2003)
- Kontogianni MD, "Blood leptin and adiponectin as possible mediators of the relation between fat mass and BMD in perimenopausal women", J Bone Miner Res, 19, pp.546~551 (2004)
- Douchi T, "Relationship Between Body Fat Distribution and Bone Mineral Density in Premenopausal Women", Obstet Gynecol, 95, pp.722~725 (2000)
- Douchi T, "Difference in the effect of adiposity on bone density between preand postmenopausal women", Maturitas, 34, pp.261~266 (2000)
- 송영득, "폐경기전후 여성에서 체지방량과 골밀도와의 관계", 대한내분비학회지, 3, pp.251~258 (1993)
- 남문석, "폐경전, 후 여성에서의 체조직분포와 골밀도의 상관성", 대한내분비학회지, 2, pp.180~186 (1993)
- Wang Q, "Total and regional body-composition changes in early postmenopausal women: age-related or menopause-related?", Am J Clin Nutr, 60, pp.843~848 (1994)
- Tremollieres FA, "Relative influence of age and menopause on total and regional body composition changes in postmenopausal women", Am J Obstet Gynecol, 175, pp.1594~1600 (1996)
- Panotopoulos G, "Menopause, fat and lean distribution in obese women", Maturitas, 25, pp.11~19 (1996)
- Ijuin H, "The contribution of menopause to changes in bodyfat distribution", J Obstet Gynaecol Res, 25, pp.367~372 (1999)
- Toth MJ, "Menopause-related changes in body fat distribution", Ann N Y Acad Sci, 904, pp.502~506 (2000)
- Schubert CM, "Lipids, lipoproteins, lifestyle, adiposity and fat-free mass during middle age: the Fels Longitudinal Study", Int J Obes, 30, pp.251~260 (2006)
- Drinkwater BL, "Menstrual history as a determinant of current boned density in young athletes", J Am Med Assoc, 263, pp.545~548 (1990)
- Reid IR, "Fat mass is an important determinant of whole body bone density in premenopausal women but not in men", J Clin Endocrionol Metab, 75, pp.779~782 (1992)
- Slemenda CW, "Bone mass and anthropometric measurements in adult females", Bone Miner, 11, pp.101~109 (1990)
- Compstone JW, "Body composition and bone mass in post-menopausal women", Clin Endocrinol, 37, pp.426~431 (1992)
- Sower MR, "Joint influence of fat and lean body composition compartment on femoral bone mineral density in premenopausal women", Am J Epidemiol, 136, pp.141~148 (1992)
- 신근우, "폐경기 여성에서 골다공증 유무에 따른 체성분 비교", 가정의학회지, 23(7), pp.12~940 (2002), 대한가정의학회
- Kannayiram A, "Cholesterol and osteoporosis in postmenopausal women: a pilot study", J Am Geriatr Soc, 51, pp.1510~1511 (2003)
- Yamaguchi T, "Plasma lipids and osteoporosis in postmenopausal women", Endocrine J, 49, pp.211~217 (2002)
- Andrea P, "Plasma low-density lipoprotein cholesterol and bone mass densitometry in postmenopausal women", Obstet Gynecol, 102, pp.922~926 (2003)
- Tanko LB, "Does serum cholesterol contribute to vertebral bone loss in postmenopausal women?", Bone, 32, pp.8~14 (2003)
- Wu LY, "Correlation between bone mineral density and plasma lipids in Taiwan", Endor Res, 29, pp.317~325 (2003)
- Zabaglia SF, "An exploratory study of the association between lipid profile and bone mineral density in menopausal women in a Campinas reference hospital", Cad Saude Publica, 14, pp.779~786 (1998)
- Parhami F, "Arterial calcification in face of osteoporosis in aging: can we blame oxidized lipids?", Curr Opin Lipidol, 8, pp.312~314 (1997)
- Parhami F, "Atherogenic diet and minimally oxidized low density lipoprotein inhibit osteogenic and promote adipogenic differentiation of marrow stromal cells", J Bone Miner Res, 14, pp.2067~2078 (1999)