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골다공증-근감소성 비만 고령여성의 기능체력과 등속성 근기능 특성 및 아이리신과 아디포카인, 골대사지표의 관련성 분석

Osteosarcopenic obesity is associated with reduced functional fitness, isokinetic muscle strength and relationships among irisin, adipokines and bone metabolism markers in elderly women

김성우|서명원|송종국|정성우
국민체육진흥공단 한국스포츠과학원 (Korea Institute of Sport Science)|2017.06|체육과학연구 (Korean Journal of Sport Science)|제28권 제2호|pp. 285-299|DOI 10.24985/kjss.2017.28.2.285

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참고문헌

키워드

Elderly women고령여성Osteosarcopenic obesity아이리신Irisin골대사지표골다공증-근감소성 비만아디포카인AdipokinesBone metabolism markers
주제분류체육

초록

[목적] 본 연구는 골다공증-근감소성 비만(Osteosarcopenic obesity; OSO) 고령여성의 생리적 특성, 기능체력, 등속성 근기능 특성을 분석하고, OSO집단의 아이리신과 아디포카인, 골대사지표의 관련성을 조사하는 것이다. [방법] 본 연구는 60세 이상 고령여성 126명을 대상으로 골다공증, 근감소증, 비만의 기준으로 3가지 표현형을 모두 가진 고령여성 10명(OSO집단: 76.9±5.2 yrs)과 3가지 표현형을 모두 가지지 않는 고령여성 14명(NOSO집단: 72.9±5.6 yrs)으로 구분하여 체격, 신체구성과 골밀도(Hologic, QDR- 4500W, USA), 기능체력(Senior fitness test), 등속성 근력(Cybex 770, USA), 영양소 섭취량(CAN-Pro, version 4.0, Korea), 신체활동량(IPAQ)을 측정·분석하였다. 생화학적 변인으로는 아이리신(Irisin), FNDC5, 렙틴(Leptin), 아디포넥틴(Adiponectin)과 골대사지표(Osteocalcin, CTx, 25(OH)D, PTH)를 비교·분석 하였다. 집단 간 차이를 규명하기 위하여 독립 t-검증을 실시하였으며 OSO집단의 Irisin 수준에 영향을 미치는 생화학적 변인을 분석하기 위하여 stepwise 다중회귀분석을 실시하였다. [결과] 신장은 OSO집단이 유의하게 낮게 나타난 반면, 허리둘레, 엉덩이둘레, 허리-엉덩이 비율(WHR), 체질량지수(BMI)는 NOSO집단보다 유의하게 높게 나타났다. 지방조직과 체지방률에서는 OSO집단이 NOSO집단보다 유의하게 높았으며 요추 골무기질량과 골밀도에서는 NOSO집단보다 유의하게 낮았다. 기능체력은 악력과 2-min step test에서 OSO집단이 NOSO집단보다 유의하게 낮았다. 등속성 근력은 60°/sec에서 최대근력은 좌·우측 굴곡근에서 OSO집단이 유의하게 낮았으며, 체중 당 최대근력과 평균파워는 우측 굴곡근, 좌측 신전근, 좌측 굴곡근에서 유의하게 낮게 나타났다. 180°/sec에서 최대근력, 체중 당 최대근력, 총 일량 모두 좌측 굴곡근에서 OSO집단이 유의하게 낮게 나타났다. 영양소 섭취량에서는 단백질섭취량이 OSO집단이 NOSO집단보다 유의하게 낮았으며 신체활동량은 OSO집단에서 낮은 경향을 보였다. 렙틴의 경우 OSO집단이 NOSO집단보다 유의하게 높게 나타났으며 OSO집단의 Irisin 수준에 영향을 미치는 생화학적 변인으로는 Adiponectin, FNDC5, Osteocalcin이 유의하게 영향을 미치는 것으로 나타났다. [결론] 결론적으로 OSO집단이 대사증후군, 노화, 골절 등 위험에 더 노출되어 있는 것으로 판단되며, non dominant leg의 대퇴사두근과 대퇴이두근의 불균형으로 인한 낙상위험 증가와 일상생활과 관련된 기능체력, 이동성에 제한이 있는 것으로 사료된다. 향후 OSO의 특징을 더 명확히 규명하기 위한 cohort 연구와 운동프로그램 적용을 통한 종단연구가 진행되어야 할 것으

Abstract

[Purpose] The purpose of this study were to assess physiological and biochemical characteristics in elderly women with osteosarcopenic obesity (OSO), and to analyze relationships among irisin, adipokines and bone metabolism markers. [Methods] 126 elderly women were selected and among them 10 women were classified into OSO group (76.9±5.2 yrs) and 14 women were classified as a NOSO group (72.9±5.6 yrs). Physique, body composition and bone mineral density were measured. Senior fitness tests were 30-s chair stand, 30-s arm curl, chair sit-and-reach, back scratch, 8-foot up-and-go, grip strength, and 2-min step test. Isokinetic muscle strength was measured by isokinetic dynamometer (Cybex 770, USA). Nutrition intake and physical activity were administered. Biochemical parameters including irisin, FNDC-5, leptin, adiponectin, CTx, 25(OH)D, osteocalcin, and PTH were measured. All data were analyzed by SAS 9.4. Independent t-test was applied to compare between OSO and NOSO groups. Multiple regression analysis was used. The level of significance was set at .05. [Results] The results of the study showed that there were significantly high for waist circumference, hip circumference, WHR, and BMI in OSO group compared to those of NOSO group. Higher results were also obtained for fat tissue and percent body fat but significantly low for lumbar bone mineral density. OSO group showed significant lower results for grip strength and 2-min step test compared to NOSO group. Peak torque, and relative peak torque at 60° were significantly lower for left and right knee flexion in OSO group. Protein intake was significantly low in OSO group, but no difference was obtained in level of physical activity between two groups. Irisin was significantly related to adiponectin, FNDC-5 and osteocalcin in explaining 35.2%, 81.5% and 92.1% of the variance, respectively. [Conclusions] This study shows that elderly women with OSO have higher results for physique and body composition parameters except body height. However, lower values were obtained for functional fitness, and isokinetic muscle strength. OSO may have more risks for metabolic syndrome, bone fractures, fall, lack of daily physical activity and limit of locomotion due to the imbalance of quadriceps and biceps femoris in non dominant leg. This study suggests that criteria and mechanism of OSO should be clarified by follow-up study.

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