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복부지방축적에 따른 남자 비만청소년의 골밀도, 아디포사이토카인과 골대사지표의 관계

Relationship of Abdominal Fat, Adipocytokine, Bone Mineral Density, and Bone Turnover Markers in Obese Male Adolescents

송종국|정현철
국민체육진흥공단 한국스포츠과학원 (Korea Institute of Sport Science)|2014.06|체육과학연구 (Korean Journal of Sport Science)|제25권 제2호|pp. 238-248|DOI 10.24985/kjss.2014.25.2.238

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참고문헌

키워드

골밀도복부지방BMD아디포사이토카인Adipocytokine골대사지표비만청소년Obese AdolescentAbdominal FatBone Turnover Marker
주제분류체육

초록

이 연구의 목적은 복부지방 축적에 따른 남자 비만청소년의 골밀도, 아디포사이토카인 및 골대사지표의 관계를 규명하는 것이다. 연구대상자는 12~14세 남자 청소년으로 총 24명(비만청소년:12명, 일반청소년:12명)이었다. 신장과 체중을 측정하였고, TW3 방법을 적용하여 뼈나이를 산출하였다. 신체구성과 골밀도 4부위는 DXA(Hologic, QDR- 4500W, USA)를 이용하여 분석하였다. 복부지방조직은 CT(ECLOS, Hitachi, Japan)를 이용하여 요추 4~5번 사이를 10 mm 간격으로 촬영하였으며, 총 복부지방조직(TAT), 내장지방조직(VAT), 피하지방조직(SAT), 그리고 내장지방 대 피하지방조직비(VSR)를 산출하였다. 아디포사이토카인으로 렙틴(leptin)과 아디포넥틴(adiponectin)을 분석하였고, 골대사지표는 골형성지표인 osteocalcin(OC)과 bone-specific alkaline phosphatase(BALP), 그리고 골흡수지표인 C-terminal telopeptide(CTx), N-terminal telopeptide(NTx)를 분석하였다. 복부지방 축적에 따른 그룹 간 차이를 규명하기 위하여 독립 t-검증을 적용하였고, 피어슨 상관관계수를 이용하여 종속변인들 간의 관계를 분석하였다. 또한, 다중회기분석을 통하여 복부지방조직과 골밀도의 관계를 분석하였다. 연구 결과 비만청소년은 일반청소년보다 지방조직(p<.001), 체지방률(p<.001), 총 복부지방조직(p<.001), 내장지방조직(p<.001)과 피하지방조직(p<.001)이 높게 나타났으나, 골무기질량(p<.01)은 일반청소년이 유의하게 높게 나타났다. 전신골밀도(p<.001)와 요추골밀도(p<.01)는 일반청소년이 비만청소년보다 유의하게 높게 나타났으나, 대퇴골밀도와 전완골밀도에서는 유의한 차이가 나타나지 않았다. 복부지방조직은 전신골밀도, 요추골밀도와 부적상관을 보였으며, 렙틴은 골밀도와 부적상관을 보인 반면, 아디포넥틴은 골밀도와 정적상관을 보였다. 골흡수지표인 NTx는 복부지방조직과 정적상관을 보였다. 또한 내장지방조직은 전신골밀도와 요추골밀도의 부정적인 예견인자로 나타났다. 결론적으로 남자 비만청소년은 일반청소년에 비해 낮은 전신골밀도와 요추골밀도를 보였으며, 총 복부지방조직, 내장지방조직, 및 피하지방조직과 부적상관을 보였다. 또한 렙틴과 아디포넥틴은 골밀도와 밀접한 관련이 있는 것으로 나타났으며, 내장지방조직은 청소년의 전신골밀도와 요추골밀도를 설명하는 부정적인 예견인자로 나타났다. 추후 연구에서는 비만청소년들의 복부지방축적의 패턴을 규명하고, 운동을 통한 복부지방조직과 골대사지표의 변화를 살펴보기 위한 후속연구가 필요할 것으로 사료된다.

Abstract

The purpose of the study was to determine relationship of abdominal fat, adipocytokine, bone mineral density, and bone turnover markers in obese male adolescents. Twenty four male adolescents (obese: 12, normal: 12) volunteered to participate in the study. Anthropometry and skeletal maturity were measured. Body composition and bone mineral density were estimated by DXA (Hologic, QDR-4500, USA). Abdominal fat with total adipose tissue (TAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and visceral adipose tissue to subcutaneous adipose tissue ratio (VSR) were estimated by computed tomography (ECLOS, HITACH, Japan). Blood samples were obtained for and analysis of adipocytokines including leptin and adiponectin. Bone turnover markers, osteocalcin (OC), bone-specific alkaline phosphatase (BALP) for bone formation markers and N-terminal telopeptide (NTx), C-terminal telopeptide (CTx) for bone resorption markers were analysed. All data were analyzed utilizing SAS 9.3 (SAS Institute, NC, USA). Independent t-test was used to evaluate the differences between obese adolescents and normal adolescents. Pearson correlation analysis was applied to figure out the relationship between abdominal fat, adipocytokines, bone mineral density, and bone turnover markers. Multiple regression analysis was used to find out the factors of abdominal fat which influence on bone mineral density. A level of significance was set at p<.05. The results of the study indicated that fat tissue (p<.001), percent body fat (p<0.001), TAT (p<.001), VAT (p<.001), and SAT (p<0.001) were significantly higher in obese adolescents than normal adolescents. However bone mineral contents were significantly higher in normal adolescents. Normal adolescents have significantly higher whole body BMD and lumber BMD than obese adolescents. Abdominal fat including VAT and SAT related negatively with whole body BMD and lumbar BMD. Leptin related negatively with BMD whereas adiponectin related positively with BMD. NTx for bone resorption marker related positively with abdominal fat. Visceral adipose tissue was a predictor for whole body BMD and lumbar BMD in explaining 46% and 32% in adolescents. In conclusion, obese male adolescents have lower whole body BMD and lumbar BMD than normal adolescents. Abdominal fat including VAT and SAT related negatively with whole body BMD and Lumbar BMD. And leptin and adiponectin were closely related with BMD. Finally, visceral adipose tissue was a predictor for whole body and lumbar BMD in adolescents.

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