중년 남성에 있어서 QTc interval과 국소 지방량 및 최대산소 섭취량과의 관련성
Relationships Between QTc Interval and VO2max and Body Fat Distribution in Middle-Aged Men
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이 연구의 목적은 중년 비만남성을 대상으로 QTc interval에 따른 신체조성, 혈액성분, 최대산소 섭취량(maximal oxygen consumption, VO2max)및 국소 지방량을 비교분석하여 관련성을 조사하는 것이다. 이 연구는 심장돌연사의 위험성과 관련한 비정상 QTc interval(≥440ms) 집단과 연령 및 체질량지수(body mass index, BMI)가 유사한 정상 QTc interval(≤430ms) 집단으로 배정하였다. 신체조성, 혈액성분, VO2max 및 컴퓨터 단층촬영(computerized tomography, 이하 CT)와 이중에너지 방사선 흡수 계측법(dual-energy x-ray absorptiometry, 이하 DEXA)에 의한 국소 지방량의 차이를 분석하였고, 전체 집단에서 QTc interval과 측정변인들 사이에 관련성을 평가하였다. 연구 결과 집단 간 수축기혈압(p<.05), 인슐린(p<.05), HOMA-IR(p<.05), VO2max(p<.05), 다리지방률(p<.05)에서 유의한 차이가 나타났다. 전체 집단에서 QTc interval은 BMI(r=.540, p=.011), 수축기혈압(r=.473, p=.030)와 유의한 관련을 나타냈다. 또한, QTc interval은 CT를 이용하여 측정한 총 지방면적(r=.497, p=.022) 및 복부내장 지방면적(r=.520, p=.014)과 유의한 상관을 나타내었으며 DEXA를 이용하여 측정한 다리지방률(r=.529, p=.014) 및 전신지방률(r=.450, p=.041)과도 유의한 관련성이 확인되었다. QTc interval과 VO2max 사이에도 유의한 상관(r=.614, p=.003)이 나타났으며 이는 BMI를 보정한 편 상관분석(r=.480, p=.032)에서도 관련성이 확인되었다. 이상의 결과를 종합해 볼 때 연장된 QTc interval은 정상 QTc interval을 가진 집단에 비해 내장지방축적과 인슐린 저항성 그리고 고혈압 요인들과 관련이 되어 있으며, 또한 최대유산소능력과도 밀접한 관련성을 가지는 것으로 나타났다. 차후에는 비만치료 및 유산소운동능력 향상에 초점을 둔 트레이닝을 통해 연장된 QTc interval의 변화를 파악하고 그 관련 변인을 탐색하는 것이 필요할 것으로 판단된다.
Abstract
The purpose of this study was to examine the relationship between QTc interval and maximal oxygen consumption(VO2max) and body fat distribution in middle-aged men. Abnormal subjects (QTc interval, ≥440ms, n=10) and normal subjects(≤430ms, n=11) using QTc interval based on the Bazzet's equation were involved in the study. After overnight fasting, blood and blood pressure were measured. Abdominal fat area and regional fat compartment were measured by computed tomography(CT) and dual-energy X-ray absorptiometry(DXA), respectively. For VO2max, the subjects underwent a maximal graded exercise test on a cycling ergometer. Abnormal group was significantly higher in SBP, basal insulin, HOMA-IR, and leg fat compared with normal. There was a significant relationship(r=.614, p=.03) between QTc interval and VO2max in all subjects. Also, partial correlation analysis showed a significant relationship(r=.480, p=.032) between the QTc interval and VO2max. Having a QTc interval outside normal range significantly worsened risk parameters for metabolic syndrome, in particular blood pressure and insulin resistance. Moreover, QTc interval was strongly correlated with cardiorespiratory fitness in middle-aged men. This study indicates that further study will be needed to assess the exercise training effects on QTc interval.
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