노인 여성의 근감소증과 비만에 따른 체력, 생활습관병 지표 및 근육의 생화학적 특성의 비교 분석
Comparison of physical fitness, indices of lifestyle disease, and biochemical property of muscle according to sarcopenia and obesity in elderly women
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[목적] 이 연구의 목적은 노인 여성을 대상으로 근감소증과 비만에 따라 체력, 생활습관병 지표, 그리고 근육의 생화화적 특성의 차이를 비교·분석하는 것이었다. [방법] 이 연구의 대상자는 노인 여성으로서 근감소증 기준인 ASM/Height2이 5.4 kg/㎡ 이하, 그리고 비만 기준인 체지방률이 35% 이상을 적용하여 근감소증+비만집단 20명, 근감소증집단 20명, 비만집단 29명, 그리고 정상집단 31명, 총 100명을 선정하였다. 이와 같이 구성한 4개의 집단 간에 체력, 생활습관병 지표, 그리고 근육의 생화화적 특성을 비교하였다. [결과] 이 연구에서 얻은 주요 결과는 다음과 같다. 1) 일상생활체력과 관련하여 근감소증+비만집단과 근감소증집단의 악력, 상완굴신력, 앉아윗몸앞으로굽히기, up and go, 그리고 VO2max가 정상집단에 비하여 유의하게 낮았다. 등속성 근기능과 관련하여 근감소증+비만집단과 근감소증집단의 최대힘효율과 평균파워가 유의하게 낮게 나타났으며, 근감소증+비만집단과 비만집단의 체중당 수치가 유의하게 낮게 나타났다. 2) 고혈압 지표와 관련하여 근감소증+비만집단과 비만집단의 안정시 심박수와 RPP가 근감소증집단과 정상집단보다 높게 나타났다. 당뇨병 지표와 관련하여 근감소증+비만집단과 비만집단의 공복인슐린과 HOMA-IR이 근감소증과 정상집단보다 높게 나타났다. 고지혈증 지표와 관련하여 근감소증+비만집단과 비만집단의 HDL-C가 근감소증집단과 정상집단보다 낮게 나타났다. 동맥경화증 지표와 관련하여 근감소증+비만집단과 비만집단의 TC/HDL-C 비율과 LDL-C/ HDL-C 비율이 근감소증과 정상집단보다 높게 나타났다. 3) 근육의 생화학적 특성과 관련하여 근감소증+비만집단과 비만집단의 IL-6가 근감소증집단과 정상집단보다 높게 나타났다. [결론] 이상의 결과를 종합해 보면, 근감소증 노인 여성은 전반적으로 체력이 저하되어 있으며, 비만 노인 여성은 상대적인 등속성 근기능, 생활습관병 지표, 그리고 염증 지표가 악화되어 있는 것으로 나타났다. 특히, 근감소증과 비만이 동반된 노인 여성의 경우 체력과 생활습관병 지표가 모두 저하되어 있는 것으로 나타났다. 따라서 근감소증 혹은 비만을 예방 및 개선하기 위한 각각의 노력이 필요하며, 특히 근감소증+비만으로 이어지지 않도록 적극적으로 대처해야 할 것이다.
Abstract
[Purpose] The study was designed to compare physical fitness, indices of lifestyle disease, and biochemical property of muscle according to sarcopenia and obesity in elderly women. [Methods] One hundred elderly women were alloted to one of four groups, i.e., sarcopenia+obesity (SO: n=20) group, sarcopenia (S: n=20) group, obesity (O: n=29) group, and normal (N: n=31) group. Criterion for sarcopenia was 'appendicular skeletal muscle mass (ASM)/height2<5.4 kg/㎡', and criterion for obesity was 'percent body fat>35%'. Dependent variables regarding physical fitness, lifestyle disease, and biochemical property of muscle were measured and compared among four groups. [Results] 1) Regarding daily living fitness, grip strength, upper arm flexion, sit-and-reach, up and go, and VO2max in SO group and S group were significantly lower than N group. Regarding isokinetic function, peak torque and average power in SO group and S group were significantly lower, and relative values to body weight in SO group and O group were significantly lower than N group. 2) Regarding hypertension, resting HR and RPP in SO group and O group were significantly higher than S group and N group. Regarding diabetes mellitus, fasting plasma glucose and HOMA-IR in SO group and O group were significantly higher than S group and N group. Regarding hyperlipidemia, HDL-C in SO group and O group were significantly lower than S group and N group. Regarding atherosclerosis, TC/HDL-C ratio and LDL-C/HDL-C ratio in SO group and O group were significantly higher than S group and N group. 3) Regarding biochemical property of muscle, IL-6 in SO group and O group were significantly higher than S group and N group. [Conclusion] It was concluded that physical fitness was declined in sarcopenia elderly, and that relative value of isokinetic function, indices of lifestyle disease, and inflammation markers were deteriorated in obesity elderly. Especially, the decline and deterioration of physical fitness and indices of lifestyle disease were even more severe in the elderly who had the both status. Therefore, the efforts should be made to prevent and improve sarcopenia and/or obesity.
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