당뇨와 고혈압 환자를 제외한 건강검진을 실시한 한국 성인남녀의 대사증후군 구성요소와 총 빌리루빈간의 관련성
Association between the Components of Metabolic Syndrome and Total Bilirubin at the Health Care Check Up in Korean Men and Women: Based on Adults Except for Diabetes and Hypertension
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초록
빌리루빈은 내인성 항산화제로서 항염작용이 있으며, 고혈압, 당뇨병, 대사증후군 및 인슐린 저항성과 역상관 관계에 있다고 보고된다. 그러나 간 특이적 지표와 비교하여 빌리루빈과 대사증후군간의 관련성을 평가한 연구는 부족하다. 본 연구에서는 건강검진을 실시한 한국 성인남녀를 대상으로 ALT, GGT와비교하여 총 빌리루빈과 대사증후군 유병률 사이의 관련성을조사하고자 하였다. 이 횡단면 연구에는 2015년 3월부터 2018 년 2월까지 경기도 소재 종합병원에서 건강검진을 실시한 20세이상 성인남녀 22,568명이 포함되었다. American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI)의 지침에 따라 대사증후군을 진단하였다. 남녀모두에서 대사증후군 위험요인이 없는 군보다 대사증후군 진단군에서 간 효소치가 높았으며, 총 빌리루빈과 직접 빌리루빈치는 낮게 나타났다. 남녀 모두에서 혈청 총 빌리루빈은 복부비만(r=−0.066 vs r=−0.055), 중성지방(r=−0.127 vs r=−0.136) 과 약한 역상관 관계를 보였으며, 이는 ALT와 GGT보다 약한 관련성이었다. 또한 남녀 모두에서 ALT와 GGT뿐만 아니라 총 빌리루빈은 대사증후군 발생 가능성을 예측하는 지표는 아닌 것으로 나타났다.
Abstract
Bilirubin has an anti-inflammatory effect as an endogenous antioxidant and has been reported to be inversely correlated with hypertension, diabetes, metabolic syndrome, and insulin resistance. On the other hand, there is a lack of research evaluating the association between bilirubin and metabolic syndrome compared to liver-specific indicators. This study examined the association between the total bilirubin and metabolic syndrome prevalence in Korean adults who underwent health screening compared to ALT and GGT. This cross sectional study included 22,568 adult males and females aged 20 years or older who underwent a health examination at the General Hospital of Gyeonggi Province from March 2015 to February 2018. Metabolic syndrome was diagnosed based on the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) guidelines. In both genders, the metabolic syndrome diagnosed group had higher liver enzymes, and the total bilirubin and direct bilirubin were lower than those without the metabolic syndrome risk factors. The serum total bilirubin showed a weak inverse correlation with abdominal obesity (r= −0.066 vs r=−0.055) and triglyceride (r=−0.127 vs r=−0.136) in both males and females, which is weaker than ALT and GGT The data were statistically significant. In addition, total bilirubin as well as ALT and GGT in both men and women were not predictors of the likelihood of developing metabolic syndrome.
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