초음파를 이용한 경동맥 내-중막 두께와 대사증후군 진단지표의 연관성
Relationship Between Carotid Intima-Media Thickness Using Ultrasonography and Diagnostic Indices of Metabolic Syndrome
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본 연구의 목적은 대사증후군(MetS) 진단지표와 경동맥 내-중막 두께(carotid IMT)의 관련성을 이해하기 위하여 수행하였다. 연구대상자는 동맥경화와 기타 심혈관계 질환이 없는 남성 근로자 315명으로 하였다. 이 연구는 한국산업안전보건공단 산업안전보건연구원의 생명윤리위원회의 승인을 받은 후, 연구대상자의 동의를 받고 수행하였다. 인체계측과 혈청생화학 항목에 대한 검사는 체성분분석기기와 생화학자동분석 기기를 이용하여 측정하였고, MetS의 진단은 NCEP-ATP III 기준에 의하여 판단하였다. Carotid IMT는 고해상도 B-mode 초음파기기를 이용하여 경동맥 분지점과 근위부의 내-중막 두께를 측정하였다. Carotid IMT는 0.739±0.137mm이었고 연령증가와 더불어 유의하게 증가되었다. 또한 수축기 및 이완기혈압, 중성지방 및 공복혈당도 연령증가에 따라 유의한 증가를 보였다. Carotid IMT는 BMI(r=0.170, p=0.004), 수축기(r=0.148, p=0.011)와 이완기혈압(r=0.123, p=0.036) 및 HDL-cholesterol(r=-0.164, p=0.005)과 통계적으로 유의한 상관성을 보였다. MetS 진단지표와 carotid IMT에 대한 다중 로지스틱 회귀분석을 실시한 결과, carotid IMT는 혈압(교차비=4.220, p<0.01)과 MetS(교차비=1.301, p<0.05)과 유의한 관련성을 보였다. 이상의 결과는 혈압과 대사증후군이 죽상동맥경화증의 중요한 위험인자로 작용함을 보여주는 결과라 판단된다.
Abstract
The aim of the present study was undertaken to investigate the association between diagnostic indices of metabolic syndrome(MetS) with carotid intima-media thickness using ultrasonography. The participants in the study were 315 male employees without carotid atherosclerosis and other cardiovascular disease. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. Anthropometric parameters and biochemical characteristics were done using each specific equipments and the NCEP-ATP III criteria were used to define MetS. They were examined by B-mode ultrasound to measure the carotid intima-media thickness(carotid IMT) at the near and far walls of common carotid and bifurcation(bulb). The mean carotid IMT was 0.739±0.137mm and it's thickness significantly increased with the increase in age. Also, amounts of systolic and diastolic blood pressure, triglyceride and fasting glucose were significantly increased with the increase in age. Carotid IMT were significantly correlated with BMI(r=0.170, p=0.004), systolic(r=0.148, p=0.011) and diastolic blood pressure(r=0.123, p=0.036) and HDL-cholesterol(r=-0.164, p=0.005). On multiple logistic regression analysis for the diagnostic indices of MetS, carotid IMT were significantly associated with blood pressure(OR=4.220, p<0.01) and MetS(OR=1.301, p<0.05). The results indicate that blood pressure and MetS are important risk factors for carotid atherosclerosis.
참고문헌 (20)
- 허경화, "만성적인 스티렌 노출 근로자에 있어 대사증후군 유발에 관여하는 위험요인의 생리적 수준 변화", 한국산업위생학회지, 19(1), pp.30~38 (2009), 한국산업위생학회
- Yamada Y, "Prediction of genetic risk for metabolic syndrome", Atherosclerosis, 191, pp.298~304 (2007)
- "Definition, diagnosis and classification of diabetes mellitus and its complications, Part I. Diagnosis and classification of diabetes mellitus"[URL]
- National Cholesterol Education Program's Adult Treatment Panel III Report : Third report of the National Cholesterol Education Program(NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adults Treatment Panel III) final report, , Circulation, 3143~3421 (2002)
- 국민건강영양조사 제3기 조사결과 심층분석 연구 보고서, "보건복지가족부 질병관리본부", ~ (2007)
- 2007 국민건강통계 :국민건강영양조사 제 4기 1차년도(2007), "보건복지가족부 질병관리본부", ~ (2008)
- Avramoglu RK, "Lipid and lipoprotein dysregulation in insulin resistant states", Clin Chim Acta, 368, pp.1~19 (2006)
- Mercuri M, "For the MIDAS group, baseline reproducibility of B-mode ultrasound imaging measurements of carotid intima media thickness", J Cardiavasc Diagn Procedure, 11, pp.241~252 (1993)
- 고영국, "인슐린비의존형 당뇨병에서 고해상도 B-mode 초음파로 측정한 경동맥 내중막두께와 죽상동맥경화증 위험인자들과의 관계", 당뇨병, 23, pp.234~242 (1999)
- 이현진, "보건소 비만 프로그램을 통한 성인 여성의체지방 변화에 따른 건강상태 및 식생활 비교", 석사, pp.2007
- Pignoli W, "Intimal plus media thickness of the arterial wall : a direct measurement with ultrasound imaging", Circulation, 74, pp.1399~1406 (1986)
- Park HS, "Prevalence and associated factors of metabolic syndrome among adults in primary care", J Korean Soc Study Obes, 12, pp.108~123 (2003)
- Lee WY, "Effects of smoking, alcohol, exercise, education, and family history on the metabolic syndrome as defined by the NCEP-ATP III", Diabetes Res Clin Pract, 67, pp.70~77 (2005)
- Miyatake N, "Relationship between metabolic syndrome and cigarette smoking in the Japanese population", Intern Med, 45, pp.1069~1043 (2006)
- Howard G, "Active and passive smoking are associated with increased carotid wall thickness, The Atherosclerosis Risk in Communities Study", Arch Intern Med, 154, pp.1277~1282 (1994)
- Salonen R, "Determinations of carotid intima-media thickness. A populationbased ultrasonographic study in eastern Finnishmen", J Intern Med, 229, pp.225~231 (1991)
- Folsom AR, "Relation of carotid artery wall thickness to diabetes mellitus, fasting glucose and insulin, body size, and physical activity", Stroke, 25, pp.66~73 (1994)
- 최수연, "심혈관계 위험인자로서의 비알코올지방간질환; 경동맥 동맥경화와의 상관관계", The Korean Journal of Hepatology, 14(1), pp.77~88 (2008), 대한간학회
- 윤현태, "제 2형 당뇨병에서 대혈관합병증 유무에 따른 경동맥내막-중막 두께와 죽상동맥경화증 위험인자에 대한연구", 임상당뇨병, 3, pp.326~337 (2002)
- Heiss G, "Alzola and the ARIC study investigators : carotid atherosclerosis measured by B-mode ultrasound in populations : associations with cardiovascular risk factors in the ARIC study", Am J Epidemiol, 134, pp.250~256 (1991)