건강한 성인의 담석 유병률과 위험인자
Prevalence and Risk Factors of Gallstones in Adult Health Screening Population
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
담석은 담도계의 가장 흔한 질환으로 최근 우리나라에서 콜레스테롤 담석의 비율이 증가하고 있으며 그 대표적인 위험인자로는 연령, 여성, 비만 등이 거론되고 있다. 본 연구는 건강검진자를 대상으로 최근 3년간의 담석의 유병률 및 위험인자를 알아보고자 하였다. 2011년 1월에서 2013년 12월까지 대구지역 종합검진전문병원에서 건강검진을 받은 4,696명을 대상으로 성별과 연령별 분표를 조사하고 키와 몸무게, 공복혈당과 간기능 및 기본 지질 검사를 하였고, 초음파 검사를 통해 담낭의 담석을 진단하였다. 체질량 지수에 따라 저체중, 정상체중, 과다체중, 비만 집단으로 나누었고, 공복혈당 수치는 미국 당뇨 협회에서 제시한 당뇨병의 진단 기준에 따라 분류하였다. 간기능 수치는 본원에서 사용하는 간기능 정상치를 참조하여 대상군을 나누고 지질 수치는 NCEP APTⅢ에 따라 분류하였다. 분석결과 담석이 발견된 경우는 148명(3.15%)으로 남자 84명(1.79%), 여자 64명(1.36%)으로 남자에서 더 높았으나 성별 간 유병률은 차이는 없었다. 연령별 유병률은 40대 이하 1.84%, 40대 3.38%, 50대 이상 4.66%로 담석이 없는 집단에 비해서 유의하게 높았다(p<0.003). 또한 담낭 담석으로 판명된 대상자의 신체검사 상 고지혈분류 항목에서 비정상군은 Total-cholesterol 52명으로 가장 많았고, LDL-cholesterol 39명, Triglyceride가 36명, HDL-cholesterol 19명이였다. 단변량 분석을 시행한 결과 연령, 공복혈당, 체질량지수는 담석의 유병률과 의미 있는 상관관계를 보였고, 다중 로지스틱 회귀분석에서도 연령, 체질량지수가 담석증의 독립적인 위험인자로 선정되었다. 결론적으로 비록 담석이 대사증후군과의 관계에서 나타나지 않았지만 이를 규명하기 위해서는 건강검진 대상자뿐만 아니라 일반 국민을 대상으로 한 추가적인 연구가 필요하다고 사료된다.
Abstract
Gallstone is the most common disease of the biliary system. Korean has experienced an increase in the percentage of cholesterol gallstones. The major risk factors associated with cholesterol gallstones are age, gender as well as obesity. This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. The study population consisted of 2,484 males and 2,212 females who visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. Classified as underweight, normal weight or overweight using the population of obese according to the body mass index, and classified according to mood diagnosis of diabetes presented by the American Diabetes Association. Fasting blood glucose and number of liver function, the divided the control group by referring to the normal liver function values used herein. The geological map, I was classified as NCEP APT Ⅲ. A showed of total 148 people were found to have gallstones. The prevalence of sex among 148 patients (3.15%) 84 men (1.79%) and 64 women 1.36%) which shows significantly there is little difference. 1.84% 40 years and below, 3.38% 40's showed age prevalence was 4.66% in 50's and above. In addition, Total-cholesterol was at the most in 52 people, LDL-cholesterol in 398 people, Triglyceride in 36 people, HDL-cholesterol in 19 people. The abnormal group, was created from the total-cholesterol categories from a physical examination of a subject that has been found to be gallstones in the gallbladder. A result of conducting the univariate analysis shows the prevalence of gallstones, a correlation that is meaningful. The logistic regression analysis of multiple ages was chosen to show risk factors age independent cholelithiasis. In spite of the conclusion, gallstones are not displayed in relation to the metabolic syndrome but in order to clarify this, not only the subject of a health examination is needed but, a further study of the general public when possible.
참고문헌 (35)
- Yeong-myeong Moon, "Status of Koreans in cholelithiasis", The Korean Journal of Gastroenterology, 19, pp.1~5 (1987)
- Se-jong Kim, "Ultrasoud ex -amination of the incidence of asymptomatic gallstones in health examinee", Journal of Korean Society of Ultrasound in Medicine, 7, pp.11~13 (1988)
- Jong Kyun Lee, "Prevalence and Risk Factors of Gallstone in Health Screening People", The Korean journal of gastroenterology, 29, pp.85~92 (1997)
- The Rome Group for Epidemiology and Prevention of Cholelithiasis, "The epidemiology of gallstone disease in Rome, Italy: part II. Factors associated with the disease", Hepatology, 8, pp.907~913 (1998)
- Maura KR, "Prevalence of gallstone disease in Hispanic populationsin the United States", Gastroenteroloty, 96, pp.487~492 (1989)
- Maura KR, "Prevalence of gallstone disease in Hispanic populations in the United States", Gastroenteroloty, pp.487~492 (1989)
- Seung-uk Hwang, "Associated factor of prevalence of asymptomatic gallstone", The Korean Academy of Family Medicine, 22, pp.1596~1602 (2001)
- Trotman BW, "Pigment vs cholesterol cholelithiasis: clinical and epidemiological aspects", Am J Dis, 20, pp.735~740 (1975)
- Sampliner RE, "Gallbladder disease in pima indians:demonstration of high prevalence and early onset by cholecystography", N Eng J Med, 283, pp.595~602 (1998)
- Hye-won jeong, "The prevalence of gallstone Korea", The Korean Academ -y of Family Medicine, 13, pp.581~591 (1992)
- Angelico F, "Ten year incidence and natural history of gallstone disease in a rural population of women in central Italy", J Gastroenterol Hepatol, 29, pp.249~254 (1997)
- Barbara L, "population study on the prevalence of gallstone disease: The Sirmione Study", Hepatology, 7, pp.913~917 (1987)
- Berger MY, "Abdominal symptoms:do they predict gallstones: a systematic review", Scand J Gastroenterol, 35, pp.70~ (2000)
- 정윤진, "건강검진자에서 담낭 담석의 유병률과 위험인자", 대한내과학회지, 72(5), pp.480~490 (2007), 대한내과학회
- Mi-hwa Lee, "Prevalence and risk factors of gallstones on the abdominal son -ography", The Korean Society of Medical Sonographers, 2, pp.51~ (2011)
- Tao LY, "et Prevalences of and risk factors for billiary stones and gallbladder polyps in a large Chinese population", The Official Journal Of The International Hepato Pancreato Billiary Association, 14(6), pp.373~381 (2012)
- Myeong-hwan Kim, "The Pathogenesis and Symptoms of Gallstones", Journal of the Korean Medical Association, 36, pp.401~407 (1993)
- WHO West Pacific Region, "The Asia-Pacific Perspective:Redefining Obesity and its Treatment", IOTF, ~ (2000)
- Yong-hyeon Park, "To evaluate Some epidemiological and dinical characteristics of gallstones disease in Korea", Journal of the Korean Surgical, 35, pp.29~35 (1993)
- Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, "Report of the expert committee of the diagnosis and claasification of diabetes mellitus", Diabetes Care, 26(Suppl), pp.S5~S20 (1993)
- Evaluation, and Treatment of High Blood Cholesterol in adults(Adult Treatment Panel Ⅲ). Third Report of the National Cholesterol Education Program(NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults(Adult Treatment Panel Ⅲ) final report, "National Cholesterol Education Program Expert committee on the Detection", ~
- Reducing Risks – Promoting Healthy Life. World Health Report, "World Health Organization", ~ (2002)
- Attili AF, "Epidenmiology of gallstone disease in Italy: prevalence data fo the Multicenter Italian Study on Cholelithiasis(M.I.COL.)", Am J Epidemiol, 141, pp.158~165 (1995)
- Nomura H, "Prevalence of gallstone disease in a general population of Okinawa, Japan", Am J Epidemiol, 128, pp.598~605 (1988)
- Chen CY, "Age is one of the risk factors in developing gallstone disease in Taiwan", Age Ageing, 27, pp.437~441 (1998)
- Yi, Sun Young, "Clinical Study on Gallstone Prevalence in General Health Screening People", Korean journal of internal medicine, 47, pp.352~358 (1994)
- Ho geun Ryu, "Research on gallstone-related factors", The Korean Academy of Family Medicine, 16, pp.767~776 (1995)
- Sama C, "Epidemiology an natural history of gallstone disease", Semin Liver Dis, 10, pp.149~158 (1990)
- Tsunoda K, "Prevalence of cholesterol gallstone positivel correlates with per capita daily calorie intake", Hepatogastroenterology, 51, pp.1271~1274 (2004)
- Kyung Bal Hur, "Comparative Study between the Ultrasonic Pattern and the Chemical Analysis of Composition of the Gallstones", The Korean Journal of Gastroenterology, 24, pp.119~1127 (1992)
- Kameda H., "Gallstone disease in Japan: a report of 812 cases", Gastroenterology, 46, pp.109~114 (1964)
- Daniel S, "Prospetive evaluation of unexplained chronic liver transminase abnormalities in asymptomatic and symptomatic patients", Am J Gastroenterol, 94, pp.3010~3014 (1999)
- Mathiesen UL, "The clinical significance of slightly to moderately increased liver transminase values in asymptomatic patients", Scand J Gastroenterol, 34, pp.85~91 (1999)
- Méndez-Sánchez N, "Metabolic syndrome as a risk factor for gallstone disease", World J Gastroenterol, 11, pp.1653~1657 (2005)
- National Cholesterol Evaluation Program Expert Panel on Detection, "Evaluation and Treatment of High Blood Cholesterol in Adults(Adult Treatment Panel Ⅲ). Third Report of the National Cholesterol Education Program(NCEP)", Circulation, 106, pp.3143~3421 (2002)