제5기 국민건강영양조사 자료 중 남성에서 흡연 상태와 고밀도지단백-콜레스테롤 농도의 관련성
Association of Smoking Status and High Density Lipoprotein-Cholesterol in Males in the Fifth Korea National Health and Nutrition Examination Survey
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연구배경: 대사증후군 환자의 경우 혈중 HDL-C가 낮으며 흡연이 저HDL-C혈증의 독립위험인자라는 보고가 있었다. 이 연구는 우리나라 대규모의 일반인 인구집단을 대상으로 흡연 상태와 HDL-C 농도의 상관관계를 조사하기위한 것이다. 방법: 대상자들의 일반적 특성은 복합표본에 대한 빈도분석과 기술통계를, 흡연 상태와 저HDL-C혈증 사이의 관련성은 교차분석으로 분석하였다. 각 요인과 저HDL-C혈증의 관련성은 로지스틱회귀분석으로, 흡연 상태 및 기타요인이 HDL-C 농도에 미치는 영향은 일반선형모형으로조사하였다. 결과: 단변량로지스틱회귀분석 결과 흡연 상태와 저HDL-C혈증은 관련성이 있었다. 20세 이상의 한국 남성에서 저HDL-C혈증 유병률은 29.4±0.3%였고 비흡연자 대비현재흡연자와 과거흡연자의 저HDL-C혈증의 OR은 각각1.345 및 1.123이었다. 인구사회적특성요인, 신체활동요인, BMI 및 연령의 영향을 모두 보정하였을 때도 비흡연자에비한 현재흡연자의 저HDL-C혈증의 OR이 1.328배 증가하였으나 과거흡연자의 OR은 0.892로 낮아졌다. 비흡연자대비 현재흡연자 그룹의 HDL-C는 1.009 mg/dL 낮았고, 반면 과거흡연자는 0.478 mg/dL 높았다. BMI가 1단위 증가하면 HDL-C가 0.922 mg/dL씩 감소하였고, 나이 1세 증가시 0.080 mg/dL씩 감소하였다(P<0.05). 결론: 일반인을 대상으로 한 연구에서 흡연 상태와 HDL-C 농도 사이에는 유의한 상관관계가 있었다. 또한 직업군, 신체활동, BMI, 나이도 HDL-C 농도에 유의한 관련성을 나타냈다. 결론적으로 적정 BMI를 유지하며 일상생활에서 신체활동을 늘리고 금연을 실천하는 등 라이프스타일을 개선하는것이 혈액 중 HDL-C의 농도를 개선하기 위한 방법으로생각된다.
Abstract
Background:The patients with metabolic syndrome had shown low high density lipoprotein-cholesterol (HDL-C) and smoking had been reported to be an independent risk factor for low HDL-C. This study aimed to study the association of smoking status and low HDL-C in general population of Korea. Methods:Frequency analysis and descriptive statistics for general characteristics and chi-square test for the association of smoking status and low HDL-C were used. Then, logistic regression analyses for the effect of smoking on low HDL-C and general linear method for HDL-C estimates were used. Results:Univariate regression showed that smoking status showed an association with low HDL-C. Prevalence of low HDL-C was 29.4±0.3% of Korean males in their twenties or over, and low HDL-C possibilities of current and past-smokers compared with non-smokers were odds ratio 1.345 and 1.123 respectively. After adjustments with sociodemographic factors, physical activity, body mass index (BMI), and age, the low HDL-C possibility of current-smokers was 1.328 times higher and for past-smokers was 0.892 times than non-smokers (P<0.05). The HDL-C concentration of current-smokers was 1.009 mg/dL lower than non-smokers', whereas that of past-smokers' was 0.478 mg/dL higher than non-smokers'. HDL-C concentration decreased 0.922 mg/dL for every 1 unit of BMI increase and 0.080 mg/dL for every 1-year age increase (P<0.05). Conclusions:In this study using general population, HDL-C showed significant association with smoking status. The occupation, BMI and age also had significant associations. Conclusively, the possible strategies to maintain serum HDL-C include cessation of smoking, increase of physical exercise, and weight loss.
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