대사증후군과 만성 신질환
Metabolic Syndrome and Chronic Kidney Disease
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연구배경 만성 신질환의 위험 인자로서 대사증후군에 대한 중요성이 증가하고 있다. 이에 일반 성인에서 대사증후군 및 대사증후군 각 인자들과 만성 신질환과의 관계를 살펴보고자 하였다. 방 법 2001년 국민건강영양조사에 참여한 사람 중 5453명을 대상으로 하였다. 대사증후군은 복부비만, 높은 혈압, 높은 혈당, 고중 성지방혈증, 저고밀도콜레스테롤혈증의 5개 항목 중 3개 이상의 항목을 가질 때로 정의하였으며 American Heart Association/National Heart, Lung, and Blood Institute(AHA/NHLBI)에서 제안한 기준을 사용하였다. 만성 신질환은 요검사상 요단백이 1+이상 측정되거나 계산된 사구체 여과율이 60mL/min per 1.73m2 미만인 경우로 정의하였다. 결 과 대사증후군의 각 인자 별 교차비를 비교해 보았을 때 단변량 분석에서는 높은 혈압에서 만성 신질환의 교차비가 3.31(95% 신뢰구간, 2.68-4.09)로 가장 높았지만, 다변량 분석에서는 고중성지방혈증이 1.64(95% 신뢰구간, 1.28-2.09)로 가장 높았다. 대 사증후군을 갖고 있는 대상자들은 그렇지 않은 대상자들에 비해 단변량 분석에서는 만성 신질환의 교차비가 3.21(95% 신뢰 구간, 2.60-3.96), 다변량 분석에서는 1.65(95% 신뢰구간, 1.29-2.12)이였다(p<0.001). 결 론 대사증후군은 나이, 성별, 교육수준, 월평균소득, 흡연, 음주, 운동 등과 독립적으로 만성 신질환의 중요한 위험인자로 생각 된다.
Abstract
Background The significance of metabolic syndrome has been raised as a risk factor in chronic kidney disease. We examined the association between metabolic syndrome and its components and chronic kidney disease in adults. Methods A total of 5453 subjects who participated in the Korean National Health and Nutrition Examination survey 2001 were included. Metabolic syndrome was defined as the presence of 3 or more of the following components: abdominal obesity, elevated blood pressure, elevated glucose level, high triglyceride level, and low high-density lipoprotein cholesterol level according to the criteria of the American Heart Association/National Heart, Lung, and Blood Institute(AHA/NHLBI). Chronic kidney disease was defined as dipstick-positive proteinuria(≥1+) or a estimated glomerular filtration rate less than 60mL per 1.73m2. Results Compared with the odds ratios of the each components of metabolic syndrome, the crude odds ratio of the chronic kidney disease in subjects with the elevated blood pressure compared with subjects without the elevated blood pressure was 3.31(95% CI, 2.68 to 4.09) and the multivariate-adjusted odds ratio in subjects with the high triglyceride level compared with subjects without the high triglyceride level was 1.64(95% CI, 1.28 to 2.09). In subjects with metabolic syndrome compared with subjects without metabolic syndrome, the crude and multivariate-adjusted odds ratios of chronic kidney disease were 3.21(95% CI, 2.60 to 3.96) and 1.65(95% CI, 1.29-2.12) (p<0.001). Conclusions Metabolic syndrome might be an important risk factor of chronic kidney disease, independently of age, sex, education level, monthly income, current smoking, at-risk drinking, and regular exercise.
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