건강한 성인남성에서 폐활량저하와 대사증후군의 관련성
The Association of Low Vital Capacity with the Metabolic Risk Factors Among Healthy Korean Adult Men
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초록
-연구배경 폐기능이 현저히 떨어진 사람들은 인슐린저항성이 높게 관찰되며 그 중에서도 제한성 폐질환은 일부 대사증후군과 관련성이 보고 되었다. 하지만, 폐질환이 없는 비교적 정상범위 내에서의 폐활량 저하와 대사증후군의 관련성은 분명하지 않다. 따라서 본 연구는 폐질환이 없는 정상성인 남성에서 폐활량 저하와 대사증후군의 관련성을 알아보고자 한다. 방 법 2006년 1월부터 12월까지 일개 대학병원 건강검진센터를 방문한 성인남성 4583명을 대상으로 폐기능검사, 생활습관조사, 신체계측, 대사증후군의 항목에 대한 검사를 실시하였다. 결 과 노력성 폐활량(FVC) 예측값에 따라 가장 높은 군부터 사분위 그룹(Q1~4)로 나누었을 때, 대사증후군의 비율은 Q1에서 144명(12.9%), Q2에서 171명(15.2%), Q3에서 173명(15.4%), Q4에서 228명(18.9%)으로 증가하였다(P for trend < 0.0001). 나이, 체질량지수 그리고 흡연상태를 보정한 후 대사증후군 항목별로 FVC 평균값의 차이를 관찰한 결과, 혈압(P=0.308)을 제외한 복부비만(P < 0.0001), 고혈당(P=0.002), 중성지방(P < 0.0001), 고밀도콜레스테롤(P=0.034) 등은 모두 의미 있는 차이를 보였다. 대사증후군을 갖는 집단의 평균 FVC값은 99.6%로, 대사증후군이 없는 집단의 101.7%보다 낮았다(P < 0.0001). 교란변수를 보정한 후에 대사증후군 항목의 개수에 따라 FVC 평균값을 비교했을 때 항목이 하나도 없는 그룹은 102.5%, 항목이 1개일 때 101.6%, 2개일 때 99.8%, 3개일 때 98.9%, 4개 이상일 때 98.3%로 의미 있게 감소하는 양상을 보였다(P for trend < 0.0001). 결 론 건강한 성인남성에서 폐활량의 저하는 대사증후군의 높은 유병률과 관련이 있다. 향후 폐기능저하와 대사증후군, 더 나아가 심혈관질환의 인과관계를 밝히기 위한 전향적인 연구가 필요하다.
Abstract
Background Impaired lung function, especially low vital capacity is associated with insulin resistance. In this study, we investigated the relationship between low vital capacity and metabolic syndrome in healthy Korean adult men. Methods We analyzed pulmonary function tests including FVC and component of metabolic syndrome from male participants (n=4583), more than 20 years old who had visited a health promotion center in a university hospital between January and December, 2006. Results In this cross-sectional analyses, there was a inverse association between metabolic syndrome and quartiles of FVC (P for trend < 0.0001) after adjusting for age, BMI, and smoking status. The mean of FVC in subjects with each risk factor of metabolic syndrome was significantly higher than in subjects without risk factors(abdominal obesity P < 0.0001, hyperglycemia P=0.002, high triglyceride P < 0.0001, low HDL-Cholesterol P=0.034) except hypertension (P=0.308) after adjusting for age, BMI, and smoking status. The mean level of FVC decreased with increasing number of risk factors of metabolic syndrome (P for trend < 0.0001). Conclusions Vital capacity was inversely associated with the metabolic syndrome in healthy Korean adult men. Insulin resistance may be the common pathways underlying low vital capacity and metabolic syndrome. Further prospective study about the relationship between impaired lung function and metabolic syndrome would be required.
참고문헌 (30)
- Mannino DM, "Lungfunction and mortality in the United States data from the FirstNational Health and Nutrition Examination Survey follow upstudy", 58(5), pp.388~393 (2003)
- Schunemann HJ, "Pulmonary function is a long-term predictor of mortality inthe general population 29-year follow-up of the Buffalo HealthStudy", 118(3), pp.656~664 (2000)
- Sin DD, "The relationship between reduced lungfunction and cardiovascular mortality a population-based studyand a systematic review of the literature", 127(6), pp.1952~1959 (2005)
- Engstrom G, "Lung function, insulin resistance and incidence ofcardiovascular disease: a longitudinal cohort study", 253(5), pp.574~581 (2003)
- Lazarus R, "Impaired ventilatory functionand elevated insulin levels in nondiabetic males: the NormativeAging Study", 12(3), pp.635~640 (1998)
- Ford ES, "Prospective association between lungfunction and the incidence of diabetes: findings from the NationalHealth and Nutrition Examination Survey EpidemiologicFollow-up Study", 27(12), pp.2966~2970 (2004)
- Yeh HC, "Vital capacity as a predictor of incident type 2diabetes: the Atherosclerosis Risk in Communities study", 28(6), pp.1472~1479 (2005)
- Engstrom G, "Lung function and cardiovascular risk:relationship with inflammation-sensitive plasma proteins", 106(20), pp.2555~2560 (2002)
- Mannino DM, "Obstructive and restrictivelung disease and functional limitation: data from the ThirdNational Health and Nutrition Examination", 254(6), pp.540~547 (2003)
- Sin DD, "Why are patients with chronic obstructivepulmonary disease at increased risk of cardiovascular diseases?The potential role of systemic inflammation in chronicobstructive pulmonary disease", 107(11), pp.1514~1519 (2003)
- Hanson RL, "Imperatore G, Bennett PH, Knowler WC.Components of the ″metabolic syndrome″ and incidence of type2 diabetes", 51(10), pp.3120~3127 (2002)
- Klein BE, "Components of the metabolicsyndrome and risk of cardiovascular disease and diabetes inBeaver Dam", 25(10), pp.1790~1794 (2002)
- Isomaa B, "Cardiovascular morbidity and mortality associated withthe metabolic syndrome", 24(4), pp.683~689 (2001)
- Lakka HM, "The metabolic syndrome andtotal and cardiovascular disease mortality in middle-aged men", 288(21), pp.2709~2716 (2002)
- Pyorala M, "Insulin resistance syndrome predicts the risk of coronary heartdisease and stroke in healthy middle-aged men: the 22-yearfollow-up results of the Helsinki Policemen Study", 20(2), pp.538~544 (2000)
- Park HS, "Prevalence and trends of metabolic syndrome in Korea: KoreanNational Health and Nutrition Survey 1998-2001", 9(1), pp.50~58 (2007)
- Canoy D, "Abdominal obesity and respiratory function in men andwomen in the EPIC-Norfolk Study", 159(12), pp.1140~1149 (2004)
- Carey IM, "The effects of adiposity andweight change on forced expiratory volume decline in alongitudinal study of adults", 23(9), pp.979~985 (1999)
- Lazarus R, "Effects of bodycomposition and fat distribution on ventilatory function inadults", 68(1), pp.35~41 (1998)
- Fimognari FL, "The association between metabolic syndromeand restrictive ventilatory dysfunction in older persons", 62(7), pp.760~765 (2007)
- Lin WY, "Impaired lungfunction is associated with obesity and metabolic syndrome inadults", 14(9), pp.1654~1661 (2006), Silver Spring
- Lager I, "Smoking induces insulin resistance--a potential link with theinsulin resistance syndrome", pp.327~32 (1993)
- Park YW, "The metabolic syndrome: prevalence andassociated risk factor findings in the US population from theThird National Health and Nutrition Examination Survey,1988-1994", 163(4), pp.427~436 (2003)
- Collins LC, "Theeffect of body fat distribution on pulmonary function tests", 107(5), pp.1298~1302 (1995)
- Sahebjami H, "Pulmonary function in obese subjectswith a normal FEV1", FVC ratio, 1996, pp.110(6), 1425~1429
- Braun B, "Women at altitude: short-term exposure to hypoxiaand", or alpha(1)-adrenergic blockade reduces insulin sensitivity, 2001, pp.91(2), 623~631
- Larsen JJ, "The effect ofaltitude hypoxia on glucose homeostasis in men", 504(1), pp.241~249 (1997)
- Kony S, "Association of bronchial hyperresponsiveness and lungfunction with C-reactive protein (CRP): a population basedstudy", 59(10), pp.892~896 (2004)
- Rutter MK, "C-reactive protein, the metabolic syndrome, and predictionof cardiovascular events in the Framingham Offspring Study", 110(4), pp.380~385 (2004)
- Higgins MW, "Seven measures of ventilatory lungfunction Population values and a comparison of their ability todiscriminate between persons with and without chronicrespiratory symptoms and disease", pp.258~72 (1973)