20세 이상 한국인에서 상대 악력과 제2형 당뇨병과의 관련성
The Association of Relative Handgrip Strength with Type 2 Diabetes among Koreans Aged 20 Years or More
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초록
연구배경: 악력은 근력을 평가하는 단순하고 간편하며 경제적인 도구이다. 악력과 제2형 당뇨병과의 관련성에 관한연구가 소수 있지만, 아직 논란의 여지가 있다. 본 연구는20세 이상의 한국인을 대상으로 악력과 제2형 당뇨병과의관련성을 조사하였다. 방법: 2014년과 2015년에 시행된 국민건강영양조사에 참여한 20세 이상의 성인 남녀 중 체중과 키, 악력 및 공복 혈당을 모두 측정한 총 8,082명을 대상으로 하였다. 상대 악력은 양손의 최대 악력의 합을 체질량지수로 나누어서 사용하였다. 상대 악력과 당뇨병과의 관련성은 인구사회학적 요인(성별, 연령그룹, 교육)과 생활습관요인(흡연, 음주, 신체활동 및 비만), 동반질환(만성 폐쇄성 폐질환, 뇌졸중, 관상동맥질환, 관절염) 등을 보정하여 복합표본 다중 로지스틱 회귀분석으로 시행하였으며, 인구사회학적 요인과 생활습관요인에 따른 계층별 분석도 시행하였다. 결과: 20세 이상 성인에서 당뇨병의 유병률은 8.3% (표준오차, 0.4)였다. 인구사회학적 요인과 생활습관요인, 동반질환을보정한 이후에도 상대 악력의 성별 특이 4분위가 감소할수록당뇨병의 위험이 유의하게 증가하였으며(Ptrend<0.001), 상대악력이 1표준편차 감소함에 따라 당뇨병의 오즈비가 1.6 (95% 신뢰구간, 1.3-2.0; P<0.001)으로 증가하였다. 인구사회학적 요인과 생활습관요인에 상관없이 전 계층에서 상대 악력이 감소함에 따라 당뇨병의 위험은 유의하게 증가하였다. 결론: 20세 이상 한국 성인에서 근력의 지표인 상대 악력의 감소는 사회경제적인 계층이나 생활습관에 따른 계층에관계 없이 당뇨병의 위험 증가와 관련이 있었다.
Abstract
Background: Handgrip strength is a simple, convenient and economic tool measuring the muscle strength. A few studies investigated the relationship between diabetes and handgrip strength but the results are conflicting. This study investigated the association of handgrip strength with diabetes among the adult Koreans. Methods: This cross-sectional study analyzed data from participants aged 20 years or more (n=8,082) who measured height, weight, handgrip strength and fasting blood glucose in the 2014-2015 Korea National Health and Nutrition Examination Survey. Relative handgrip strength (RHGS) was defined as the sum of the greatest handgrip strengths in both hands divided by body mass index. To investigate the association of diabetes with handgrip strength, complex sample multivariate logistic regression analyses were done after adjusting for socioeconomic (age, sex, education), lifestyle (smoking, alcohol drinking, physical activity, obesity) and comorbid (chronic obstructive pulmonary disease, stroke, coronary artery disease, arthritis) variables. Stratified analysis were done according to socioeconomic and lifestyle variables. Results: The prevalence of diabetes was 8.3% (standard error, 0.4). After adjusting for socioeconomic, lifestyle, and comorbid variables, the risk of diabetes increased according to the decrease in sex-specific quartile of RHGS (Ptrend<0.001). Individuals with lower RHGS (per 1 standard deviation decrease) had higher odds of diabetes (adjusted odds ratio, 1.6; 95% confidence interval, 1.3-2.0). Furthermore, lower RHGS was associated with higher odds for diabetes throughout the strata of socioeconomic and lifestyle variables. Conclusions: This population-based, nationally representative study suggests that lower RHGS is associated with the increased risk of diabetes regardless of socioeconomic and lifestyle variables.
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