성인 여성에서 혈중 오스테오칼신 농도와 대사증후군과의 관련성
Association of Serum Osteocalcin with Metabolic Syndrome in Korean Adult Women
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연구배경: 오스테오칼신은 골표지자로 임상에서 널리 사용되어 왔으며, 최근 당 대사와 에너지 대사를 조절하는 호르몬으로서의 역할이 알려지고 있다. 본 연구에서는 성인 여성에서 혈중 오스테오칼신 농도와 심혈관계 질환 위험인자로서 대사증후군과의 관련성에 대하여 분석하였다. 방법: 건강검진센터를 방문하여 검진목적으로 혈중 오스테오칼신 농도와 요추 골밀도를 자발적으로 측정한 성인여성 89명을 대상으로 후향적 의무기록 조사를 시행하였다. 대사증후군의 정의는 NCEP-ATP III의 기준을 사용하였으며, 허리둘레는 대한비만학회에서 제시한 기준인 85 cm 이상을 복부비만의 정의로 사용하였다. 대사증후군과혈청 오스테오칼신 농도와의 연관성을 보기 위해 대사증후군 유무를 종속변수로 하는 로지스틱회귀분석을 시행하였으며 대사증후군 개별인자의 군집성에 따른 오스테오칼신의 농도는 일원분산분석(one-way analysis of variance)로분석하였다. 결과: 연구 대상자는 성인 여성 89명(폐경 전 29명, 폐경후 60명)으로 대사증후군이 있는 군(12명, 13.48%)이 없는군(77명, 86.52%)에 비해 혈중 오스테오칼신 농도가 유의하게 낮았다(15.4±8.0 ng/mL vs. 22.4±12.2 ng/mL; P=0.001). 대사증후군 개별요소 군집성에 따른 오스테오칼신의 농도는 대사증후군 위험요소 4개 이상인 군(10.1±6.7 ng/mL)이3개인 군(18.0±7.6 ng/mL) 및 2개인 군(23.6±7.1 ng/mL)과유의한 차이를 보였다. 대사증후군 유무를 종속변수로 혈청 오스테오칼신, 연령, 폐경 유무, 요추 평균 골밀도를 독립변수로 이용하여 로지스틱회귀분석을 시행한 결과, 오스테오칼신 농도가 대사증후군 유무와 독립적인 관련성을 보였으며(β=-0.154, P=0.014), 추가적으로 체질량지수로보정한 모델에서도 동일한 결과를 나타내었다(β=-0.151, P=0.018). 결론: 결론적으로 본 연구에서 혈중 오스테오칼신 농도는 성인 여성에서 대사증후군에 해당되는 군에서 골밀도, 연령, 폐경 유무, 체질량지수와 독립적으로 유의하게 낮은것으로 나타났으며 대사증후군 위험요소 군집성이 높은 군에서 오스테오칼신 농도가 유의하게 낮았다.
Abstract
Background:Serum osteocalcin level has been widely used as a bone turnover marker in clinical setting. In this study, we analyzed the relationship between serum osteocalcin concentration and metabolic syndrome as a cardiovascular risk factor in adult women. Methods:We retrospectively reviewed the medical records of 89 adult women (29 premenopausal, 60 postmenopausal) who voluntarily measured serum osteocalcin concentration and lumbar spine bone mineral density (BMD) for the purpose of screening. The definition of metabolic syndrome was used National Cholesterol Education Program’s Adult Treatment Panel III criteria except waist circumference which was adopted the Korean standard. Results:The serum osteocalcin concentration with metabolic syndrome was significantly lower than those without metabolic syndrome (15.4±8.0 ng/mL vs. 22.4±12.2 ng/mL; P=0.001). The osteocalcin level was significantly lower in the groups with more than 4 risk factors for metabolic syndrome (10.1±6.7 ng/mL) than the groups with more than 3 (18.0±7.6 ng/mL) or 2 (23.6±7.1 ng/mL) risk factors. As a result of logistic regression analysis using serum osteocalcin, age, menopausal status, lumbar spine BMD and body mass index as independent variables, the presence of metabolic syndrome was independently associated with the serum osteocalcin level (β=-0.151, P=0.018). Conclusions:The serum osteocalcin levels in adult women were significantly lower in the metabolic syndrome group, and also lower in the group with higher clustering of individual risk factors of metabolic syndrome.
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