건강한 한국인 성인 남자에서 혈중 총 빌리루빈 농도와 Framingham 위험 점수와의 관계
The Relationship Between Serum Total Bilirubin and Framingham Risk Score in Healthy Korean Men
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배경: 총 빌리루빈은 산화작용을 하는 해로운 물질로 생각되어 왔으나 최근 항산화, 항염증 효과 및 과산화기 제거기능이 밝혀지면서 심혈관계 보호인자로서 주목을 받고있다. Framingham 위험점수는 20-79세 성인에서 향후 10년간 관상동맥 심혈관 질환의 위험도를 평가할 수 있는 점수로 본 연구는 총 빌리루빈과 Framingham 위험 점수와의관계를 밝히고자 한다. 방법: 검진센터의 검진자 중 심혈관계 질환이 없는 성인남자 3,414명을 대상으로 연령, 흡연, 수축기 혈압, 총 콜레스테롤, 고밀도 지단백 콜레스테롤을 점수화하여 Framingham 위험점수를 계산하였다. 로그 치환한 총 빌리루빈과 Framingham 위험점수와의 관계는 단순선형회귀분석을 시행하여 분석하였고 이후 다중선형회귀분석을 시행하였다. 결과: 로그치환 혈중 총 빌리루빈과 Framingham 위험점수는 단순선형회귀분석 결과 음의 상관관계를 보였고(R2:0.018, P＜0.001) 이완기 혈압, 맥박수, 체질량 지수, 공복혈당,중성지방, 저밀도 콜레스테롤, aspartate aminotransferase,alanine aminotransferase, 흡연 유무를 통제한 후 분석한 다중선형회귀분석 결과 음의 상관관계를 보였다(R2: 0.384, P ＜0.001). 결론: 총 빌리루빈 수치와 Framingham 위험점수와의음의 상관관계가 있음을 확인하였고 이는 총 빌리루빈 수치가 심혈관계 질환의 독립적인 위험인자이며 심혈관계위험도를 예측하는 유용한 인자로 활용될 수 있음을 의미한다.
Abstract
Background: Serum total bilirubin has been considered a harmful substance inducing oxidative reaction; but recently,there have been reports of it possessing antioxidative, anti-inflammatory and protective features against cardiovascular diseases. The purpose of this study was to investigate the relationship between total bilirubin and the Framingham risk score. Methods: This study involved 3,414 healthy Korean men who underwent a medical check-up in a health promotion center in 2008. We calculated the Framingham risk score using age, smoking status, systolic blood pressure,total cholesterol and high-density lipoprotein cholesterol. Results: The mean age of the participants was 44.9±8.8 years. The log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship in a simple linear regression analysis (R2:0.018, P<0.001). In a multivariable analysis model, as well, the log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship (R2: 0.384, P<0.001). Conclusions: Our study showed a statistically significant negative relationship between total bilirubin and the Framingham risk score. Total bilirubin had a stronger relationship with the Framingham risk score than other standard cardiovascular risk factors except smoking, and thus may be useful in predicting cardiovascular risk in the outpatient clinic.
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