무증상 성인에서 대사증후군과 관상동맥석회화의 관련성
Metabolic Syndrome as a Predictor of Coronary Artery Calcification in Asymptomatic Korean Adults
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초록
연구배경: 심혈관질환은 심각하면서도 예방이 가능하다. 따라서 조기진단을 위한 많은 방법들이 논의되고 있다. 본 연구는 심혈관질환의 예측인자로 관심을 받고 있는 대사증후군과 최근 관상동맥질환의 표지자로 알려진관상동맥석회화의 관련성을 평가하려는 목적으로 수행되었다. 방법: 서울의 한 검진센터를 방문해서 관동동맥석회화검사를 수행한 사람을 대상으로 하였다. 2010년 한 해 동안해당대상자의 과거력, 가족력, 흡연력과 신체측정, 검사실검사를 분석하였으며 칼슘스코어는 multi-detector computed tomography로 촬영하여 구하였다. 결과: 총 연구대상자는 남자 11,884명(평균나이 41.9±6.6년), 여자 2,544명(평균나이 42.9±8.0년)로 대사증후군의 유병률은 각각 21%, 13.2%이었다. 관동동맥석회화는 남자의 15%, 여자의 5.4%에서 관찰되었다. 대사증후군이 없는군에 비해 대사증후군이 있는 사람의 관상동맥석회화 유병률이 통계적으로 의미 있게 높았다. 연령, 흡연, 중풍과관상동맥질환의 가족력을 보정하고 남자에서는 대응비1.82 (95% 신뢰구간, 1.62-2.05; P<0.001), 여자에서는 대응비 2.23 (95% 신뢰구간, 1.49-3.33; P<0.001)로 나왔다. 대사증후군의 각 인자는 저 HDL 콜레스테롤 외에는 관상동맥석회화와 유의한 관련성이 있었다. 결론: 대사증후군을 가진 성인이 없는 사람에 비해 관상동맥석회화 유병률이 높았다.
Abstract
Introduction: Identification of individuals at high risk for coronary heart disease (CHD) is a challenge, though essential,for the prevention of future events. Thus, early detection of CHD has been a priority in research and practice. We conducted a study to evaluate the relationship between metabolic syndrome (MS) and its components with coronary artery calcium (CAC) as a surrogate of CHD in a large Korean adult population. Methods: The study subjects (n=14,429) were individuals who visited a health promotion center in Seoul, Korea from Jan. 2010 to Dec. 2010. Personal and family medical histories were collected and smoking status, anthropometric measurements, and laboratory tests were measured. CAC scores were measured by the multi-detector computed tomography. Results: The study population consisted of 11,884 men (mean age 41.9±6.6 years) and 2,544 women (mean age 42.9±8.0 years). The total prevalence of MS was 19.6%, with 21% in men and 13.2% in women. CAC (CAC>0) was found in 15.0% of men and 5.4% of women. When compared to the non-MS group, the MS group had a higher prevalence of CAC after adjusting for age, smoking, and family history of stroke and CHD in both men (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.62-2.05; P<0.001) and women (OR, 2.23; 95% CI,1.49-3.33; P<0.001). All individual components of MS, except high density lipoprotein cholesterol level, were associated with a high risk for CAC presence. Conclusions: Individuals with MS had a greater prevalence of CAC compared with individuals without this condition.
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