한국인 심혈관질환의 유병률과 관련 위험인자: 2005년, 2007년 국민건강영양 조사를 바탕으로
Prevalence and Associated Risk Factors for Cardiovascular Disease: Findings from the 2005, 2007 Korea National Health and Nutrition Examination Survey
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연구배경: 우리나라는 대표성 있는 역학조사의 부족으로 외국 연구결과에 의존하여 심혈관질환 관리를 해오고있다. 심혈관질환은 각 나라의 사회경제적, 보건 의식 등에따라 다른 양상을 보이므로 각 나라에 맞게 관리되어야 효율적인 질환관리를 할 수 있다. 본 연구는 효과적인 만성질환 관리와 건강증진을 위하여 한국인에게서 나타나는심혈관질환의 위험인자를 규명하고 외국의 그것과 비교분석하였다. 방법: 2005년과 2007년에 시행된 제3기와 4기 1차년도국민건강영양조사 데이터를 이용한 역학조사연구이다(n=38,746). 본 연구에서 심혈관질환의 조작적 정의는 고혈압, 뇌졸중, 심근경색증, 협심증을 의사로부터 진단받은 사람이다. χ2 및 t-test를 사용한 이변량 분석을 통해 단일 위험인자와 심혈관질환과의 관계를 분석하고, 로지스틱 회귀분석을 사용한 다변량 분석을 통해 위험도를 산출하였다. 결과: 본 연구에서 나타난 한국인 심혈관질환의 유병률은 12.2%였다. 연령별 심혈관질환의 유병률은 40세부터증가하며 중년층에서는 남성에게서 높게 나타났으며 50세이후부터는 여성의 유병률이 높게 나타났다. 또한 교육수준, 소득수준, 결혼상태 등의 사회경제적 요인이 심혈관질환에 영향을 미치는 인자임을 확인하였다. 이변량 분석에서는 만성신장질환, 당뇨, 우울증, 류마티스관절염, 만성폐쇄성폐질환, 체질량지수, 저밀도지단백콜레스테롤, 고밀도지단백콜레스테롤, 중성지방, 중성지방과 고밀도지단백콜레스테롤 비율, 허리둘레, 운동, 야채류, 생선류, 과일류의 섭취빈도가 심혈관질환의 발생에 통계적으로 유의하였다. 비가역적 요인들을 통제한 다변량 분석에서는 만성신장질환(odds ratio, OR 5.266, P<0.001)과 당뇨(OR 2.872,P<0.001)가 심혈관질환에 심각한 영향을 미치는 독립적인인자로 규명되었다. 결론: 본 연구에서는 외국 연구에서 밝혀진 위험인자들중 스트레스, 현재 흡연상태, 콩류 섭취 빈도를 제외한 모든 인자들이 한국인에게도 유의함을 증명하였다. 특히 만성신장질환과 당뇨병은 초기에 집중적인 질병관리 대책이요구된다.
Abstract
Background: Socio-economic factors, culture, and the health care delivery system are all associated with increased risk of cardiovascular disease (CVD). However, their significance and prevalence in Korea have not been precisely determined. The purposes of this study were to identify factors related to increased CVD risk among Koreans, and compare the results with those of previous studies. Methods: This study is an analysis of secondary data collected through the Korea National Health and Nutrition Examination Survey. For the purposes of this research, CVD is defined as medically diagnosed hypertension,stroke, angina, and myocardial infarction. Of the 38,746 survey participants, we analyzed 4,727 subjects who suffered from CVD. Results: Before the age of 50, men have a greater risk of CVD than women while a woman's risk of CVD after 50 begins to rise with age. Socioeconomic factors such as education, income, single living pattern, chronic kidney disease (CKD), diabetes mellitus (DM), depression, rheumatic arthritis, chronic obstructive pulmonary disease,body mass index and waist circumference, lipids, physical activity, and diet are all associated with the prevalence of CVD. A multi-variate analysis demonstrated that CKD (odds ratio, OR=5.266, P<0.001) and DM (OR=2.872, P<0.001) are the strongest independent predictors of CVD among Koreans. Conclusions: The prevalence of CVD among Korean was about 12.2%. While most risk factors had similar influence on the development of CVD, depression, CKD, and DM showed stronger correlations than those seen in studies performed in other countries. Our results show that a greater importance should be placed on strict and early management of these diseases.
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