건강검진 수진자에서 체질량지수 변화와 폐기능의 관련성
Relationship between Changes in Body Mass Index and Pulmonary Function in Adults
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연구배경: 비만은 호흡기 질환과도 연관성이 높으며, 현재의 체중이나 체중의 변화가 폐기능에 영향을 줄 수 있음이 보고되고 있으나, 연구마다 이견이 있다. 본 연구에서는성인 남녀에서 체질량지수의 변화와 폐기능 사이의 관련성을 알아보고자 하였다. 방법: 2000년 1월부터 2002년 12월까지 일개 대학병원의건강증진센터를 방문하여 폐기능 검사를 포함한 건강검진을 시행한 40-64세의 수진자들 중에 5년 이상의 간격을 두고 2009년 12월까지 다시 건강검진을 받은 499명(남자 309명, 여자 190명)을 연구 대상으로 하였다. 처음 검진과 추적검진 시의 체질량지수에 따라 남녀를 각각 Group 1 (정상-정상), Group 2 (정상-비만), Group 3 (비만-정상), Group 4(비만-비만)의 4 그룹으로 분류하였다. 폐기능 지표로 1초간 노력성 호기량(forced expiratory volume in one second,FEV1), 노력성 폐활량(forced vital capacity, FVC), FEV1/FVC을 측정하였다. 결과: 남자의 경우, FEV1/FVC의 변화는 4 그룹에 따라유의한 차이가 있는 것으로 나타났다. FEV1/FVC의 변화는 Group 1과 Group 3, Group 1과 Group 4 사이에 유의한 차이가 있는 것으로 나타났다. 여자의 경우, FEV1,FVC, FEV1/FVC의 변화는 4 그룹에 따라 유의한 차이가있는 것으로 나타났다. FEV1의 변화는 Group 3과 Group 4 사이에, FVC의 변화는 Group 1과 Group 3 사이에 유의한 차이가 있는 것으로 나타났다. 결론: 본 연구에서 체질량지수 변화와 폐기능은 음의 상관관계가 있음을 확인하였고, 비만 자체가 폐기능 저하의위험요인이 될 수 있으며, 체중 감량을 통한 체질량지수감소가 폐기능 저하를 줄이거나 호전시킬 수 있음을 알 수있었다.
Abstract
Background: Obesity is linked to a wide range of respiratory diseases. Several studies have shown that body weight at baseline and weight change were related to pulmonary function. The purpose of this study was to investigate the relationship between change in body mass index (BMI) and pulmonary function in adults. Methods: Of those aged 40-64 years at baseline who had initially visited the health promotion center at one university-level hospital from January 2000 to December 2002, 499 (men: 309, women: 190) patients revisited the center over a 5-year period up to December 2009 and were enrolled in the study. Subjects were classified into 4 groups- group 1: normal-normal, group 2: normal-obese, group 3: obese-normal, and group 4: obese-obese,based on their BMI at baseline and follow-up. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC were measured by spirometry. Results: Change in FEV1/FVC was significantly associated with change in BMI for men in all 4 groups. Change in FEV1/FVC was significantly different between group 1 and 3 and between group 1 and 4. Changes in FEV1,FVC and FEV1/FVC were significantly associated with change in BMI for women in all 4 groups. Change in FEV1 was significantly different between group 3 and 4, and change in FVC was significantly different between group 1 and 3. Conclusions: These results suggest that a change in BMI is negatively associated with change in pulmonary function. Obesity itself can be a risk factor for pulmonary dysfunction, and a decrease in BMI through weight reduction could reduce pulmonary dysfunction or improve pulmonary function in adults.
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