비만과 근위축비만이 한국고령자의 신체기능에 미치는 영향
The Effects of Obesity and Sarcopenic Obesity on Physical Functionin Korean Older Adults
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초록
연구배경 최근 급속한 고령화 및 노인장기요양보험의 시행과 더불어 고령자의 신체기능저하에 대한 관심이 증가하고 있으나 국내 고령자를 대상으로 이와 관련된 연구는 극히 제한적이다. 이에 본 연구는 고령자의 비만 및 근위축비만이 신체기능에 미치는 영향을 조사함으로써 고령자를 위한 건강증진 전략에 기초자료를 제공하고자 한다. 방 법 연구대상자는 서울시내 15개 구에서 자립적으로 거주하는 60세 이상 여성 573명이었다. 생체전기저항법으로 체지방률, 체지방량, 제지방량, 체질량지수를 측정하였으며 아시아-태평양지역 지침에 따른 체질량지수를 이용한 5단계 비만구분, 체지방률 5분위수를 이용한 비만구분, 그리고 Cogswell and Dietz의 방식을 이용한 4단계의 근위축비만구분을 실시하였다. 신체기능은 Rikli와 Jones의 노인체력검사로 측정하였으며 통계분석은 SPSS 13.0을 이용하였다. 결 과 여성고령자의 비만과 신체기능간의 관계는 비만구분 방법에 따라서 상이하게 나타났다. 즉, 비만구분을 체지방률 5분위수(quintile)로 나누어 분석할 경우 체지방률이 상위 20%군이 하위 20%군과 비교하여 상지 및 하지근력이 유의하게 낮았으며 (p<.05) 유산소지구력 역시 상위 20%군이 하위 40%군보다 낮았으나(p<.05), 체질량지수로 비만을 분류 시 이 같은 결과는 나타나지 않았다. 근위축비만의 경우 근위축비만군이 정상군에 비하여 하지근력, 상지근력, 정적평형성 및 유산소지구력에서 모두 유의하게 낮았다 (p<.05). 결 론 고령자의 근위축비만과 비만은 신체기능에 영향을 미치므로 노후의 신체기능 향상을 위해서는 단순한 체중감량이 아닌 체지방률 감소와 근육량 증가를 동시에 도모함으로써 근위축비만을 저하시키는 건강증진 전략이 수행되어야 할 것이다.
Abstract
Background Despite the growing importance of physical function in later life, there is still lack of information explaining the relationship between obesity, sarcopenic obesity and functional capacity in seniors. The objective of this study is to examine the influence of obesity and sarcopenic obesity on functional capacity. Methods 673 sedentary older women were recruited from 16 different districts and their body compositions as well as 5 different functional capacities (chair stand, arm curl, one leg stand, 2-min steps, and shoulder flexibility) were examined. Participants were classified into 4 groups by the way of Cogswell and Dietz’s sarcopenic obesity classification; Normal muscle+normal fat(Group-A), normal muscle +high fat(Group-B), low muscle+normal fat(Group-C), and low muscle+high fat(Group-D: Sarcopenic obese). GLM and LSD-test were conducted with SPSS 13.0. Results For 673 older women, mean age of 75, chair-stand (p<.05), arm curl (p<.001), one leg stand(p<.01), 2-min steps(p<.001) were associated with the level of muscle mass and fat mass. For chair stand, sarcopenic obese group has much lower score than that of Group-A and Group-B (p<.05). For arm curl, sarcopenic obese group has lower score that that of Group- A (p<.05). For One leg stand and 2-min steps show same results that sarcopenic obese group has lower score that that of Group A(normal muscle + normal fat) (p<.05). Conclusions We concluded that sarcopenic obese, percent fat affect functional capacity in sedentary older adults.
참고문헌 (32)
- 통계청, "2005 고령자통계" (2006), 통계청
- 한국보건사회연구원, "한국인의 건강 관련 삶의 질과 기대 여명" (2007), 한국보건사회연구원
- Galanos, A. N., "Nutrition and function: is there a relationship between body mass index and the functional capabilities of community-dwelling elderly?", Journal of the American Geriatrics Society, 42(4), pp.368~373 (1994)
- Hubert, H. B., "Risk factors for physical disability in an aging cohort: the NHANES I Epidemiologic Followup Study", Journal of Rheumatology, 20(3), pp.480~488 (1993)
- Launer, L. J., "Body mass index, weight change, and risk of mobility disability in middle-aged and older women. The epidemiologic follow-up study of NHANES I", Journal of American Medical Association, 271(14), pp.1093~1098 (1994)
- Brown, M., "Physical and performance measures for the identification of mild to moderate frailty", Journal of Gerontology: Biological Sciences, 55(6), pp.M350~M355 (2000)
- Villareal, D. T., "Physical frailty and body composition in obese elderly men and women", Obesity Research, 12(6), pp.93~920 (2004)
- Baumgartner, R. N., "Epidemiology of Sarcopenia among the Elderly in New Mexico", American Journal of Epidemiology, 147(8), pp.755~763 (1998)
- Baumgartner, R. N., "Body composition in healthy aging", Annal of New York Academy of Science, 904, pp.437~447 (2000)
- Baumgartner, R. N., "Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly", Obesity Research, 12(12), pp.1995~2004 (2004)
- Zoico, E., "Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women", International Journal of Obesity Related Metabolic Disorders, 28(2), pp.234~241 (2004)
- 조승희, "한국 노인의 비만과 신체적 기능 제한과의 관련성", Korean Journal of Family Medicine, 23(12), pp.5~1452 (2002), 대한가정의학회
- "비만의진단과치료.아시아-태평양지역지침", pp.24~33 (2000), 대한비만학회
- Davison, K. K., "Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III", Journal of American Geriatric Society, 50(11), pp.1802~1809 (2002)
- Rikli, R. E., "Functional Fitness Normative Scores for Community-Residing. Older Adults, Ages 60-94", Journal of Aging and Physical Activity, 7(2) (1999)
- Rikli, R. E., "Senior Fitness Test Manual" (2001), Human Kinetics
- Brach, J. S., "Identifying early decline of physical function in communitydwelling older women: performance-based and self-report measures", Physical Therapy, 82(4), pp.320~328 (2002)
- 조경희, "포괄적 노인평가의 개념과 내용", 가정의학회지, 26(4), pp.S293~S295 (2005)
- Guralnik, J. M., "Physical performance measures in aging research", Journal of Gerontology, 44(5), pp.M141~M146 (1989)
- Guralnik, J. M., "Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability", New England Journal of Medicine, 332(9), pp.556~561 (1995)
- Sternfeld, B., "Associations of body composition with physical performance and self-reported functional limitation in elderly men and women", American Journal of Epidemiology, 156(2), pp.110~121 (2002)
- Janssen, I., "Influence of Sarcopenia on the Development of Physical Disability: The Cardiovascular Health Study", Journal of the American Geriatrics Society, 54(1), pp.56~62 (2006)
- Janssen, I., "Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women", American Journal of Epidemiology, 159(4), pp.413~421 (2004)
- Janssen, I., "Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability", Journal of American Geriatric Society, 50(5), pp.889~896 (2002)
- Apovian, C. M., "Body mass index and physical function in obese older women", Journal of American Geriatric Society, 44(12), pp.1487~1488 (1996)
- Apovian, C. M., "Body mass index and physical function in older women", Obesity Research, 10(8), pp.740~747 (2002)
- Coakley, E. H., "Lower levels of physical functioning are associated with higher body weight among middle-aged and older women", International Journal of Obesity, 22, pp.958~965 (1998)
- National Heart, L., "Clinical Guidelines on the identification, evaluation and treatment of overweight and obesity in aduts", pp.98~4083 (1998), NIH Publication
- Friedmann, J., "The relationship between Body Mass Index and self-reported functional limitation among older adults: A gender difference", Journal of the American Geriatrics Society, 49(398), pp.398~403 (1998)
- Davis, J. W., "Strength, physical activity, and body mass index: relationship to performance-based measures and activities of daily living among older Japanese women in Hawaii", Journal of the American Geriatrics Society, 46(3), pp.274~279 (1998)
- Fontaine, K. R., "Years of life lost due to obesity", Journal of American Medical Association, 289(2), pp.197~193 (2003)
- Visser, M., "Muscle mass, muscle strength,and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons", Journal of Gerontology: Biological Sciences, 60(3), pp.324~333 (2005)