폐경전 여성과 50세 이전 남성에서 골밀도와 혈중지질의 관련성
Relationship between Bone Mineral Density and Blood Lipid in Young and Middle-Aged Men and Pre-Menopausal Women
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연구배경 골다공증과 동맥경화는 노인에서 흔히 동반되나 골밀도와 혈중지질간의 관련성을 설명할 수 있는 기전은 확실치 않으며 결과는 다양하게 보고되었다. 따라서 본 연구는 폐경전 여성과 50세 이전 남성에서 골밀도와 혈중지질과의 관련성을 알아보고자 하였다. 방 법 대상군은 2004년 12월부터 2005년 11월까지 대구지역 일개 대학병원 비만클리닉 및 건강증진센타를 방문하여 전신 골밀도를 측정한 성인 환자중 폐경전 여성 100명과 50세 이전 남성 80명을 대상으로 하였다. 신체계측 및 이중에너지방사선 흡수측정기(DXA)를 이용하여 전신 골밀도를 측정하였다. 공복시 정맥혈을 채혈하여 혈중지질을 측정하였다. 결 과 1) 골밀도와 혈중지질과의 편상관성 분석 결과 남성군에서 총콜레스테롤과 관련성이 높은 부위별 골밀도는 총무기질량, 총 골밀도, 두부 및 척추부 골밀도였다. 중성지방과 HDL 콜레스테롤은 두부 골밀도와 척추부 골밀도와 각각 역상관성이 있었다. LDL 콜레스테롤은 골무기질량, 총골밀도 및 척추부 골밀도에서 음의 관련성이 있었다. 여성군에서는 HDL 콜레스테롤과 골무기질량, 늑골부 및 척추부에서 음의 관련성이 있었다. 중성지방은 늑골부, 상지부 및 척추부 골밀도와 양의 상관성이 있었다. 2) 혈중 지질정도에 따른 부위별 골밀도의 비교결과 남성군에서 총콜레스테롤이 높아질수록 골무기질량, 총골밀도, 두부 및 척추부 골밀도는 낮았다. LDL 콜레스테롤을 3군으로 나눈 후에도 LDL 콜레스테롤이 높은 군에서 골무기질량, 총골밀도, 척추부 골밀도가 유의하게 낮았다. 여성군에서 총콜레스테롤과 HDL 콜레스테롤이 높은 군에서 골무기질량이 유의하게 적었다. 결 론 부위별 골밀도는 남성군에서 총콜레스테롤, HDL 콜레스테롤, LDL 콜레스테롤과 음의 관련성이 있었고, 여성군에서 HDL 콜레스테롤과 음의 상관성이 있었고 중성지방과 양의 상관성이 있었다.
Abstract
Background Although some cross sectional studies found association between lipid profile and bone mineral density(BMD) in human, neither large population-based studies nor prospective studies support links between lipid levels and BMD. The aim of this study was to investigate association of lipid level and BMD after adjustment for obesity in Korean. Methods 180 adult subjects enrolled from health promotion center and Obesity Clinic at university hospital. 80 male subjects were lower than 50 year-old. 100 female subject were pre-menopausal women. Anthropometric data and lipid profile were determined. BMD of whole body was measured by dual energy X-ray absorptiometry. Results 1.Partial correlations analysis between bone mineral content, BMD at various sites and lipid profile were performed. Lipid profile in male was inversely related with various sites of BMD and bone mineral content. In female subjects, HDL cholesterol and triglyceride were negatively and positively associated with various sites of BMD and bone mineral content. 2.In subgroup analysis according to blood level of lipid, higher level group of total cholesterol was significantly lower bone mineral content, total BMD, head BMD, and spine BMD in male subjects. Higher level group of HDL cholesterol was significantly lower bone mineral content, total BMD, and spine BMD. In female subjects, bone mineral content was significantly different between subgroup of total cholesterol and HDL cholesterol. Conclusions This study suggest that lipid profile may be inversely associated with BMD in male subjects, and HDL cholesterol and triglyceride may be related with BMD in female subjects.
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