대사증후군 인자 증가에 따른 심혈관계 위험인자 및 비만지표와의 관련성
Association of Obesity and Metabolic Syndrome Score on Cardiovascular Risk
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-연구배경 하나의 심혈관질환의 위험인자보다는 다수의 위험인자가 있을 때 동맥경화 위험이 더 증가하는 것으로 알려져 있다 . 대사증후군은 여러 대사질환을 의미하며 이는 내장지방에 기초하는 것을 평가되고 있다 . 대사증후군은 점진적으로 나타나며 , 대사증후군인자들의 수와 정도에 따라 예측되어진다 . 본 연구는 대사증군을 구성하는 인자 수를 점수화하여 복부비만정도 , 대사 질환의 위험인자 및 복부지방의 관련성을 알아보고자 하였다 . 방 법 단면적 연구로서 서울의 모 대학병원의 비만 클리닉에 내원한 환자 중 752명을 대상으로 임상적 , 신체계측 자료를 측정한 후 컴퓨터 단층촬영을 이용한 복부촬영을 시행하여 선택 조건에 맞는 320명을 대상으로 하여 대사증후군의 인자 수에 따라 여섯 군(0~5)으로 분류하였으며 각 군과 복부총지방 , 내장지방, 피하지방면적, 수축기 및 이완기혈압 , 키, 몸무게, 체질량지수, 허리둘레, 키허리둘레비, 혈중지질농도등과의 상관성을 비교하였다 . 결 과 대사증후군인자가 3개를 갖는 군이 상대적으로 가장 많은 빈도로 분포하였다 . 대사증후군인자에서는 허리둘레 증가가 가장 많은 빈도로 나타났으며 , 혈압상승, 고밀도지단백감소, 공복혈당증가, 중성지방증가 순서로 빈도가 관찰 되었다 . 대사증후군 인자의 점수가 증가 할수록 신체계측지수 , 복부지방 및 대사증후군인자의 평균값은 증가하였으며 , 피하내장지방비 및 저밀도지단백은 유의성이 발견되지 않았다 . 대사증후군의 인자수가 증가 할수록 유의하게 비만지수의 정도가 심하게 나타났으며 특히 내장지방비만도 및 키허리둘레비가 점진적인 양상을 보였다 . 결 론 : 폐경 이후 여성의 골 밀도는 체중, 체질량지수, 체지방량, 제지방량, 근육량 등의 체성분에 영향을 미치나, 이 중 특히 제지방량과 근육량이 골 밀도와 보다 큰 연관성이 있으며, 골다공증 예방을 위해서는 제지방량, 특히 근육량을 높이기 위한 적정량의 운동과 음식섭취가 필요할 것으로 생각된다.
Abstract
Background : The purpose of this study was to analyze the relationship between BMD(bone mineral density) and body composition in women in a community and find the protective factor of the osteoporosis. Methods : The study subjects were 36 premenopausal women and 111 postmenopausal women who did not take any drugs and have any diseases affecting BMD. We analyzed the relationship between BMD and body composition. So, BMD was measured at the os calcis with dual energy X-ray absorptiometry, and body composition was measured with bioelectrical impedance analysis. Results : The mean age of premenopausal women was 46.69 years and postmenopausal women was 60.85 years. There were statistical differences in BMD of the two groups; 0.53±0.08, 0.39±0.10 respectively. In premenopausal women, only age was correlated with BMD(r=-0.366, p<0.05). But in postmenopausal women, age(r=-0.471, p<0.01), parity(r=-0.231, p<0.05), and lactation period(r=-0.247, p<0.05) were negatively correlated with BMD, whereas weight(r=0.481, p<0.01), BMI(r=0.332, p<0.01), fat mass(r=0.370, p<0.01), fat free mass(r=0.536, p<0.01) and muscle mass(r=0.538, p<0.01) were positively correlated with BMD. In a multiple linear regression analysis adjusted by age, parity, lactation period and exercise, total and partial R were 0.422, 0.196 in weight, 0.365, 0.118 in BMI, 0.386, 0.148 in fat mass, 0.410, 0.236 in fat free mass and 0.409, 0.233 in muscle mass respectively. Conclusions : This study suggests that fat free mass and muscle mass, among body compositions, are the major determinants of BMD at the os calcis in postmenopausal women. Thus, we think that proper exercise and diet will be required for increasing fat free mass, especially muscle mass, to prevent the osteoporosis.
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