서울시 자치구 보건소 대사증후군 관리사업의 재검진기간에 따른 상담중재효과 비교: 서울시 일개 보건소 사례
Comparison of Intervention Outcomes by Test-retest Period of Metabolic Syndrome Management Service at Community Health Center in Seoul: Case of a Center
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본 연구는 서울시 보건소에서 수행하고 있는 대사증후군 관리사업의 재검진기간에 따른 중재효과를 검증하는 데 있다. 연구대상은 서울시 일개 자치구 대사증후군관리센터에 등록하여 체중감량에 성공한 40대 이상의 중․고령자 366명으로 하였다. 연구대상자를 ‘3개월후재검진군’과 ‘6개월후재검진군’으로 분류한 후 집단별 사전-사후 검사결과와 집단 간 사전-사후 검사 변화량 및 변화율을 비교 분석하였다. ‘3개월후재검진군’의 남자는 DBP와 HDL-C를 제외한 모든 ‘형태요인’과 ‘대사요인’이 개선된 것으로 나타났다. 여자는 FBS와 HDL-C를 제외한 모든 요인이 개선된 것으로 나타났다. 반면 ‘6개월후재검진군’의 남자는 체중, 허리둘레, BMI의 ‘형태요인’은 감소했으나 ‘대사요인’은 증가하여 대사증후군 위험수준이 악화된 것으로 나타났다. 여자는 체중, 허리둘레, BMI, SBP는 개선되었으나 나머지 요인들은 유의한 차이가 나타나지 않았다. 두 집단 간의 사전-사후 검사 변화율 차이를 비교한 결과 남자는 ‘3개월후재검진군’의 DBP, T-Chol, TG의 감소율이 ‘6개월후재검진군’에 비하여 높은 것으로 나타났다. 여자는 허리둘레와 DBP, T-Chol의 감소율이 ‘3개월후재검진군’에서 더 높은 것으로 나타나 남녀 모두 ‘3개월후재검진군’이 ‘6개월후재검진군’에 비하여 대사증후군 위험요인의 개선효과가 큰 것으로 나타났다. 결론적으로 두 집단의 재검진기간 간 ‘형태요인’의 개선효과는 유지된 반면 ‘대사요인’은 ‘6개월후재검진군’에서 감소되는 것이 확인되어 대사증후군 관리사업의 재검진기간이 길어질수록 상담중재효과는 감소하는 것으로 나타나 현행 재검진 권장기간에 대한 검토가 필요할 것으로 사료된다.
Abstract
This study evaluated the influence of test-retest period recommended by Metabolic Syndrome Management Service (MSMS) of the city of Seoul on intervention outcomes. A total of 366 men and women aged 40 years and older who registered and participated in MSMS in a community and managed to lose body weight during the program was included for the analyses. They were divided into two groups; 3 month test-retest group (3TG) vs. 6 month test-retest group (6TG). Comparisons of within and between groups for the absolute and relative changes of testing variables were made. For man of 3TG, all morphological variables and metabolic parameters except diastolic blood pressure and high-density lipoprotein cholesterol (HDL-C) were improved during three month period. For woman of 3TG, all variables measured except fasting blood glucose and HDL-C were favorably changed. In contrast, while body weight, waist circumference, and body mass index (BMI) decreased significantly in man of 6TG, metabolic risk factors were aggravated during six months period. In woman of 6TG, body weight, waist circumference, BMI and systolic blood pressure were improved, but other variables measured were not changed during the period. Comparisons of rate change between test and retest revealed that the magnitude of diastolic blood pressure, total cholesterol, and triglycerides were greater in 3TG than 6TG in man. For woman, the reduction of waist circumference, diastolic blood pressure, and total cholesterol was greater in 3TG than 6TG. The magnitude of improvement in metabolic risk factors was greater for 3TG than 6TG in both man and woman. While no group differences were found in changes of morphological variables, the favorable change in metabolic risk factors was reduced in 6TG. The analyses showed that the intervention effect could be minimized as the test and retest period of MSMS was prolonged. The results suggest that intervention period of MSMS in a community should be reexamined for better health outcomes of the population.
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