당뇨병이 없는 농촌지역의 건강한 성인 남녀에서 당화혈색소와 내장지방과의 관계
Association of Hemoglobin A1c with Visceral Fat Measured by Computed Tomography in Nondiabetic Adults
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당화혈색소 5.7%이상에서 6.4%이하인 당뇨전단계는 당뇨와 심혈관 질환의 위험요소임이 이미알려져 있다. 최근 미국 당뇨병 학회에서는 당화혈색소를 당뇨의 진단 기준으로 추가하였다. 이러한 배경을 바탕으로 본 연구에서는 농촌 지역건강한 성인 남녀를 대상으로 당화혈색소와 내장지방과의 관련성을 살펴보았다. 일개 대학병원건강 검진 수진자 중 건강한 성인 남녀 507명을연구 대상자로 선정하였다. 연구 대상자에게 설문지를 기입하도록 하고 혈압, BMI, 혈액검사를측정하였고, 총 복부지방, 내장지방, 피하지방은CT를 이용하여 측정하였다. 연구 대상자를 남녀로구분지어 평균값을 비교한 결과 내장지방, 피하지방, 중성지방, 당화혈색소가 유의한 차이를 보였다. 남녀로 구분지어 당화혈색소 5.7%를 기준으로 미만 군과 이상 군으로 분류하고 피하지방과내장지방 및 혈액검사를 비교해보았다. 이 중 내장지방만이 남녀 모두에서 5.7%이상 군과 미만 군사이에서 유의한 차이를 보였다. 당화혈색소 5.7%이상 군에서 5.7% 미만 군에 비해 내장지방이높았다. 전진선택법으로 변수를 선택하여 로지스틱 회귀분석을 한 결과, 비교 위험도 1.007(95% CI 1.002∼1.012) 으로 복부 지방 중 내장지방이 증가함에 따라 당화혈색소가 약간 증가하는 결과를관찰하였다. 그러므로 본 연구가 시사하는 바와 같이, 당화혈색소가 5.7% 이상처럼 정상이 아닌 경우에는당뇨병의 유무와 상관없이 여러 심혈관질환 관련위험 인자를 조사하여 이에 적절한 치료와 예방이필요할 것으로 사료된다.
Abstract
Objective: A prediabetes hemoglobin A1c (HbA1c) level of 5.7%–6.4% is considered a risk factor for diabetes mellitus and cardiovascular disease (CVD) in the USA. In this study, we assessed the HbA1c and visceral fat levels as CVD risk factors in health check-up examinees who were not yet diagnosed with diabetes. Methods: Totally, 507 study subject were categorized as per criteria of the American Diabetes Association, depending on whether the HbA1c level was ≥5.7% or <5.7%. Lipid levels, blood pressure, BMI (kg/m2), total abdominal, and visceral fat levels were measured by computed tomography. Results: The mean of HbA1c in the male group was larger than the mean in the female group and their values were, respectively, 6.03±0.82% and 5.88±0.72%(p<0.05). Only the mean values of age and visceral fat area were different between HbA1c≥5.7% and <5.7% in both male and female group(p<0.05). Visceral fat levels were significantly associated with HbA1c in the group of HbA1c ≥5.7% (odds ratio=1.005, 95% CI 1.002∼1.008). Conclusions: Visceral fat levels were significantly higher and correlated with the group which HbA1c level is ≥5.7%. This finding suggests that subjects who have high levels of HbA1c should be carefully monitored during prediabetes and should have chance to have health education programs. Key words: Hemoglobin A1c, Visceral fat, Prediabetes
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