일부 종합검진 수검자 중 비알코올성 지방간과 심혈관질환 위험요인과의 관련성
The Association of Cardiovascular Risk Factors with Nonalcoholic Fatty Liver Disease in Health Checkup Examinees
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Objectives : The purpose of this study was to evaluate the relationship of nonalcoholic fatty liver and cardiovascular risk factors. Methods : This study was conducted to investigate the association of nonalcoholic fatty liver and cardiovascular risk factors for adult men (n=2976) and women (n=2442) who were over 19 years old, after excluding the HBsAg(+) or anti-HCV(+) patients and the men and women with increased alcohol intake (men: 40 g/week, women: 20 g/week). Results : Compared with the normal liver subjects, the nonalcoholic fatty liver subjects showed a significantly increased frequency of abnormal systolic blood pressure ( 120 mmHg), fasting blood sugar ( 100 mg/dL), total cholesterol ( 200 mg/dL), triglyceride ( 150 mg/dL), high density lipoprotein cholesterol (<40 mg/dL), low density lipoprotein cholesterol ( 130g m/dL) and abdominal obesity in men, and all these measures were significantly increased in the women except for abnormal HDL cholesterol. After adjusting for the body mass index, age, smoking, exercise and a nonalcoholic liver, the odds ratios of an abnormal waist hip ratio were 1.35(95% Confidence Interval=1.05-4.72) in the mild fatty liver, 1.61(1.19-2.18) in the moderate fatty liver, 2.77(1.57-4.92) in the severe fatty liver compared with a normal liver. The adjusted odds ratios for abnormal fasting blood sugar were 1.26(1.03-1.53) in the mild fatty liver, 1.62(1.27-2.06) in the moderate fatty lliver and 1.77(1.12-2.78) in the severe fatty liver. The adjusted odds ratios for abnormal triglyceride were 1.38(1.11-1.72) in the mild fatty liver, 1.73(0.33-2.24) in the moderate fatty liver and 1.91(1.17-3.10) in the severe fatty liver of men. Adjusted odds ratios for abnormal triglyceride were 1.50(1.04-2.15) in mild, 1.71(1.07-2.68) in moderate, 1.81(0.69-4.38) in severe fatty liver of women. Conclusions : The nonalcoholic fatty liver subjects had more cardiovascular risk factors compared with the normal liver subjects. Thus, prevention and treatment of the nonalcoholic fatty liver is necessary by lifestyle modifications such as restriction of alcohol intake, no smoking, exercise and adequate eating habits.
Abstract
Objectives : The purpose of this study was to evaluate the relationship of nonalcoholic fatty liver and cardiovascular risk factors. Methods : This study was conducted to investigate the association of nonalcoholic fatty liver and cardiovascular risk factors for adult men (n=2976) and women (n=2442) who were over 19 years old, after excluding the HBsAg(+) or anti-HCV(+) patients and the men and women with increased alcohol intake (men: 40 g/week, women: 20 g/week). Results : Compared with the normal liver subjects, the nonalcoholic fatty liver subjects showed a significantly increased frequency of abnormal systolic blood pressure ( 120 mmHg), fasting blood sugar ( 100 mg/dL), total cholesterol ( 200 mg/dL), triglyceride ( 150 mg/dL), high density lipoprotein cholesterol (<40 mg/dL), low density lipoprotein cholesterol ( 130g m/dL) and abdominal obesity in men, and all these measures were significantly increased in the women except for abnormal HDL cholesterol. After adjusting for the body mass index, age, smoking, exercise and a nonalcoholic liver, the odds ratios of an abnormal waist hip ratio were 1.35(95% Confidence Interval=1.05-4.72) in the mild fatty liver, 1.61(1.19-2.18) in the moderate fatty liver, 2.77(1.57-4.92) in the severe fatty liver compared with a normal liver. The adjusted odds ratios for abnormal fasting blood sugar were 1.26(1.03-1.53) in the mild fatty liver, 1.62(1.27-2.06) in the moderate fatty lliver and 1.77(1.12-2.78) in the severe fatty liver. The adjusted odds ratios for abnormal triglyceride were 1.38(1.11-1.72) in the mild fatty liver, 1.73(0.33-2.24) in the moderate fatty liver and 1.91(1.17-3.10) in the severe fatty liver of men. Adjusted odds ratios for abnormal triglyceride were 1.50(1.04-2.15) in mild, 1.71(1.07-2.68) in moderate, 1.81(0.69-4.38) in severe fatty liver of women. Conclusions : The nonalcoholic fatty liver subjects had more cardiovascular risk factors compared with the normal liver subjects. Thus, prevention and treatment of the nonalcoholic fatty liver is necessary by lifestyle modifications such as restriction of alcohol intake, no smoking, exercise and adequate eating habits.
참고문헌 (30)
- Sheth SG, "Nonalcoholic steatohepatitis", Ann Intern Med, 126(2), pp.137~145 (1997)
- Angulo P, "Nonalcoholic fatty liver disease", N Engl J Med, 346(16), pp.1221~1231 (2002)
- Poonawala A, "Prevalence of obesity and diabetes in patients with cryptogenic cirrhosis: A case-control study", Hepatology, 32, pp.689~692 (2000)
- Matteoni CA, "fatty liver disease: A spectrum of clinical and pathological severity", Gastroenterology, 116(6), pp.1413~1419 (1999)
- Knobler H, "Fatty liver: An additional and treatable feature of the insulin resistance syndrome", QJM, 92(2), pp.73~79 (1999)
- McCullough AJ, "Update on nonalcoholic fatty liver disease", J Clin Gastroenterol, 34(3), pp.255~262 (2002)
- McCullough AJ, "The clinical features, diagnosis and natural history of nonalcoholic fatty liver disease", Clin Liver Dis, 8(3), pp.521~533 (2004)
- Parés A, "Prevalence and factors associated to the presence of fatty liver in apparently healthy adult men", Med Clin, 114(15), pp.561~565 (2000)
- Clark JM, "Nonal coholic fatty liver disease", Gastroenterology, 122(6), pp.1649~1657 (2002)
- Yeon JE, "Nonalcoholic fatty liver disease: Pathogenesis and treatment", Korean J Med, 70(3), pp.246~252 (2006)
- 김형진, "한국 성인에서 비알콜성 지방간의 중증도에 따른 대사이상의 특징", 대한내분비학회지, 17(4), pp.514~525 (2002), 대한내분비학회
- Jin SY, "Fatty liver", Korean J Hepatol, 12(1), pp.112~115 (2006)
- Marchesini G, "Nonalcoholic fatty liver disease: A feature of the metabolic syndrome", Diabetes, 50(8), pp.1844~1850 (2001)
- Marchesini G, "Association of nonalcoholic fatty liver disease with insulin resistance", Am J Med, 107(5), pp.450~455 (1999)
- Musso G, "Dietary habits and their relations to insulin resistance and postprandial lipemia in nonalcoholic steatohepatitis", Hepatology, 37(4), pp.909~916 (2003)
- Kim SM, "Nonalcoholic fatty liver disease and metabolic syndrome in nonobese, nondiabetic adults", Korean J Obes, 15(1), pp.44~51 (2006)
- Kim KS, "The relationship between fatty liver and parameters of metabolic syndrome in the non alcoholic health screen examinees", Kosin Med J, 21(1), pp.207~217 (2006)
- 서상혁, "건강검진 수진자에서 비알콜성 지방간질환의 유병률 및 연관 인자들", 대한내과학회지, 70(1), pp.26~32 (2006), 대한내과학회
- 나은희, "건강검진에서 진단된 비알코올성 지방간의 대사적 특징 및 관련인자", Annals of Laboratory Medicine, 28(3), pp.244~250 (2008), 대한진단검사의학회
- 박선균, "비알코올성 지방간과 대사증후군 및 혈청 카로테노이드와의 관련성", 예방의학회지, 41(1), pp.39~44 (2008), 대한예방의학회
- Chobanian AV, "Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure", Hypertension, 42(6), pp.1206~1252 (2003)
- Genuth S, "Follow-up report on the diagnosis of diabetes mellitus", Diabetes Care, 26(11), pp.3160~3167 (2003)
- Einhorn D, "American College of Endocrinology position statement on the insulin resistance syndrome", Endocr Pract, 9(3), pp.237~252 (2003)
- World Health Organization, "Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications" (1999), Department of Noncommunicable Disease Surveillance
- Seppälä-Lindroos A, "Fat accumulation in the liver is associated with defects in insulin suppression of glucose production and serum free fatty acids independent of obesity in normal men", J Clin Endocrinol Metab, 87(7), pp.3023~3028 (2002)
- Sanyal AJ, "Nonalcoholic steatohepatitis: Association of insulin resistance and mitochondrial abnormalities", Gastroenterology, 120(5), pp.1183~1192 (2001)
- Anderson AJ, "Body fat distribution, plasma lipids, and lipoproteins", Arteriosclerosis, 8(1), pp.88~94 (1988)
- Akahoshi M, "Correlation between fatty liver and coronary risk factors: A population study of elderly men and women in Nagasaki, Japan", Hypertens Res, 24(4), pp.337~343 (2001)
- 강지현, "성인 남성에서 비알코올성 지방간 질환과 대사증후군과의 관련성", Korean Journal of Family Medicine, 25(10), pp.746~753 (2004), 대한가정의학회
- Adams LA, "The natural history of nonalcoholic fatty liver disease: A population-based cohort study", Gastroenterology, 129(1), pp.113~121 (2005)