대사증후군과 인슐린저항성 평가를 위한 시상복부 직경의 유용성
Usefulness of Sagittal Abdominal Diameter for Evaluation of Metabolic Syndrome and Insulin Resistance
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연구배경: 본 연구에서는 한국인 성인에서 시상복부직경의대사증후군 및 인슐린저항성과의 연관성을 알아보고자 하였다. 방법: 2008년 11월 11일부터 11월 14일까지 부산의 일개 대학병원 건강증진센터를 방문한 190명을 대상으로 단면연구를 시행하였다. 허리둘레, 체질량지수, 시상복부직경과 여러가지 대사요인 및 인슐린저항성(HOMA-IR), 인슐린 감수성(QUICKI) 지표와의 상관관계를 분석하고, 나이, 성별, 생활습관인자를 보정한 후 시상복부직경의 사분위에 따라 대사증후군의 이환에 대한 교차비를 조사하였다. 결과: 시상복부직경이 체질량지수와 비교하여 인슐린 저항성지표와 유의한 상관관계가 있었다. 시상복부직경이 증가할수록 대사위험인자 중 복부비만, 높은 혈압, 인슐린 저항성지표, 비만이 증가하는 경향을 보였으며, 고중성지방혈증, 저고밀도콜레스테롤혈증은 유의성이 없었다. 남자에서 인슐린감수성 저하의 지표는 유의하게 증가하였다. 나이, 성별, 흡연, 음주, 운동, HOMA-IR, QUICKI 등을 보정하여 분석하였을 때 시상복부직경이 증가할수록 대사증후군의 교차비가 3rd quartile (odds ratios, 9.467; 95% confidence interval [CI], 3.225-27.789;P<0.001)과 4th quartile (OR, 7.253; 95% CI, 2.437-21.586;P<0.001)에서 증가하는 경향을 보였으며 이는 통계적으로 유의하였다. 결론: 본 연구에서 시상복부직경은 한국인 성인에서 인슐린저항성, 인슐린 감수성 저하를 예측하고 대사증후군 위험을평가하는 강한 예측치임을 알 수 있었다.
Abstract
Background: We studied the association of sagittal abdominal diameter (SAD) and metabolic syndrome and insulin resistance in Korean adults. Methods: This is a cross-sectional study by 190 patients who visited a Health Promotion Center of National University of Pusan from 11 November to 14 November, 2008. We analyzed the association of anthropometry (waist circumference,BMI, SAD), insulin resistance (homeostatic model assessment-insulin resistance, HOMA-IR), insulin sensitivity (quantitative insulin sensitivity check index, QUICKI), and plasma concentrations of glucose, insulin, total cholesterol,LDL, HDL, triglyceride. SAD was categorized into quartiles and assessed odds ratio of metabolic syndrome adjusted for age, sex, lifestyle factors. Results: SAD showed significance correlation to HOMA-IR than BMI. Quartiles of SAD showed a positive trend with metabolic risk factors including abdominal obesity, high blood pressure, HOMA-IR and obesity but hypertriglyceridemia,low HDL-cholesterolemia did not show significant association. In men QUICKI was significantly high. A multivariate model, adjusted for age, sex, smoking status, physical activity, heavy drinking, HOMA-IR and QUICKI, revealed a progressively increased odds ratio of metabolic syndrome, 3rd quartile (odds ratio [OR]; 9.467; 95% confidence interval [CI], 3.225 to 27.789; P < 0.001) and 4th quartile (OR, 7.253; 95% CI, 2.437 to 21.586; P < 0.001), with increasing SAD. Conclusion: As shown above, SAD was a strong anthropometric marker of insulin resistance, risk of metabolic syndrome and decreased insulin sensitivity in Korean adults.
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