정상 체중 및 허리둘레를 갖는 성인 남자에서 체중, 체지방률, 허리둘레의 변화에 따른 혈압, 혈당, 지질 수치의 변화
Changes in Blood Pressure, Blood Glucose, and Lipid Profile Caused by Changes of Weight, Percent Body Fat, and Waist Circumference in Adult Men with Normal Weight and Waist Circumference
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연구배경: 비만 지표(체중, 체지방률, 허리둘레)가 정상 범위라도 낮은 정상과 높은 정상간에 대사 지표(혈압, 혈당, 지질)는 차이를 보인다. 따라서, 정상 체중 및 허리둘레를 지닌 성인에서 비만 지표가 변할 때 대사 지표의 변화를 보고자 하였다. 방법: 2001년 4월에서 2005년 2월까지 검진센터를 방문한 성인 남자 중 1-2년 추적 전후에 정상 체중 및 허리둘레를 유지한 344명을 대상으로 하였다. 추적 전후 비만 지표 변화율과대사 지표 변화량과의 상관성을 다중회귀분석을 통해 실시했고 비만 지표 증가/감소군에서 대사 지표의 변화를 t-검정을통해 보았다. 초기에 대사 지표가 정상일 때 비만 지표 감소/증가군에서 대사 지표가 비정상이 되는 교차비를 로지스틱회귀분석을 통해 구했고, 반대로 초기에 대사 지표가 비정상일 때 비만 지표 증가/감소군에서 대사 지표가 정상이 되는 교차비를 구했다. 결과: 평균 추적은 1.38±0.32년이었고 체중 변화율은 수축기혈압(SBP), 이완기 혈압(DBP), 중성지방(TG), 고밀도 지단백(HDL) 변화량과(P-value, 0.001, 0.03, 0.001, 0.01), BMI 변화량은SBP, DBP, 혈당(FBG), TG 변화량과(P-value, 0.02, 0.002, <0.001,0.03) 허리둘레 변화률은 FBG, TG, HDL 변화량과 유의한 상관성이 있었다(P-value, 0.01, 0.01, 0.02). SBP, HDL은 체중 감소/증가군에서(P-value, 0.04, <0.001), FBG은 체지방률 감소/증가군에서(P-value, 0.01), FBG, TG는 허리둘레 감소/증가군에서유의한 차이가 있었다(P-value, 0.03, 0.03). 초기에 정상이었던각 대사지표 중에, FBG에 대해서만 체지방률 감소군에 비해증가군이 FBG100 될 교차비는 2.98였고(P-value, 0.02), 초기에 비정상이었던 각 대사지표 중에도, FBG에 대해서만 체지방률 증가군에 비해 감소군이 FBG<100 될 교차비는 3.22였다(P-value, 0.02). 결론: 정상 범위에서 비만 지표의 변화라도 대사 지표가 변할수 있으므로, 비만 지표가 증가하는 것은 좋지 않다.
Abstract
Background: Metabolic indexes (blood pressure, blood glucose, and lipid) differ depending on lower or upper normal value of obesity indexes (weight, percent-body-fat, and waist circumference) despite normal value. Therefore, we examined metabolic indexes changes across obesity indexes changes. Methods: We analyzed 344 adult men who received routine-checkups with normal weight and waist circumference before and after follow-up. We used multiple-linear-regression to examine associations between changes of obesity indexes and metabolic indexes before and after follow-up. We examined differences of metabolic indexes by t-test and odds ratios of normal or abnormal metabolic indexes by multiple-logistic-regression in groups where obesity indexes were increased and decreased. Results: The mean follow-up was 1.38 ± 0.32 years and there were associations between weight change rate and changes in systolic-blood-pressure (SBP), diastolic-blood-pressure (DBP), triglyceride (TG), and high–density-lipoprotein (HDL) (P = 0.001, 0.03, 0.001, 0.01), associations between percent-body-fat change and changes in SBP, DBP, fasting-blood-glucose (FBG) and TG (P = 0.02, 0.002, < 0.001, 0.03), and associations between waist circumference change rate and changes in FBG, TG, HDL (P = 0.01, 0.01, 0.02). There were significant SBP and HDL differences in weight decrease and increase groups (P = 0.04, < 0.001), FBG difference in percent-body-fat decrease and increase groups (P = 0.01), and FBG and TG differences in waist circumference decrease/increase groups (P = 0.03, 0.03). As compared with percent-body-fat decrease group, percent-body-fat increase group had odds ratio of FBG ≥ 100 of 2.98 (95% confidential interval [CI], 1.18 to 7.51)with a significance on only FBG of initially normal metabolic components and conversely percent-body-fat decrease group had odds ratio of FBG < 100 of 3.22 (95% CI, 1.21 to 8.60) with a significance on only FBG of initially abnormal metabolic components. Conclusion: Increased obesity indexes even within normal range, could change metabolic indexes.
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