상부 위장관 내시경 소견과 비만 관련 위험인자들 사이의 연관성
The Association between Esophagogastroduodenoscopic Findings and the Related Risk Factors of Obesity
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연구배경: 비만과 상부 위장관 질환(위염, 위궤양 혹은 십이지장 궤양, 그리고 역류성 식도염)과의 연관성에 관한 연구들은 많이 있지만 일관된 결과를 보여주지 못하고 있다. 본 연구는 상부 위장관 내시경 소견과 비만 관련 위험 인자들 사이의연관성에 대해 알아보기 위해 시행하였다. 방법: 2006년 1월부터 12월까지 일개 대학병원 건강검진센터를 내원한 2,210명을 대상으로 하여 기초설문조사를 시행하여 연령, 성별, 과거력 및 사회력 등을 조사하였으며 신장, 체중, 혈압, 공복혈당, 당화혈색소, 혈청지질을 측정하였고 상부위장관 내시경을 시행하였다. BMI < 23 kg/m2을 정상 그룹으로, BMI ≥ 23 kg/m2을 과체중 혹은 비만 그룹으로 분류하였다. 대상자들은 상부 위장관 내시경 소견에 따라 4개의 그룹(그룹0, 정상; 그룹1, 위염; 그룹2, 위궤양 혹은 십이지장 궤양; 그룹3,역류성 식도염)으로 나누어 분석하였다. 결과: 혈압, BMI, 공복혈당, HbA1c, 총콜레스테롤, 중성지방,HDL-콜레스테롤, LDL-콜레스테롤은 그룹 0에 비해 그룹 1, 2,3에서 유의하게 높았으나 나이, 성별, 음주, 흡연, BMI로 보정한 후에는 BMI만이 유의한 차이를 보였다(P<0.001). 과체중혹은 비만인 군에서 상부 위장관 내시경 소견 정상(그룹 0)에대해 위염(그룹 1)이 있을 위험이 높았다(OR, 2.098; 95% CI,1.195-3.682; P=0.01). 또한 과체중 혹은 비만인 그룹에서, 상부위장관 내시경상 정상인 그룹(그룹 0)에 대해 위궤양 혹은 십이지장 궤양(그룹 2)이 있을 위험도 높았다(OR, 2.562; 95% CI,1.282-5.117; P=0.008). 그리고 과체중 혹은 비만인 그룹에서,상부 위장관 내시경상 정상인 그룹(그룹 0)에 대해 역류성 식도염(그룹 3)이 있을 위험도 높았다(OR 2.856; 95% CI, 1.522-5.360; P=0.001). 결론: 과체중 혹은 비만은 위염, 위궤양 혹은 십이지장 궤양및 역류성 식도염 발생의 위험 인자가 될 수 있을 것으로 생각되어진다.
Abstract
Background: The reports that obesity could be associated with upper gastrointestinal disorders such as gastritis, gastric ulcer, duodenal ulcer, reflux esophagitis have not been consistent. Therefore, we studied the association between esophagogastroduodenoscopic (EGD) fi ndings and the related risk factors of obesity. Methods: The study subjects include 2,210 adults who visited the Health Promotion Center of one university hospital from January 2006 to December 2006. All subjects had standard physical measurements as well as resting blood pressure,fasting blood glucose, HbA1c, serum lipids, and gastroendoscopic examination. BMI was classifi ed into two groups (BMI ≥ 23 kg/m2, normal; BMI < 23 kg/m2, overweight or obese). The study subjects were classifi ed into four groups according to the EGD fi ndings; normal, gastritis, gastric or duodenal ulcer, refl ux esophagitis. Results: Mean BMI of gastritis, gastric or duodenal ulcer, and refl ux esophagitis groups were higher than normal group after adjusting age, sex, alcohol and smoking (P < 0.001). Gastritis risk (OR, 2.098; 95% CI, 1.195 to 3.682; P = 0.01), gastric or duodenal ulcer risk (OR, 2.562; 95% CI, 1.282 to 5.117; P = 0.008), and refl ux esophagitis risk (OR, 2.856; 95% CI, 1.522to 5.360; P = 0.001) were signifi cantly higher in overweight and obesity group compare with normal weight group after adjusting age, sex, alcohol and smoking. Conclusion: We suggest that overweight or obesity is the risk factor of gastritis, gastric or duodenal ulcer, and reflux esophagitis.
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