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검진수진자에서 대사증후군과 담낭결석의 연관성

Relationship between Metabolic Syndrome and Gallbladder Stone

이근미|김종욱
대한가정의학회 (The Korean Academy Of Family Medicine)|2009.08|Korean Journal of Family Medicine|제30권 제8호|pp. 610-616

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비만대사증후군Obesity체질량지수Body Mass Index담낭결석Metabolic Syndrome XGallbladder Stone
주제분류가정의학

초록

연구배경: 대사증후군은 전 세계적으로 유병률이 증가하고 있고, 이로 인한 사망률이 증가하고 있는데, 국내에는 아직 체 계적으로 연구된 바가 많지 않고, 특히 대사증후군 인자의 군 집 분포에 따른 담낭결석의 연관성에 대해서는 연구된 바가 없어 알아보고자 하였다. 방법: 일개 종합병원 건강건진센터에서 2001년 1월에서 2005 년 12월 사이에 건강검진을 시행한 34,574명 중 통계 자료가 부정확한 104명을 제외한 34,470명(남자 20,277명, 여자 14,193 명)을 대상으로 하였고, 대사증후군의 정의는 체질량지수 ≥ 25 ㎏/㎡, 혈압 ≥130/85 ㎜Hg, 공복혈당 ≥110 ㎎/㎗, 중성지 방 ≥150 ㎜Hg, 고밀도지단백-콜레스테롤 남자 <40 ㎎/㎗, 여 자 <50 ㎎/㎗로 하고 이중 3가지 이상이 있을 때로 하였다. 대 사증후군과 담낭결석의 연관성을 알아보기 위하여 나이와 성 별을 보정하고, 다중 로지스틱 회귀 분석을 시행하였다. 결과: 대사증후군 유병률은 전체 17.6%로 나타났으며, 체질 량지수가 증가할수록 담낭결석이 증가하였으며, 높은 중성지 방을 제외한 고혈압, 높은공복혈당, 낮은고밀도지단백의 경 우 담낭결석의 비교 위험도가 증가하였다. 대사증후군 인자 의 군집 분포에 따른 담낭결석의 상관관계는 군집현상이 증 가할수록 담낭결석의 위험도가 증가하였다. 대사증후군 군집 분포가 없는 군과 비교하였을 때 군집수가 1개일 때의 비교위 험도는 1.42 (95% CI, 1.20-1.69), P=0.000, 2개일 때는 1.86 (95% CI, 1.57-2.21), P=0.000, 3개일 때는 2.02 (95% CI, 1.66-2.45), P=0.000, 4개일 때는 2.17 (95% CI, 1.66-2.85), P=0.000, 5개일 때는 2.17 (95% CI, 1.17-4.02), P=0.014로 나타났다. 결론: 체질량지수가 증가할수록 담낭결석이 증가하였으며, 대사증후군 인자를 많이 동반할수록 담낭결석의 위험이 증가 하였다.

Abstract

Background: The prevalence of metabolic syndrome is increasing in Korea. The aim of this study was to establish if there is an association between the presence of metabolic syndrome and the development of gallbladder stones in Koreans. Methods: Among the subjects who visited a health promotion center of a general hospital from January 2001 to December 2005, a total of 34,574 adults was examined. Among them, the fi nal 34,470 adults (males 20,277, females 14,193) were included. Metabolic syndrome was defi ned if they fell under the three conditions of BMI ≥ 25 ㎏/㎡, blood pressure ≥ 130/85 ㎜Hg, fasting glucose 110 ㎎/㎗, triglyceride ≥ 150 ㎜Hg and low HDL-cholesterol (< 40 ㎎/㎗ in men, < 50 ㎎/㎗ in women). After adjusting for age and sex, logistic regression analysis was done to evaluate the relationship between metabolic syndrome and gallstones. Results: This study showed that the prevalence of metabolic syndrome was 17.6% (males 21.1%, females 12.4%). Gallbladder stone risk was increased according to BMI, high blood pressure, high fasting blood glucose and low HDL. Gallbladder stone risk was increased according to clustering of components of metabolic syndrome after adjustment for age and sex (1 criterion: OR = 1.42, 95% CI, 1.20-1.69, P = 0.000; 2 criterion: OR = 1.86, 95% CI, 1.57-2.21, P = 0.000; 3 criterion: OR = 2.02, 95% CI, 1.66-2.45, P = 0.000; 4 criterion: OR = 2.17, 95% CI, 1.66-2.85, P = 0.000; 5 criterion: OR = 2.17, 95% CI, 1.17-4.02, P < 0.014). Conclusion: Gallbladder stone risk was increased according to BMI, and increased with people who had combination of more metabolic syndrome components.

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