성인 남녀에서 혈장 호모시스테인 농도와 상완: 발목 동맥파속도의 연관성
Association between Plasma Homocysteine Level and Brachial-ankle Pulse Wave Velocity in Korean Adults
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연구배경: 혈중 호모시스테인 농도의 증가는 혈관내피의 기능 뿐 아니라, 구조적 변화를 초래함으로써 동맥의 죽상경화증 발생에 기여한다. 상완-발목 동맥파속도는 비 침습적으로 동맥의 죽상경화 정도를 측정하는 방법으로, 동맥의 경직도를 반영한다. 이 연구는 중년의 성인남녀를 대상으로 혈중 호모시스테인 농도와 동맥의 경직도와의 연관성을 알아보고자 하였다. 방법: 건강증진센터에 방문한 성인 남녀 405명을 대상으로 하였다. 대상자들의 병력과 약물 복용력, 생활습관 등은 자가 기입 설문지와 의사의 면담을 통해 조사하였다. 기본적인 신체검사와 함께 검사실 검사로 당대사지표, 지질대사지표, 염증관련지표 및 혈중 호모시스테인 농도를 측정하였다. 동맥의 경직도를 측정하는 지표로 상완-발목 동맥파속도를 측정하였다. 결과: 모든 항목에 대한 조사가 이루어진 대상자는 379명이었다. 이중 남성이 121명(31.9%), 여성이 258명(68.1%)이었고, 이들의 평균연령은 각각 54.5±8.7세와 57.2±7.0세였다. 남성에서는 연령, 혈압, 심박동수, 혈액의 백혈구, 고감도 C-반응단백 농도, 혈중 호모시스테인 농도가, 여성에서는 연령, 체질량지수, 허리둘레, 혈압, 심박동수, 당대사지표, 고밀도지질단백을 제외한 지질지표, 고감도 C-반응단백 농도, 혈장 호모시스테인 농도가 상완-발목 동맥파속도와 유의한 양의 상관관계를 나타내었다. 남성에서는 혈중 호모시스테인 농도가 증가할수록 상완-발목 동맥파속도가 유의하게 증가하였으며, 심혈관계 질환 관련 위험인자를 통제하더라도 호모시스테인이 상완-발목 동맥파속도와 연관이 있는 것으로 나타났다(β=19.01, P=0.02). 결론: 중년남성에서 혈중 호모시스테인 농도는 심혈관계 질환 관련 위험인자를 통제하더라도 상완-발목 동맥파속도와 연관이 있었다.
Abstract
Background: Elevated plasma homocysteine appears to be causally related to atherosclerosis by inducing both endothelial dysfunction and vascular structure alteration. Brachial-ankle pulse wave velocity, a non-invasive means of measuring atherosclerosis, reflects arterial stiffness. In this study, we investigated the association between the plasma homocysteine level and arterial stiffness in Korean adults. Methods: The study group comprised of 405 subjects selected from examinees in the Health Promotion Center. Medical history, medication, and life style were recorded through a questionnaire and physical examination was performed on all subjects. We measured glucose tolerance index, lipid profile, inflammatory index, and plasma homocysteine level. We studied brachial-ankle pulse wave velocity (baPWV) as a measure of arterial stiffness. Results: A total of 379 subjects were examined on all components. The mean age in 172 males was 54.5 ± 8.7 years and in females was 57.2 ± 7.0 years. The baPWV was observed to be positively correlated with age, blood pressure, hs-CRP, and homocysteine in males. In contrast, males, age, BMI, waist circumference, blood pressure, glucose tolerance index, lipid profile except for HDL cholesterol, hs-CRP, and homocysteine were positively correlated with baPWV in females. The baPWV was increased according to the level of plasma homocysteine in males. After ontrolling or risk factors of cardiovascular diseases, homocysteine was associated with increased baPWV. Conclusion: The results indicate that elevated plasma homocysteine was associated with baPWV in middle-aged male after adjustment for the risk factors of cardiovascular diseases.
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