건강증진센터를 내원한 성인에서 혈청 페리틴과 고감도 C-반응 단백과의 관련성
The Relationship between Serum Ferritin and High Sensitivity C-reactive Protein among Adults in a Health Promotion Center
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연구배경: 최근 죽상경화를 염증반응으로 인식하면서 이를 일으키는 산화가설에 주목하고 있다. 이에 건강증진센터를 내원한 성인을 대상으로 지질 과산화를 촉매하는 것으로 생각되어지는 혈청 페리틴과 혈관염증을 반영하는 대표적인 인자인 고감도 C-반응 단백과의 관련성을 알아보고자 한다. 방법: 2004년 10월 1일부터 2005년 4월 1일까지 일개 종합병원 건강증진센터 20세 이상 수진자 297명을 대상으로 설문조사를 시행하고 신체계측, 혈액 검사, 혈압 및 상완-발목 맥파속도를 측정하였다. 그 중 고혈압, 고지혈증, 당뇨병으로 치료중인 환자, 백혈구 11,000×103/mm3이 넘거나, 혈청 페리틴 200 ug/L이 넘는 경우, 급성 감염성 질환자, 고감도 C-반응 단백이 10 mg/L를 초과하는 경우, 급성 간 질환자, 빈혈 해당자 및 ABI (Ankle Brachial Index) 0.9 미만인 군을 제외한 111명을 연구대상으로 하였다. 결과: 혈청 페리틴 농도는 남자에서 131.57±43.12 ng/ml, 여자에서 78.23±38.10 ng/ml로 남자가 여자보다 약 1.7배 높았다(P<0.001). 혈청 페리틴은 상관분석에서 체질량지수(r=0.227), 고밀도지단백(r=−0.189) 및 고감도 C-반응 단백(r=0.332)과 상관성을 보였으며, 단계적 다중회귀분석에서도 고감도 C-반응단백과 독립적인 관련성이 있었다(β=0.138, P=0.010). 또한 성별을 나누어 분석하였을때, 여성에서 혈청 페리틴은 여전히 고감도 C-반응 단백과 독립적인 관련성이 지속되었으나 (β=0.131, P=0.031), 남성에서는 체질량 지수만이 혈청 페리틴과 상관성을 보이는 정도였다(β=9.510, P=0.059). 결론: 건강한 성인 여성에서 혈청 페리틴의 증가는 심혈관계 질환의 예측인자인 고감도 C-반응 단백과 독립적인 관련성을 보였으며, 남성에 대해 결론을 내리기 위해서는 추후 연구가 필요하다.
Abstract
Background: More attention is given to oxidative hypothesis which causes atherosclerosis to be recognized as inflammatory response. The relationship between serum ferritin which catalyzes lipid peroxidation and high sensitivity C-reactive protein which reflects vascular inflammation was investigated among adults in a health promotion center. Methods: The study group consisted of 297 men and women (men 86, women 211) who visited the health promotion center of a hospital in Seoul to have a health checkup from October 1, 2004 to April 1, 2005. These subjects answered the questionnares and were measured in the following; blood tests, brachial-ankle pulse wave velocity and several anthropometric measurements. Statistical analysis was performed on 111 subjects after exclusion of those subjects who were taking antihypertensive agents or antidiabetic agents, and who had acute inflammatory diseases, acute liver diseases, anemia, and who had a WBC ≥11,000×103/mm3 or a serum ferritin ≥200 ug/L or a ABI (Ankle Brachial Index) <0.9. Results: The average serum ferritin concentration of men against women was 132.57±43.12 ng/ml to 78.23±38.10 ng/ml which means that men have about 1.7 times as high concentration than women (P<0.001). Serum ferritin was significantly correlated with high sensitivity C-reactive protein (r=0.332). Even in multiple stepwise regression analysis, there was a independent relationship between serum ferritin and high sensitivity C-reactive protein (β=0.138, P=0.010). When we analyzed with distinction of sex, this relationship in women was constant (β=0.131, P=0.031), but serum ferritin in men just showed the trend of correlation with BMI (β=9.510, P=0.059). Conclusion: There is a significant relationship between the increase of serum ferritin and high sensitivity C- reactive protein in healthy women; furthermore, studies in men need to be confirmed.
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