혈청 감마지티피 농도에 따른 대사증후군 발생 위험
Relations of Serum γ-glutamyltransferase Levels to Incidence of the Metabolic Syndrome
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연구배경: 최근 많은 연구에서 γ-glutamyltransferase는 고혈압, 당뇨, 비만, 이상지질혈증 등을 나타내는 대사증후군의 예측인자로서 그 중요성이 보고되었다. 본 연구는 기저 γ-glutamyltransferase 농도가 대사증후군 발생 위험도를 예측할 수 있는지를 조사하고자 하였다. 방법: 일개 대학병원 건강증진센터에서 2002년과 2005년에 공통적으로 건강검진을 받은 총 741명 중 2002년에 대사증후군이 없고 기저 γ-glutamyltransferase의 농도가 정상인 429명을 대상으로 3년간 추적 관찰하여 2005년에 대사증후군의 발생 여부를 조사하였다. 대사증후군의 유무는 modified Adult Treatment Panel III definition에 따라 분석하였다(허리둘레는 예외로 남성은 90 cm 이상, 여성은 85 cm 이상을 기준으로 하였다). 결과: 기저 혈청 γ-glutamyltransferase를 사분위수로 나누어 향후 대사증후군의 발생 위험도를 연령, 성별 및 음주력을 보정후 로지스틱 회귀분석을 실시한 결과 교차비(95% Confidence Interval, P-value)는 각각 2.28 (0.58∼9.01, P=0.240), 1.53 (0.36∼6.66, P=0.564), 4.56 (1.08∼19.32, P=0.040)이었다. 결론: 본 연구의 결과 기저 혈청 γ-glutamyltransferase는 대사증후군의 발생과 관련이 있었다. 대사증후군이 없는 한국인 성인에서 기저 혈청 γ-glutamyltransferase 수치가 정상 범위에서 높으면 향후 대사증후군 발생위험이 증가한다.
Abstract
Background: The metabolic syndrome is a cluster of risk factors for cardiovascular diseases. Recently, serum gamma-glutamyltransferase (GGT) has been suggested as a predictor for development of the metabolic syndrome. Therefore, we investigated the association between serum GGT levels and the incidence of the metabolic syndrome in the Korean healthy adults with normal serum GGT with a 3 year follow-up. Methods: The study subjects consisted of 741 individuals who visited the Center for Health Promotion in Pusan National University Hospital for a medical checkup in 2002 to 2005. Among 741 subjects, 312 were excluded: 71 were positive for HBsAg, 17 were positive for Anti-HCV Ab, 40 showed GGT higher levels than limit of reference range, and 224 had metabolic syndrome. The final subjects were 429 individuals. We measured serum GGT levels, lipid profiles, fasting glucose, blood pressure and their metabolic components. Results: As the quartile of serum GGT increased, 3 year follow-up incidence of the metabolic syndrome was increased. Logistic regression analysis adjusting for sex, age, and alcohol drinking status showed that the odds ratio (95% confidence Interval, P-value) of each GGT quartile was 2.28 (0.58∼9.01, P=0.240), 1.53 (0.36∼6.66, P=0.564), 4.56 (1.08∼19.32, P=0.040), respectively. Conclusion: These results showed that the serum GGT was closely related to the metabolic syndrome. In Korean adults without the metabolic syndrome, the serum GGT levels within normal limit were associated with an increased risk of incident, metabolic syndrome.
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