건강한 한국 성인에서 CRP와 비만지표 및 대사질환 위험도와의 관계
Correlations of C-reactive Protein Levels with Obesity Index and Metabolic Risk Factors in Healthy Adults
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연구배경: C-반응성 단백(C-reactive protein, CRP)은 염증성 질환 또는 체내 조직의 괴사와 같은 질환에서 현저하게 증가하는 혈장 단백의 하나로, 최근에는 심혈관 질환이나 비만 등과도 관련이 있다는 보고가 증가하고 있다. 본 연구에서는 비만의 정도와 CRP와 연관성에 대해서 알아보기 위해 한국 성인에서 비만지표와 CRP와의 관계에 대해 알아보았다. 방법: 2004년 5월부터 12월 까지 일개 대학병원 건강증진센터를 내원한 20세 이상의 성인 1,975명에서 염증성 질환을 제외한 1,926명(남자 1,168명, 여자 758명)을 대상으로 연령, 신체 계측, 설문 조사, 혈압, 공복 혈당, 혈청 지질대사치, 체지방률, 체질량지수를 조사하였다. C-반응성 단백은 TIA (Turbid Immuno Assay)법을 이용하였고, 체지방률, 체질량지수, 대사증후군 위험인자의 군집성에 따른 CRP 값을 조사하였다. 결과: 체지방률, 체질량지수, 대사증후군 위험인자 개수에 따라 CRP 중간값을 비교했을 때, 체지방률, 체질량지수, 대사증후군 위험인자 개수가 증가 할수록 CRP 수치가 유의하게 증가하였다(P＜0.001). 상승된 CRP 값을 0.22 mg/dL 이상으로 정의하였을 때, 체지방률, 체질량지수, 대사증후군 위험인자 개수가 증가할수록 상승된 CRP (≥0.22 mg/dL)의 비율(prevalence)도 증가하였다(P＜0.05). 상승된 CRP 값을 0.22 mg/dL 이상으로 정의하여, 비만에 속하는 체질량지수가 25 kg/m2 이상은 그 이하보다 CRP 증가에 대한 위험이 남자에서는 교차비 1.5 (95% 신뢰구간 1.0～2.1), 여자에서는 교차비 2.9 (95% 신뢰구간 1.7～4.8)로 유의하게 높았다. 남자에서 체지방률이 25% 이상, 여자에서 체지방률이 30% 이상은 그 이하보다 CRP 증가에 대한 위험이 각각 교차비 2.0 (95% 신뢰구간 1.3～2.9), 교차비 2.5 (95% 신뢰구간 1.4～4.1)로 유의하게 높았다. 결론: 우리나라 성인 남녀 모두에서 체지방률이 증가할수록 CRP 값이 증가되어 있는(＞0.22 mg/dL) 비율(%)이 높아지는 것을 보여주어 CRP와 체지방률과의 양의 상관관계를 관찰할 수 있었다. 체지방률 남자 25% 이상, 여자 30% 이상부터 CRP 증가 위험이 높게 나타났으며, 비만도가 증가할수록 CRP 상승 형태도 증가하였다.
Abstract
Background: C-reactive protein (CRP) is one of the increasing plasma proteins in inflammatory diseases and tissue necrosis and recent evidence show that increased elevated levels of CRP are associated with an increased risk of coronary heart disease (CHD) and obesity. To investigate the relationship of obesity and CRP, we evaluated the correlation of CRP with obesity index in healthy adults. Methods: The subjects included 1,926 healthy adults (1,168 men and 758 women) who visited the Health Promotion Center of a general hospital from May to December 2004. We excluded subjects who had inflammatory diseases, and investigated based on age, physical examination, blood pressure, fasting plasma glucose, serum lipid profile, percentage of body fat, and body mass index (BMI). CRP was analyzed by method of Turbid Immuno Assay (TIA) which has high sensitivity-CRP. We evaluated serum level of CRP in relation to %body fat, BMI, and clustering of metabolic risk factors. Results: Comparing the median CRP with the percentage of body fat, BMI, clustering of metabolic risk factors the value of CRP significantly increased according to increase in %body fat BMI and metabolic risk fakfor (P＜0.001). The proportion of elevated CRP levels (≥0.22 mg/dL) was increased as %body fat, BMI, and clustering of metabolic risk factor increased. The Odds Ratios for elevated levels of CRP were 1.5 (95% CI 1.0～2.1) in men and 2.9 (95% CI 1.7～4.8) in women for subjects with obesity (BMI≥25 kg/m2), 2.0 (95% CI 1.3～2.9) in men with more than 25% %body fat, and 2.5 (95% CI 1.4～4.1) in women with more than 30% %body fat. Conclusion: As %body fat increased, the proportion of elevated CRP (≥0.22 mg/dL) level increased in men and women. We conclude that obesity is related with CRP. (J Korean Acad Fam Med 2006;27:620-628)
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