한국성인에서 비만관련 질환을 높이는 내장지방량 기준치
Cut-off Value of Visceral Fat Area at Risk of Obesity-related Disorders in Korean Adult Population
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연구배경: 최근 들어 비만은 우리나라에서도 중요한 건강문제로 대두되었다. 2000년 WHO 서태평양 지부에서 동양인의 비만 진단 기준을 제시하였지만, 동양인 간에도 체형의 차이가 존재하기에 이를 한국인에게 그대로 적용하는 것은 문제가 있다. 이 논문의 목적은 한국인 성인에서 비만 관련 질환의 위험도를 높이는 내장지방량 기준치와 이에 대응하는 허리둘레를 분석함으로써 한국 성인에 적합한 복부비만과 대사증후군을 진단하는 데 도움이 되고자 한다. 방법: 1999년 1월부터 2005년 8월까지 성모병원 가정의학과에 내원한 18세에서 70세까지의 한국인 성인 중 컴퓨터 단층촬영으로 내장지방을 측정한 278명(남성 101명, 여성 177명)을 대상으로 하였다. 비만 관련 질환의 기준은 (1) 고혈압(혈압강하제를 복용하고 있거나, 수축기 혈압≥140 mmHg 또는 이완기 혈압≥90 mmHg), (2) 고혈당(혈당강하제를 복용 중이거나 공복혈당≥110 mg/dL) (3) 고지혈증(총콜레스테롤≥220 mg/dL 또는 중성지방≥150 mg/dL 또는 HDL＜40 mg/dL)을 기준으로 정의하였다. 결과: ROC curve로 분석하였을 때 비만 관련 질환의 빈도를 높이는 내장지방량의 cut-off value는 114.3cm2 (민감도 76.3%, 특이도 65.9%, P＜0.005)였고, 이에 대응되는 허리둘레는 남성은 74.2 cm, 여성은 87.37 cm였다(P＜0.05). 결론: 본 연구에서 한국인에서 비만 관련 질환의 위험이 증가하는 내장지방량은 114.3 cm2이며 이에 대응되는 허리둘레는 남자의 경우 74.2 cm, 여성에서 87.37 cm으로 한국인에게 적합한 복부비만과 대사증후군 진단기준을 위해 향후 대규모의 한국 성인을 대상으로 비만 관련 질환 인자들에 대한 연구가 필요할 것으로 생각한다.
Abstract
Background: Recently, obesity has become an important health problem in Korea. In 2000, the WHO Western Pacific Region recommended an obesity diagnostic criteria for Asian population. But among Asians, each ethnic group had their own anthrometric characteristics and so it was difficult to apply the same criteria to different ethnic groups. Thus, the aim of this study was to study the appropriate cut-off value of visceral fat area (VFA) and waist circumference (WC) which increases the risk of obesity-related disorders and to validate the diagnostic criteria of abdominal obesity and metabolic syndrome in Korean adult population. Methods: A total of 278 of subjects (101 men and 177 women) were included for this study. The subjects were selected among Korean adults who visited the Department of Family Medicine, St. Mary's Hospital from January 1999 to August 2005. Three obesity-related disorders were defined to hypertension, hyperglycemia, and dyslipidemia. Results: The cut-off value of visceral fat area which increased the risk of obesity-related disorders by ROC curve was 114.3 cm2 (sensitivity 76.3%, specificity 65.9%, P＜0.005), and the waist circumference corresponding to a VFA of 114.3 cm2 by simple regression analysis was 74.2 cm in men and 87.37 cm in women (P＜0.05). Conclusion: Based on the results of this study, the visceral fat area which increased the risk of obesity-related disorders was 114.3 cm2 and the WC corresponding to this VFA was 74.2 cm in men and 87.37 cm in women. For appropriate diagnostic criteria of abdominal obesity and metabolic syndrome in Korean adult population, further studies are required.
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