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국내 만성간질환의 이환여부와 건강관련행동과의 관련성

The Association Chronic Liver Diseases with Health Related Behaviors in South Korea

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주제분류가정의학

초록

연구배경: 국내의 일차진료현장에서 만성간질환은 비교적흔한 건강 문제이지만, 국내 만성간질환의 유병률 자료가 부족한 실정이며 만성간질환 환자의 관리 실태에 대한 연구 또한 미미하다. 본 연구의 목적은 국내 만성간질환 환자의 건강관련 행태의 비율을 알아보고, 만성간질환 이환 여부와 민간보험가입, 간암검진, 금연, 금주, 운동 등 건강 관련 행태의 관련성에 대해 분석하는 것이다. 방법: 본 연구는 국민건강영양조사 제3기(2005년) 자료를 바탕으로, 40세 이상의 성인 4,724명을 분석하였다. 이 연구에서는 사회 인구적 특성, 만성간질환 여부와 보건행태 자료를 이용하였다. 결과: 만성간질환 이환군는 2.4%였다. 만성간질환 이환군의민간보험가입 및 간암검진의 비율은 71.6%, 44.2%였고, 금연,금주, 규칙적인 운동의 비율은 각각 70.0%, 52.6%, 33.8%였다. 인구학적 변수를 보정하였을 때, 만성간질환 이환군에서 간암검진의 교차비는 8.4이며(P<0.001), 완전한 금주의 교차비는 1.2였다(P=0.434). 민간의료보험 가입률의 교정 교차비는1.3 (P=0.425), 금연과 운동의 교정 교차비는 1.2 (P=0.578), 0.6(P<0.05)이었다. 결론: 국내에서의 만성간질환 환자에 대한 1차 예방 활동은 2차 예방 활동에 비해 상대적으로 부족한 것으로 생각된다. 따라서 일차진료 현장에서 만성간질환 환자에 대한 간암 조기검진뿐만 아니라 금연, 완전한 금주 및 적절한 운동에 대한 지도가 함께 필요할 것으로 생각된다.

Abstract

Background: The chronic liver disease is a relatively common health problem in primary care in Korea. But there are few studies of the prevalence and management status of chronic liver disease in Korea. The aim of this study is to estimate the ratio of health relative behavior among the patients of chronic liver disease, and analyse the association of chronic liver disease with health related behaviors such as private insurance, liver cancer screening examination, smoking, drinking,and exercise. Methods: We analyzed data from the third Korea National Health and Nutrition Examination Survey (KNANES III) 2005. The subjects of this study included the persons over 40 years. We used data about demographics, chronic liver disease,and health behavior data. Results: The prevalence of chronic liver disease was 2.4%. The ratios of private insurance, liver cancer screening examination among the patients of chronic liver disease were 72.6%, 44.2% respectively. The ratios of no smoking,abstinence from drinking, and exercise were 70.0%, 52.6%, and 33.8% respectively. After adjusted with demographic data,the odds ratio of liver cancer screening among the patients of chronic liver disease was 8.4 (P < 0.001), that of abstinence from drinking was 1.2 (P = 0.434). Adjusted odds ratio of private insurance, no smoking and exercise were 1.3 (P = 0.425), 1.2(P = 0.578), 0.6 (P < 0.05). Conclusion: The primary prevention is less satisfactory than secondary prevention among the patients with chronic liver disease in Korea. In primary care, it is necessary for them not only to check liver cancer screening examination but also encourage no smoking, abstinence from drinking, and exercise.

참고문헌 (30)

  1. Breslow L, "Persistence of health habits and their relationship to mortality", Prev Med, 9, pp.469~483 (1980)
  2. Belloc NB, "Relationship of physical health status and health practices", Prev Med, 1, pp.409~421 (1972)
  3. Houston TP, "The U.S. preventive services task force guide to clinical preventive services, second edition: AMA council on scientic aairs", Am J Prev Med, 14, pp.374~376 (1998)
  4. Richmond JB, "Building the next generation of healthy people", Public Health Rep, 114, pp.212~217 (1999)
  5. Schoenborn CA, "Health habits of U.S. adults, 1985: the "Alameda 7" revisited", Public Health Rep, 101, pp.571~580 (1986)
  6. 백국현, "가정의학과는 다른 진료과에 비해 양질의 일차의료를 제공하고 있는가?", 가정의학회지, 26(7), pp.30~37 (2005), 대한가정의학회
  7. Duk-HeeLee, "Epidemiological Findings of Hepatitis B Infection Based on 1998 National Health and Nutrition Survey in Korea", Journal of Korean Medical Science, 17(4), pp.457~462 (2002), 대한의학회
  8. "Prevalence of liver disease"[URL]
  9. Chen CJ, "Epidemiology of hepatitis B virus infection in the Asia-Pacific region", J Gastroenterol Hepatol, 15, pp.3~6 (2000)
  10. Tsukuma H, "Risk factors for hepatocellular carcinoma among patients with chronic liver disease", N Engl J Med, 328, pp.1797~1801 (1993)
  11. El-Serag HB, "Hepatocellular carcinoma: recent trends in the United States", Gastroenterology, 127, pp.27~34 (2004)
  12. "Annual report of cancer incidence statistics 2005" (2008)[URL]
  13. Cantarini MC, "Effect of the etiology of viral cirrhosis on the survival of patients with hepatocellular carcinoma", Am J Gastroenterol, 101, pp.91~98 (2006)
  14. Chiesa R, "Etiology of hepatocellular carcinoma in Italian patients with and without cirrhosis", Cancer Epidemiol Biomarkers Prev, 9, pp.213~216 (2000)
  15. Fracanzani AL, "Increased cancer risk in a cohort of 230 patients with hereditary hemochromatosis in comparison to matched control patients with non-iron-related chronic liver disease", Hepatology, 33, pp.647~651 (2001)
  16. Poon D, "Management of hepatocellular carcinoma in Asia: consensus statement from the Asian Oncology Summit 2009", Lancet Oncol, 10, pp.1111~1118 (2009)
  17. Bruix J, "Management of hepatocellular carcinoma", Hepatology, 42, pp.1208~1236 (2005)
  18. Kuper H, "Tobacco smoking, alcohol consumption and their interaction in the causation of hepatocellular carcinoma", Int J Cancer, 85, pp.498~502 (2000)
  19. Donato F, "Alcohol and hepatocellular carcinoma: the effect of lifetime intake and hepatitis virus infections in men and women", Am J Epidemiol, 155, pp.323~331 (2002)
  20. Tanaka K, "Hepatitis B virus, cigarette smoking and alcohol consumption in the development of hepatocellular carcinoma: a case-control study in Fukuoka, Japan", Int J Cancer, 51, pp.509~514 (1992)
  21. "The Third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005" (2006)[URL]
  22. Wun YT, "Alpha-fetoprotein and", or liver ultrasonography for liver cancer screening in patients with chronic hepatitis B, 2003, pp.(2), ~
  23. Zhang BH, "Randomized controlled trial of screening for hepatocellular carcinoma", J Cancer Res Clin Oncol, 130, pp.417~422 (2004)
  24. Chen JG, "Screening for liver cancer: results of a randomised controlled trial in Qidong, China", J Med Screen, 10, pp.204~209 (2003)
  25. Welch HG, "Are increasing 5-year survival rates evidence of success against cancer?", JAMA, 283, pp.2975~2978 (2000)
  26. A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma, "Groupe d'Etude et de Traitement du Carcinome Hepatocellulaire", N Engl J Med, 332, pp.1256~1261 (1995)
  27. Riley TR 3rd, "Preventive strategies in chronic liver disease: part II. Cirrhosis", Am Fam Physician, 64, pp.1735~1740 (2001)
  28. Riley TR 3rd, "Preventive strategies in chronic liver disease: part I. Alcohol, vaccines, toxic medications and supplements, diet and exercise", Am Fam Physician, 64, pp.1555~1560 (2001)
  29. Riley TR, "Preventive care in chronic liver disease", J Gen Intern Med, 14, pp.699~704 (1999)
  30. Rigamonti C, "Moderate alcohol consumption increases oxidative stress in patients with chronic hepatitis C", Hepatology, 38, pp.42~49 (2003)

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