중년 남성에서 수면의 질과 대사증후군 및 염증지표와의 관련성
Relationship between Sleep Quality and Metabolic Syndrome and nfl ammatory Markers in Middle-aged Men in Korea
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연구 배경: 최근 수면 박탈이 비만, 인슐린 저항성 및 혈압 상 승 등과 연관되어 있다고 밝혀지면서 수면과 대사증후군과의 관계에 대해 관심을 갖게 되었다. 그러나 수면의 질과 대사증 후군과의 관계에 대한 연구는 미미한 실정으로 본 논문에서는 Pitt sburgh Sleep Quality Scale (PSQI)을 이용하여 평가한 수면의 질과 대사증후군과의 관계를 알아보고자 하였다. 방법: 2008년 3월부터 5월까지 일개 대학병원 건강증진센 터에 내원한 중년 남성 100명을 대상으로 하였다. PSQI 총 점에 따라 불만족스러운 수면군(N=47)과 만족스러운 수면 군(N=53), 두 군으로 분류하였으며 수면의 질과 대사증후군 지표 및 염증 표지자와의 관계를 분석하였다. 대사증후군은 2005년 AHA/NHLBI에서 제시한 진단기준에 따라 정의하였다. 결과: 수면의 질에 따라 분류한 두 군에서 인구 사회학적 특 성은 통계적으로 유의한 차이를 보이지 않았으며 대사증후 군 지표를 비교한 결과 불만족스러운 수면군의 HDL-콜레스 테롤이 만족스러운 수면군에 비해 통계적으로 유의하게 낮 은 것으로 나타났다(P<0.05). PSQI 총점 및 각 세부 항목과 대 사증후군 지표들과의 관계를 분석한 결과에서 ‘주관적 수면 의 질’항목의 점수와 HDL-콜레스테롤은 음의 상관관계를 보 였으며(P<0.05), 입면시간은 중성지방과는 양의 상관관계를, HDL-콜레스테롤과는 음의 상관관계를 보였다(P<0.05). 입면 시간이 길수록 염증표지자 중 총 백혈구 수치가 통계적으로 유의하게 높게 나타났다(P=0.001). 결론: 이상의 결과들에서 수면의 질의 감소가 대사증후군의 지표 중 HDL 콜레스테롤의 감소와 염증표지자 중 총 백혈구 수치의 증가와 관련이 있으며, 이로서 수면의 질이 심혈관질 환의 위험요인으로 작용할 수 있음을 확인할 수 있었다. 향후 수면장애 집단을 대상으로 수면의 질을 향상시키는 중재 프 로그램이 대사증후군과 심혈관질환의 위험인자에 미치는 효 과에 관한 전향적인 연구가 필요할 것으로 여겨진다.
Abstract
Background: As many studies revealed that sleep restriction is associated with obesity and insulin resistance and blood pressure elevation, the relationship between sleep and metabolic syndrome has been concerned. But little information exists on correlation between sleep quality and metabolic syndrome. In this study, we investigated the relationship between sleep quality measured by Pittsburgh Sleep Quality Index (PSQI) and metabolic syndrome. Methods: A total of 100 middle-aged male adults were included in this study from March to May 2008 at a health promotion center. The subjects were divided into two groups of poor sleeper group (N = 47) vs. good sleeper group (N=53) by PSQI global score. The components of metabolic syndrome and infl ammatory markers were measured. The metabolic syndrome criterion of the AHA/NHLBI 2005 was adopted. Results: There was no significant differences in baseline characteristics between the two groups. HDL-cholesterol was signifi cantly lower in the poor sleeper group compared to the good sleeper group (P < 0.05). The negative correlation was noted between subjective sleep quality score with HDL-cholesterol (P < 0.05). There was a positive correlation between sleep latency and triglyceride and a negative correlation with HDL-cholesterol (P < 0.05). The longer sleep latency, the higher level of white blood cell count was observed (P = 0.001). Conclusion: The above data suggest that a possible causal interaction between poor sleep quality and lower HDLcholesterol of metabolic syndrome components and higher level of white blood cell counts. Further prospective studies regarding the change in the components of metabolic syndrome and the risk factors of cardiovascular diseases after relieving sleep disturbance seem to be warranted.
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