성인 여자에서 대사증후군과 만성 신질환과의 관계
Metabolic Syndrome and the Risk for Chronic Kidney Disease among Korean Women
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연구배경: 대사증후군은 복부 비만, 높은 중성지방, 낮은 HDL-콜레스테롤, 높은 혈압, 높은 혈당을 특징으로 하며 관 련 합병증을 발생시킨다. 본 연구는 성인 여성에서 대사증후 군과 만성 신질환과의 관련성을 살펴보고자 하였다. 방법: 2006년 1월부터 12월까지 서울아산병원 검진센터를 방 문한 30세에서 89세의 여성 10,170명으로의 자료를 토대로 단 면 연구를 시행하였다. 대사증후군의 정의는 미국 국립 콜레 스테롤 교육 프로그램 위원회, 제3차보고서(NCEP ATP Ⅲ)의 기준을 이용하였고, 허리둘레는 85 ㎝ 이상을 기준으로 하였 고 만성 신질환의 정의는 사구체 여과율<60 ㎖/min per 1.73 ㎡ 로 정의하였다. 연령, 교육 수준, 체질량 지수, 음주력, 흡연력, 관상 동맥 질환, 폐경, 운동 여부를 보정하여 교차비와 95% 신 뢰구간을 구하였다. 결과: 최종 연구 대상 10,170명 중 1,039명이 대사증후군으로 진단되었다. 대사증후군, 높은 중성지방, 높은 혈압을 나타낸 군에서 만성 신질환의 교차비가 2.68 (1.77-4.06), 1.96 (1.34- 2.88), 2.00 (1.38-2.89)으로 증가하였다 (P<0.05). 대사인자 수에 따른 만성 신질환의 교차비는 위험인자의 수가 없을 때 에 비해 1개, 2개, 3개 이상으로 많아질수록 1.24 (0.75-2.06), 1.56 (0.89-2.75), 2.18 (1.21-3.93)로 증가하는 경향을 보였다 (P<0.001). 결론: 성인 여자에서 대사증후군은 사구체 여과율의 감소를 초래하여 만성 신질환의 위험과 연관되어 있다. 결론적으로 대사증후군의 관리가 만성 신질환의 예방에 기여할 수 있을 것이다.
Abstract
Background: Metabolic syndrome (MetS), characterized by abdominal obesity, hypertriglyceridemia, low highdensity lipoprotein (HDL) cholesterol, high blood pressure, and high fasting glucose level, is a common risk factor for cardiovascular diseases and associated complications. We examined the relationship between the metabolic syndrome and risk of chronic kidney disease (CKD) in Korean women. Methods: We used data from 10,170 women, aged 30-89 years, who had visited a health examination center at a tertiary care hospital in 2006. The data were studied cross-sectionally. MetS was identified using the modified criteria of the National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ). CKD was defined as an estimated GFR < 60 ㎖/ min per 1.73 ㎡. The multivariable-adjusted (adjustment for age, education, body mass index (BMI), alcohol drinking, smoking, previous coronary heart disease, menopauses and physical inactivity) odds ratio of CKD (95% CI) associated with each component of the metabolic syndrome was calculated using the logistic regression models. Results: A total of 1,039 participants have MetS. The multivariable-adjusted odds ratios (OR) of CKD in participants with MetS, hypertriglyceridemia and high blood pressure compared with participants without such factors were 2.68 (95% CI, 1.77-4.06), 1.96 (95% CI, 1.34-2.88), and 2.00 (95% CI, 1.38-2.89). Compared with the participants with no MetS traits, those with one, two, equal to or more than three traits of MetS had OR of CKD of 1.24 (95% CI, 0.75-2.06), 1.56 (95% CI, 0.89-2.75), and 2.18 (95% CI, 1.21-3.93), respectively. Conclusion: We found that Korean women with MetS had an increased risk for developing CKD. Finally, earlier identification and management of MetS might improve patient health and prevent progression of CKD.
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