정상 공복혈당을 보이는 성인에서 공복혈당치와 대사증후군
Fasting Plasma Glucose Levels and Metabolic Syndrome in Normoglycemic Adults
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
연구배경: 대사증후군은 심혈관질환과 제2형 당뇨병의 발생을 증가시키는 것으로 알려져 있다. 본 연구에서는 정상 공복혈당을 보이는 성인에서 공복혈당치와 대사증후군의 관계를 살펴보고자 하였다. 방법: 2001년 국민건강영양조사의 자료를 이용하여 당뇨병의 과거력이 없고 정상 공복혈당 범위 내에 있는 성인을 대상으로 신체계측과 혈액검사, 생활요인의 조사를 실시하였다. 100 mg/dl 미만의 정상 공복혈당을 보이는 성인을 공복혈당치에 따라 5개 군으로 나누어 공복혈당치 증가와 대사증후군의 관계를 분석하였다. 결과: 정상 공복혈당을 보이는 성인에서 공복혈당치가 증가할수록 대사위험인자 중 복부비만, 높은 혈압, 비만이 증가하는 경향을 보였고(P＜0.001), 고중성지방혈증, 저고밀도콜레스테롤혈증과 생활요인인 흡연, 음주, 운동은 유의성이 없었다. 대사증후군은 나이, 성별, 흡연, 음주, 운동 등을 보정하여 분석하였을 때 공복혈당≤81 mg/dl인 군에 대해서 공복혈당치가 증가할수록 교차비가 1.05 (95% CI, 0.76∼1.44), 1.15 (95% CI, 0.84∼1.58), 1.33 (95% CI, 0.99∼1.80), 1.55 (95% CI, 1.14∼2.10)로 증가하는 경향을 보였으며 이는 통계적으로 유의하였다(P＜0.001). 결론: 공복혈당이 정상인 성인에서도 공복혈당치가 증가할수록 대사증후군의 위험이 증가할 수 있다.
Abstract
Background: Metabolic syndrome has been introduced to increase the incidence of cardiovascular diseases and type 2 diabetes mellitus. Our aim of this study was to investigate the association of fasting plasma glucose levels and metabolic syndrome in normoglycemic adults. Methods: We examined lifestyle factors, anthropometric and laboratory measurement of adults with no personal history of diabetes and normal fasting glucose from the Korean National Health and Nutrition Examination Survey 2001. We categorized the fasting plasma glucose levels below 100 mg/dl into the quintiles and assessed the association of metabolic syndrome with increasing glycemia in normoglycemic adults. Results: Quintiles of normal fasting plasma glucose levels showed a positive trend with metabolic risk factors including abdominal obesity, high blood pressure, and obesity in normoglycemic adults (P＜0.001). Hypertriglyceridemia, low HDL-cholesterolemia, smoking, heavy drinking, and physical activity were of no significance. A multivariate model, adjusted for age, sex, smoking status, physical activity, and heavy drinking, revealed a progressively increased odds ratio of metabolic syndrome, 1.05 (95% CI, 0.76∼1.44), 1.15 (95% CI, 0.84∼1.58), 1.33 (95% CI, 0.99∼1.80), 1.55 (95% CI, 1.14∼2.10), with increasing fasting plasma glucose levels, as compared with fasting plasma glucose level of 81 mg/dl or less (P＜0.001). Conclusion: Higher fasting plasma glucose levels within the normoglycemic range may constitute a risk of metabolic syndrome in normoglycemic adults.
참고문헌 (29)
- Genuth S, "Follow-up report on the diagnosis of diabetes mellitus", Diabetes Care, 26(11), pp.3160~3167 (2003)
- Genuth S, "Lowering the criterion for impaired fasting glucose is in order", Diabetes Care, 26, pp.3331~3332 (2003)
- Borch-Johnsen K, "Creating a pandemic of prediabetes: the proposed new diagnostic criteria for impaired fasting glycaemia", Diabetologia, 47, pp.1396~1402 (2004)
- Piché ME, "What is a normal glucose value? Differences in indexes of plasma glucose homeostasis in subjects with normal fasting glucose", Diabetes Care, 27, pp.2470~2477 (2004)
- Tai ES, "Lowering the criterion for impaired fasting glucose: impact on disease prevalence and associated risk of diabetes and ischemic heart disease", Diabetes Care, 27, pp.1728~1734 (2004)
- Schriger DL, "Lowering the cut point for impaired fasting glucose: where is the evidence? Where is the logic?", Diabetes Care, 27, pp.592~601 (2004)
- Gabir MM, "Imperatore G, Roumain J, Bennett PH, et al. The 1997 American Diabetes Association and 1999 World Health Organization criteria for hyperglycemia in the diagnosis and prediction of diabetes", Diabetes Care, 23, pp.1108~1112 (2000)
- "National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in adults (Adult Treatment Panel III). Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report", Circulation, 106, pp.3143~3421 (2002)
- Grundy SM, "Diagnosis and management of the metabolic syndrome: an American Heart Association", National Heart, Lung, and Blood Institute Scientific Statement, 2005, pp.112, 2735~2752
- Malik S, "Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults", Circulation, 110, pp.1245~1250 (2004)
- McNeill AM, "The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study", Diabetes Care, 28, pp.385~390 (2005)
- Meigs JB, "Metabolic syndrome: in search of a clinical role", Diabetes Care, 27, pp.2761~2763
- Wannamethee SG, "Metabolic syndrome vs Framingham Risk Score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus", Arch Intern Med, 165, pp.2644~2650 (2005)
- Tirosh A, "Normal fasting plasma glucose levels and type 2 diabetes in young men", N Engl J Med, 353, pp.1454~1462 (2005)
- Sung KC, "Association between insulin resistance and apolipoprotein B in normoglycemic Koreans", Atherosclerosis, 180, pp.161~169 (2005)
- Meshkani R, "The relationship between homeostasis model assessment and cardiovascular risk factors in Iranian subjects with normal fasting glucose and normal glucose tolerance", Clin Chim Acta, 371, pp.169~175 (2006)
- Thomas GN, "Deleterious impact of "high normal" glucose levels and other metabolic syndrome components on arterial endothelial function and intima-media thickness in apparently healthy Chinese subjects: the CATHAY study", Arterioscler Thromb Vasc Biol, 24, pp.739~743 (2004)
- "World Health Organization Western Pacific Region, International Association for the Study of Obesity, and International Obesity Task Force. The Asian-Pacific perspective: redefining obesity and its treatment", pp.15~21 (2000), Health Communications Australia
- Stern MP, "Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test?", Ann Intern Med, 136, pp.575~581 (2002)
- Shaw JE, "Impaired fasting glucose: how low should it go?", Diabetes Care, 23, pp.34~39 (2000)
- Tanne D, "Fasting plasma glucose and risk of incident ischemic stroke or transient ischemic attacks: a prospective cohort study", Stroke, 35, pp.2351~2355 (2004)
- Simons LA, "Fasting plasma glucose in non-diabetic elderly women predicts increased all-causes mortality and coronary heart disease risk", Aust N Z J Med, 30, pp.41~47 (2000)
- Kim DJ, "The cutoff value of fasting plasma glucose to differentiate frequencies of cardiovascular risk factors in a Korean population", Diabetes Care, 26, pp.3354~3356 (2003)
- Thomas GN, "Guangzhou Biobank Cohort Study Steering Committee. Association of vascular risk factors with increasing glycemia even in normoglycemic subjects in an older Chinese population: the Guangzhou Biobank Cohort Study", Metabolism, 55(8), pp.1035~1041 (2006)
- Thomas GN, "Determinants of normoglycemia and contribution to cardiovascular risk factors in a Chinese population: the Hong Kong Cardiovascular Risk Factor Study", J Endocrinol Invest, 29, pp.528~535 (2006)
- Trevisan M, "Syndrome X and mortality: a population-based study. Risk Factor and Life Expectancy Research Group", Am J Epidemiol, 148, pp.958~966 (1998)
- Isomaa B, "Cardiovascular morbidity and mortality associated with the metabolic syndrome", Diabetes Care, 24, pp.683~689 (2001)
- Wilson PW, "Clustering of metabolic factors and coronary heart disease", Arch Intern Med, 159, pp.1104~1109 (1999)
- Sattar N, "Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study", Circulation, 108, pp.414~419 (2003)