한국 중년 남녀에서 지방의 분포에 따른 비만 유형과 고감도 반응성 단백(High-sensitive C-reactive Protein)과의 관계
The Relationship between High-sensitive C-reactive Protein and Different Obese Types in Middle-aged Koreans
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연구배경: 비만과 대사증후군은 상호 연관되어 있고, 비만 세포는 여러 염증 인자를 방출한다고 알려져 있다. 심혈관 질환의 독립적 예측 인자로 알려져 있는 고감도 반응성 단백(high-sensitive C-Reactive Protein, hsCRP)은 비만 세포에서 분비되는 염증 인자에 의해 영향을 받는다고 알려져 있다. 이에 지방의 분포에 따른 비만 유형별로 hsCRP가 어떤 차이가 있는지를 연구하였다. 방법: 2002년 5월부터 2005년 2월까지 일개 대학병원 건강 검진 센터를 방문한 사람들 중 hsCRP를 검사한, 40세에서 60세의 중년 7,183명(남성 4,147명과 여성 3,036명)을 대상으로 단면 연구를 실시하였다. 체질량지수와 허리둘레가 모두 정상인 정상군, 체질량지수는 정상이지만 허리둘레가 기준치 이상으로 증가한 복부비만군(Obese Group 1, OB1), 복부비만이 없는 비만군(Obese Group 2, OB2), 그리고 복부비만이 있는 비만군(Obese Group 3, OB3)으로 분류하여 각 군의 신체 계측의 차이, 대사 이상의 차이와 hsCRP의 차이를 비교 분석하였다. 결과: HsCRP의 값은 비만과 관련된 여러 인자들 중 허리둘레(r=0.230, P<.001) 및 체질량지수(r=0.222, P＜.001)와 비교적 높은 상관 관계를 보였다. 비만 유형에 따른 hsCRP 값은 정상군과 비교하여 비만군에서 유의하게 높았고, 그 중에서도 복부비만이 있는 비만군(OB3)에서 가장 높은 값을 보였다(P<.001). 그러나, 복부비만군(OB1)과 복부비만 없는 비만군(OB2)과의 hsCRP 값의 차이는 없었다. 복부비만이 있는 대상자와 대사증후군이 있는 대상자에서 hsCRP값의 상승을 볼 수 있었고, 복부비만과 대사증후군을 동시에 동반한 사람에서 가장 높은 hsCRP값을 보였다. 복부비만이 동반된 사람에서의 hsCRP값은 대사증후군 유무에 따른 값의 차이가 없었다. 결론: HsCRP는 복부비만만 있는 군과 복부비만이 없는 비만군 사이에는 차이가 없었고, 복부비만을 동반한 비만군에서는 정상군 및 다른 비만군에 비해 유의한 차이가 있었고, 그 수치가 가장 컸다.
Abstract
Background: Obesity and metabolic syndrome are closely correlated where previous studies showed that adipocytes release many inflammatory substances. HsCRP is an indicator of an independent risk factor in coronary heart disease. The aim of this study was to investigate the difference of hsCRP in different types of obese patients. Methods: We analyzed the data of 7,183 middle-aged Korean adults between the ages of 40 and 60 (men 4,147 and women 3,036) by using a cross-sectional approach. We divided study subjects into 4 different groups; Normal Group (NG; normal waist and normal body mass index), Centrally Obese Group (OB1; Non-obese group with central obestiy), Obese Group without central obesity (OB2) and Obese Group with central obesity (OB3). We compared the difference of anthropometry, metabolic parameters, and hsCRP. Results: Waist circumference (r=0.230, P<.001) and body mass index (r=0.222, P<.001) positively corresponded with high levels of hsCRP. Higher values of hsCRP were found in the OB3 compared to the NG. However, there was no difference between the OB1 and the OB2. The subjects who had central obesity or the metabolic syndrome showed high hsCRP values. The hsCRP values were the highest in subjects who had central obesity with the metabolic syndrome. But, the value of hsCRP was not significantly different in central obesity subjects with or without the metabolic syndrome. Conclusion: The highest value of hsCRP was significantly shown in the obese group with central obesity. However, there were no differences found in the hsCRP levels between the non-obese group with central obesity and the obese group without central obesity.
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