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성인 남녀에서 대사증후군과 혈장 호모시스테인과의 관계

Association between Metabolic Syndrome and Plasma Homocysteine among Korean Adults

최희정|임지애|윤주호|김상환|윤경선
대한가정의학회 (The Korean Academy Of Family Medicine)|2008.07|Korean Journal of Family Medicine|제29권 제7호|pp. 499-505

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키워드

대사증후군metabolic syndrome인슐린저항성insulin resistance호모시스테인homocysteine
주제분류가정의학

초록

연구배경: 증가된 혈장 호모시스테인은 죽상동맥경화증에 의한 심혈관질환의 독립적인 위험인자이며, 고혈압, 인슐린저항성, 이상지질혈증과 같은 대사증후군의 구성요인과도 관련이 있다. 이 연구는 남녀 성인을 대상으로 호모시스테인이 대사증후군과 연관이 있는지 알아보고자 하였다. 방법: 건강검진센터를 방문한 성인남녀 중 대사증후군 107명과 짝지은 대조군 123명을 대상으로 하였다. 설문지와 의사의 면담을 통해 과거 및 현재 병력, 약물 복용력, 생활습관 등을 조사하였고, 신체계측을 하였다. 검사실 검사로는 혈장 호모시스테인과 공복혈당을 포함한 생화학지표, 혈중 지질지표, 고감도 C-반응단백 등을 측정하였다. 대사증후군은 American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) 진단기준에 따라 정의하였다. 결과: 대사증후군군과 대조군의 평균 연령은 각각 54.6±9.3세와 54.6±8.7세였고, 각 군에서 남성의 수는 29명(27.1%)과 39명(31.7%)이었다. 호모시스테인은 나이, 허리둘레, 이완기혈압, 아포지단백 A-1, 공복 혈당, 공복 인슐린, Homeostasis model assessment insulin resistance (HOMA-IR), C-반응단백과 유의한 상관관계를 나타내었다. 대사증후군의 구성요인들 중, 고혈압 유무에 따른 호모시스테인 농도는 유의한 차이를 보였으나(10.62±3.92 ųmol/L vs. 9.09±2.63 ųmol/L, P=0.001), 고혈당이나 이상지질혈증, 복부비만과 같은 요인에서는 이러한 차이를 보이지 않았다. 나이, 성별, 음주와 흡연을 보정한 후 대사증후군군에서의 평균 호모시스테인 농도는 10.320±0.290 ųmol/L로, 대조군의 9.358±0.271 ųmol/L에 비해 유의하게 높은 것으로 나타났다(P=0.017). 결론: 성인에서 혈장 호모시스테인은 나이와 성별, 음주, 흡연력을 보정하더라도 대사증후군에서 유의하게 높은 것으로 나타났다.

Abstract

Background: Elevated plasma homocysteine is an independent risk factor for cardiovascular diseases caused by atherosclerosis. Previous studies have shown that plasma homocysteine is associated with components of the metabolic syndrome such as hypertension, insulin resistance, and dyslipidemia. In this study, we investigated the association between the plasma homocysteine levels and the metabolic syndrome on Korean adults. Methods: The study group with the metabolic syndrome and the control group without the metabolic syndrome were selected from the examinees of equivalent age and gender in the Health Promotion Center. Among the subjects, 107 adults with the metabolic syndrome and 123 adults without the metabolic syndrome were categorized into the study and the control groups, respectively. Medical history, medication, and life style were recorded through a questionnaire and physical examination was performed on all subjects. We measured fasting glucose, total cholesterol, triglycerides, high-density lipoprotein, hs-CRP, homocysteine levels and others by blood sampling. The metabolic syndrome was defined by the criteria for clinical diagnosis of the metabolic syndrome by AHA/NHLBI. Results: The mean ages in the study group and the control group were 54.6±9.3 and 54.6±8.7 years, respectively, and the numbers of males 29 (27.1%) and 39 (31.7%), respectively. The plasma homocysteine was observed to be positively correlated with age, waist circumference, diastolic blood pressure, apolipoprotein A-1, fasting glucose, fasting insulin, HOMA-IR, and hs-CRP. Among the components of the metabolic syndrome, hypertension showed a strong correlation with the levels of the plasma homocysteine (10.62±3.92 ųmol/L vs. 9.09± 2.63 ųmol/L, P=0.001), whereas hyperglycemia, abdominal obesity, and dyslipidemia did not correlate with the levels of plasma homocysteine. Adjusted homocysteine levels to age, gender, alcohol drinking history, and smoking history was still higher in the study group compared to those in the control group (10.320±0.290 ųmol/L vs. 10.320±0.290 ųmol/L, P=0.017). Conclusion: The results indicate that the metabolic syndrome leads to a higher level of homocysteine in adults after adjustment to age, gender, alcohol drinking history, and smoking history.

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