복부비만을 동반한 여성에서 DEXA로 측정된 국소적 체지방과 대사적 위험요인
Regional Fat Measured by DEXA and Metabolic Risk Factors among Women with Central Obesity
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초록
연구배경: 이중에너지 방사선 흡수계측법(DEXA)으로 측정된 국소 체지방과 대사적 위험요인의 관련성을 평가하여 DEXA가 비만의 치료방침을 설정하는데 유용한 도구인지를 알아 보고자 하였다. 방법: 18세에서 65세 사이의 복부비만 (허리둘레≥80 cm)을 동반한 95명 여성을 대상으로 대사적 위험요인인 혈압, 공복혈당, 인슐린, 중성지방, 고밀도 (HDL-C-C) 및 저밀도 지단백 콜레스테롤 (LDL-C), high sensitive c-reactive protein (hs-CRP), Homeostasis model assessment of insulin resistance (HOMA-IR)과 허리둘레, 체질량지수, DEXA로 측정한 체지방률 간의 관련성 및 대사증후군(International Diabetes Federation 기준)과 인슐린저항성 (HOMA-IR≥2.48)의 유무와 국소적 체지방률 간의 관련성을 선형 및 로지스틱 회귀분석으로 평가하였다. 결과: 나이와 전체 체지방률을 보정한 후 하지 체지방률의 증가는 LDL-C, 중성지방, HOMA-IR, hs-CRP의 감소 및 HDL-C-C의 증가와 유의하게 관련성이 있고, 하지 체지방률이 1% 증가하면 대사증후군의 이환 교차비는 0.82 (95% 신뢰구간 0.71∼0.96), 인슐린저항성의 이환 교차비는 0.80 (95% 신뢰구간 0.67∼0.95)이었다. 반면에 몸통 체지방률의 증가는 LDL-C, 중성지방, HOMA-IR, hs-CRP의 증가와 유의하게 관련이 있고, 몸통 체지방률이 1% 증가하면 대사증후군 이환 교차비는 1.32 (95% 신뢰구간 1.03∼1.71), 인슐린 저항성의 이환 교차비는 1.33 (95% 신뢰구간 1.01∼1.77)이었다. 여성형지방에 비하여 남성형지방이 상대적으로 증가할수록 LDL-C, 중성지방, 혈당, HOMA-IR는 유의하게 증가하였으나 HDL-C-C은 유의하게 감소하였고, 그 비율이 0.1 증가하면 인슐린 저항성 이환 교차비가 1.66 (95% 신뢰구간 1.07∼2.60)이었다. 결론: 복부비만을 동반한 여성에서 DEXA로 측정된 몸통 체지방률, 하지 체지방률, 남성형지방과 여성형지방의 비율은 대사적 위험요인을 예측하는데 유용한 지표가 될 것으로 보인다.
Abstract
Background: This study was carried out to determine the usefulness of regional body fat measured by dual energy X-ray absorptiometry (DEXA) by examining the relationship between regional body fat and metabolic risk factors. Methods: A total of 98 women aged 18∼65 years with central obesity (waist circumference ≥80 cm) took the evaluation for metabolic risk factors (blood pressure, fasting glucose, insulin, high sensitive c-reactive protein (hs-CRP), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR)) and the anthropometric measurement, and regional body fat measurement using DEXA. The relationship of regional body fat with the metabolic risk factors, the metabolic syndrome (MS) defined by the International Diabetes Federation and insulin resistance (IR, defined by HOMA-IR≥2.48) were assessed. The analyses were conducted using regression and logistic regression analyses. Results: After adjustment for age and total body fat (%), legs fat (%) was significantly and negatively associated with LDL-C, triglyceride, HOMA-IR, and hs-CRP, while positively with HDL-C. The 1% increase of legs fat was associated with the MS by odds ratio of 0.82 (95% C.I 0.71∼0.96) and with the IR by odds ratio of 0.80 (95% C.I. 0.67∼0.95). Trunk fat (%) was significantly and positively associated with LDL-C, triglycerides, and HOMA-IR. The 1% increase of trunk fat was associated with the MS by odds ratio of 1.32 (95% C.I. 1.03∼1.71) and with the IR by odds ratio of 1.33 (95% C.I. 1.01∼1.77). The ratio of android fat to gynoid fat was significantly and positively associated with LDL-C, triglycerides, glucose, and HOMA- IR, while negatively with HDL-C. The 0.1 increase of the ratio was associated with the MS by odds ratio of 1.66 (95% C.I. 1.07∼2.60). Conclusion: The trunk fat, and legs fat, the ratio of android fat to gynoid fat assessed by DEXA seemed to be useful indicators to predict the metabolic risk factors in women with central obesity.
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