인슐린유사성장인자-1 및 인슐린유사성장인자 결합단백질-3과 대사증후군의 연관성
Association of Insulin-like Growth Factor-1 (IGF-1) and Insulin-Like Growht Factor Binding Protein-3 (IGFBP-3) with the Metabolic Syndrome
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연구배경: 인슐린유사성장인자-1 (insulin like growth factor-I, IGF-I )이 동맥경화증에 영향을 준다는 연구들이 보고되고 있다. IGF-1의 생물학적 활성은 인슐린유사성장인자 결합단백질-3 (insulin like growth factor binding protein-3, IGFBP-3)의 영향을 받는다. 본 연구에서는 혈중 IGF-1 및 IGFBP-3 농도에 따라 심혈관 질환의 군집개념인 대사증후군과 어떠한 연관성이 있는지 알아보고자 하였다. 방법: 건강검진을 위해 내원한 18～81세 사이의 성인을 대상으로 혈중 IGF-1과 IGFBP-3를 측정하였다. 혈중 IGF-1과 IGFBP-3에 영향을 줄 수 있는 경우를 제외하고 최종대상자로 12,415명(남자 6,626명, 여자 5,789명)을 선정하였다. IGF-1 및 IGFBP-3 농도와 NCEP-ATP III에서 제안한 대사증후군 진단 요인들의 연관성 및 대사증후군에 이환 될 교차곱비(odds ratio)를 비교하였다. 결과: IGF-1과 허리둘레, 수축기혈압이 유의한 양의 상관관계를 보였고(P＜0.05), IGFBP-3는 허리둘레, 수축기혈압, 이완기혈압, 공복혈당 및 중성지방과 유의한 양의 상관관계를(P＜0.05), 고밀도콜레스테롤과는 유의한 음의 상관관계를 보였다(P＜0.05). 혈중 농도에 따라 사분위로 범주화하여 IGF-1 농도가 가장 낮은 최하사분위가 대사증후군에 이환 될 교차곱비는 남자가 1.32 (95% CI 1.06～1.63), 여자가 1.41 (95% CI 1.08～1.85)로 최상사분위와 비교하여 볼 때 유의한 증가를 보였다(P＜0.05). 반면 IGFBP-3는 최하사분위가 최상사분위와 비교하여 볼 때 대사증후군에 이환될 교차곱비가 유의하게 높았다[남자 2.49 (95% CI 2.02～3.05), 여자 3.43 (95% CI 2.68～4.37)]. 결론: 혈중 IGF-1 농도가 낮거나 IGFBP-3 농도가 높은 경우 대사증후군에 이환될 위험이 높았다.
Abstract
Association of Insulin-like Growth Factor-1 (IGF-1) and Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) with the Metabolic SyndromeMi Hee Kong, M.D., Nam Seok Joo, M.D., Kwang Min Kim, M.D.†, Bom Taeck Kim, M.D., Sang Man Kim, M.D.*, Duck Joo Lee, M.D.**
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