폐경 전 한국인 비만여성에서 체중감량에 따른 CRP 변화
Weight Loss Reduce hsCRP Levels in Korean Premenopausal Obese Women
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
연구배경: 비만은 심혈관계 질환의 위험인자로 알려져 있다. C-반응성 단백(이하 CRP)은 심혈관 질환의 독립적 위험인자인 동시에, 비만도 및 지방량, 체중과 관련이 있음이 밝혀져 있다. 외국의 연구에서는 체중 감량이 CRP의 감소를 초래한다는 것이 밝혀진 바 있다. 본 연구에서는 폐경 전의 한국인 여성을 대상으로, 체중 감량이 혈중 CRP를 감소시킨다는 것을 12주간의 전향적인 연구를 통하여 확인하고자 하였다. 방법: 22세에서 48세 사이의 36명의 폐경 전 한국인 비만 여성(체질량 지수 25.00～47.02 kg/m2)을 대상으로, 고 민감도 CRP (high sensitivity CRP, 이하 hsCRP) 및 혈청지질, 혈당, 체중, 체질량지수, 체지방량 및 복부 지방량을 측정하였다. 식사 및 운동 요법과 보조적인 약물요법을 포함한 생활 습관 교정으로 12주간 체중 감량을 실시한 후, 비만도와 CRP, 지질대사인자 등을 재평가하였다. 체중 감량에 따른 CRP의 변화를 paired t-test 및 Wilcoxon signed rank test를 이용하여 분석하였다. 결과: 36명의 폐경 전 비만 여성에서, CRP는 체중, 체질량지수, 체지방량, 복부 피하 및 내장 지방량, 저밀도 콜레스테롤, 총 콜레스테롤과 양의 상관관계를 보였다(P＜0.05). 12주간의 체중 감량 프로그램을 완료한 후의 평균 체중 감량은 7.97±3.46 kg (P＜0.0001), 체지방의 감소는 5.29±2.59 kg (P＜0.0001), 제지방의 감소는 1.98±1.20 kg (P＜0.0001)이었다. 체중 감량 후의 혈중 CRP의 감소는 0.06±0.15μg/ml였다. 체중 감량(r=0.484, P=0.0028) 및 복부 내장 지방의 감소(r=0.338, P=0.0437)가 CRP 감소 정도와 상관관계가 있었다. 결론: 건강한 폐경 전 한국인 비만 여성에서 비만 및 지방량은 혈중 CRP의 의미있는 예측인자였다(단면 연구 결과). 12 주간의 식이 조절을 통한 체중 감량 후, CRP의 의미있는 감소를 보였다. 체중의 감소는 CRP 감소에 중요한 중재가 되었고, 건강한 폐경 전 한국인 비만 여성에서 심혈관 보호 효과가 있을 것으로 추측된다.
Abstract
Background: Obesity has been proposed as a risk factor for cardiovascular diseases. CRP has been proposed as an independent risk factor for cardiovascular diseases, and has been associated with body weight and body fatness. It has been known that weight reduction reduces CRP. We examined the hypothesis that weight loss can reduce plasma CRP levels in Korean, obese premenopausal women. Methods: In a sample of 36 Korean obese (BMI 25.00 ～47.02 kg/m2), premenopausal (22～48 years) women, we measured hsCRP, plasma lipid profiles, blood glucose, body weight, body mass indexes, body fatness and intra abdominal body fat area. A 12-week weight reduction program was conducted in 36 obese women. When the program was finished, fat distribution, hsCRP and lipid profile test was repeated. The effects of weight loss on CRP levels were tested by means of paired t-test and nonparametric Wilcoxon signed rank test. Results: We found that plasma CRP level was positively associated with body weight, body mass index, body fatness, CT-measured abdominal visceral and subcutaneous fat area. After a 12-week weight loss protocol, the average weight loss was 7.97±3.46 kg (P＜0.0001) with loss of fat mass 5.29±0.59 kg, and 1.98±1.20 kg lean body mass. Plasma CRP levels were both positively associated with plasma CRP level reductions (P=0.0437). Conclusion: Obesity and adiposity influenced significantly on plasma CRP in Korean premenopausal women on cross sectional basis. Moreover, 12-week caloric restriction induced weight loss decreased plasma CRP levels. Weight loss represents an intervention to reduce plasma CRP and can mediate to reduce cardiovascular disease risk in Korean obese premenopausal women. (J Korean Acad Fam Med 2005;26:529-535)
참고문헌 (28)
- National Task Force on the Prevention and Treatment of Obesity, "Overweight, obesity, and health risk", Arch Intern Med, (160), pp.898~904 (2000)
- Eckel RH, "American Heart Association call to action: obesity as a major risk factor for coronary heart disease", Circulation, (97), pp.2099~2100 (1998)
- Terry RB, "Waist’hip ratio, body mass index and premature cardiovascular disease mortality in US Army veterans during a twenty-three year follow up study", Int J Obes Relat Metab Disord, (16), pp.417~423 (1992)
- Zamboni M, "Relation of body fat distribution in men and degree of coronary narrowing in cirinary artery disease", Am J Cardiol, (70), pp.1135~1138 (1992)
- Oppert JM, "Anthropometric estimates of muscle and fat mass in relation to cardiac and cancer mortality in men: the Paris Prospective Study", Am J Clin Nutr, 75(6), pp.1107~1113 (2002)
- Feinleib M, "Obesity as an independent risk factor for cardiovascular disease: A 26-year follow-up of participants in the Frammingham Heart Studt", Circulation, 67(5), pp.968~977 (1983)
- Koenig W, "C-reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992.", Circulation, (99), pp.237~242 (1999)
- Ridker PM, "C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women", N Engl J Med, (342), pp.836~843 (2000)
- Ridker PM, "Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men", N Engl J Med, (336), pp.973~979 (1997)
- Ridker PM, "C-reactive protein adds to the predictive value of total and HDL cholesterol in determining risk of first myocardial infarction.", Circulation, (97), pp.2007~2011 (1998)
- de Ferranti S, "C-reactive protein and cardiovascular disease: a review of risk prediction and interventions", Clinica Chimica Acta, (317), pp.1~15 (2002)
- Visser M, "Elevated C-reactive protein levels in overweight and obese adults", JAMA, (28), pp.2131~2135 (1999)
- Yudkin JS, "C- reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue?", Arterioscler Thromb Vasc Biol, (19), pp.972~978 (1999)
- Ford ES, "Body mass index, diabetes, and C-reactive protein among U.S. adults", Diabetes Care, (22), pp.1971~1977 (1999)
- Hak AE, "Associations of C-reactive protein with measures of obesity, insulin resistance, and subclinical atherosclerosis in healthy, middle-aged women", Arterioscler Thromb Vasc Biol, (19), pp.1986~1991 (1999)
- Yudkin JS, "Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link?", Atherosclerosis, (148), pp.209~214 (2000)
- Tchernof A, "Weight loss reduces c-reactive protein levels in obese postmenopausal women", Circulation, (105), pp.564~569 (2002)
- Gabay C, "Acute-phase proteins and other systemic responses to inflammation", N Engl J Med, (340), pp.448~454 (1999)
- Ross R, "Atherosclerosis--an inflammatory disease", N Engl J Med, (340), pp.115~126 (1999)
- Esposito K, "Effect of weight loss and life style changes on vascular inflammatory markers in obese women", JAMA, 289(14), pp.1799~1804 (2003)
- 황정숙, "한국 성인 남성에서 CRP와 비만의 연관성", 가정의학회지, (2), pp.58~63 (2003)
- Bastard JP, "Elevated levels of Interleukin-6 are reduced in serum and subcutaneous adipose tissue of obese women after weight loss", J Clin Endocrinol Metab, (85), pp.3338~3342 (2002)
- Ziccardi P, "Reduction of inflammatory cytokine concentration and improvement of endothelial functions in obese women after weight loss over one year", Circulation, (105), pp.804~809 (2002)
- Mohamed-Ali V, "Subcutaneous adipose tissue release IL-6, but not tumor necrosis factor-alpha, in vivo", J Clin Endocrinol Metab, (82), pp.4196~4200 (1997)
- Danesh J, "Low grade inflammation and coronary heart disease: prospective study and updated meta-analysis", BMJ, (321), pp.199~204 (2000)
- Gotto AM Jr, "Effect of lovastatin on cardiovascular resource utilization and costs in the Air Force", Texas Coronary Atherosclerosis Prevention Study (AFCAPS, Am J Cardiol, pp.2000, (86)[DOI]
- Heilbronn L K, "Energy restriction and weight loss on very low fat diets reduces C-reactive protein concentration in obese, healthy women", Arterioscler Thromb Vasc Biol, 21(6), pp.968~970 (2001)
- Lagrand WK, "C-reactive protein as a cardiovascular risk factor: more than an epiphenomenon?", Circulation, (100), pp.96~102 (1999)