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성인에서 참고구간 내의 혈중 Gamma-glutamyltransferase 농도에 따른 대사증후군 및 제2형 당뇨병 발병률과의 관련성

Relationship between Serum Gamma-glutamyltransferase Levels within Reference Intervals and the Prevalence of Metabolic Syndrome and Diabetes Mellitus in Adults

김달식|이재현|이혜수|조용곤|최문석|최삼임|배태원
대한진단검사의학회 (Korean Society For Laboratory Medicine)|2013.01|Laboratory Medicine Online|제3권 제1호|pp. 15-22

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Metabolic syndromeType 2 diabetes mellitusGamma-glutamyltransferaseReference interva

초록

배경: 본 연구에서는 건강한 성인에서 혈중 GGT 농도의 참고구간을 설정하고, 참고구간 내의 혈중 GGT 농도에 따른 대사증후군 및제2형 당뇨병 발병률과의 연관성을 분석하고자 하였다. 방법: 혈중 GGT 농도의 참고구간의 설정을 위해 총 363명(남자137명, 여자 226명)의 건강한 성인을 대상으로 하였다. 2011년 3월부터 10월까지 한 대학병원의 건강증진센터를 방문하여 본 연구에 동의하고 건강검진을 실시한 총 919명(남자 519명, 여자 400명)을 대상으로 단면조사연구를 시행하였다. 남자와 여자의 혈중GGT 농도의 참고구간을 4군으로 나누어 대사증후군과 제2형 당뇨병의 발병률의 관련성을 분석하였다. 결과: 중앙 95백분위수에 의한 혈중 GGT 농도의 참고구간은 남자에서 9.0-70.6 IU/L 그리고 여자에서 4.0-31.3 IU/L였다. 참고구간 내의 혈중 GGT 농도의 사분위수군에 따른 대사증후군 유병률의 대응 위험도(95% CI)는 남자와 여자에서 각각 1.0, 3.6 (0.7-18.0), 8.8(2.0-39.1), 17.4 (4.0-75.3)와 1.0, 3.3 (0.6-16.6), 5.8 (1.2-27.3), 18.8(4.3-82.2)였고, 제2형 당뇨병에 대해서는 각각 1.0, 1.0 (0.3-3.0), 1.7(0.6-4.6), 2.6 (1.0-6.6)과 1.0, 1.6 (0.3-9.7), 1.6 (0.3-9.9), 8.0 (1.7-36.7)였다. 이러한 연관성은 나이, 알코올 섭취, BMI 및 흡연유무로 보정한 후에도 유지되었다. 결론: 혈중 GGT 농도는 참고구간내의 농도라 할지라도 대사증후군 및 제2형 당뇨병의 발병률과 용량-반응관계의 연관성을 나타냈다. 따라서 혈중 GGT 농도는 만성퇴행성질환에 대해 하나의 독립적 예측인자가 될 수 있을 것이다.

Abstract

Background: This study was conducted to establish reference intervals (RIs) for serum gamma-glutamyltransferase (GGT), and to evaluate the association between serum GGT levels within RIs and the prevalence of metabolic syndrome (MetS) and type 2 diabetes mellitus (DM) in men and women. Methods: A total of 363 healthy adults (137 men and 226 women) were enrolled for establishing the RIs of serum GGT. A cross-sectional study was conducted with 919 individuals (519 men and 400 women) to evaluate the associations between gender-specific serum GGT RI quartiles and prevalence of MetS and DM. Results: The RIs for serum GGT levels (central 95th percentile ranges) were 9.0-70.6 IU/L and 4.0-31.3 IU/L in men and women, respectively. In men, the odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of MetS in 4 serum GGT quartiles (lowest to highest) were 1.0 (reference), 3.6 (0.7-18.0), 8.8 (2.0-39.1), and 17.4 (4.0-75.3), respectively, while the ORs (95% CIs) for the prevalence of DM were 1.0 (reference), 1.0 (0.3-3.0), 1.7 (0.6-4.6), and 2.6 (1.0-6.6), respectively. In women, the corresponding ORs (95% CIs) were 1.0 (reference), 3.3 (0.6-16.6), 5.8 (1.2-27.3), and 18.8 (4.3-82.2) for MetS, respectively, and 1.0 (reference), 1.6 (0.3-9.7), 1.6 (0.3-9.9), and 8.0 (1.7-36.7) for DM, respectively. These significant relationships persisted after adjusting for age, alcohol intake, body mass index, and smoking. Conclusions: Serum GGT levels, even within RIs, were proportionally associated with prevalence of metabolic syndrome and DM in both men and women. Serum GGT level may be an independent predictor for chronic degenerative diseases.

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