몽골 이주민을 대상으로 시행한 간 검진 결과에 대한 분석: 한국인 건강검진 결과와의 비교 연구
Analysis of Results of Liver-related Health Care Checkup in Mongolian Immigrants: A Comparison with Results from Koreans
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배경: 몽골의 간암 발생률과 그로 인한 사망률이 세계에서 가장 높으며 몽골인에서 간암의 발생은 만성 B형과 C형 간염이 주된 원인이다. 이 연구의 목적은 몽골 이주민과 한국인의 간기능과 바이러스성간염, 간섬유화 검사결과를 비교 분석하는 것이다. 방법: 40세 이상의 몽골 이주민 80명을 대상으로 B형과 C형 간염표지자와 간섬유화 검사가 포함된 검진을 실시하였다. B형간염표면항원과 항체, C형간염항체, aspartate transaminase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), enhanced liver ¬fibrosis (ELF) 검사가 시행되었다. 이 몽골인들의 검사결과를 한국인 건강검진자 40명의 검사결과와 비교하였다. 결과: Signifi¬cant Fibrosis (ELF≥8.5)를 보인 몽골인의 비율은 한국인보다 높았다(66.3% vs. 47.5%, P =0.048). C형간염항체나 B형간염항원이 양성인 몽골인이 음성인 몽골인에 비해서 국제적 ELF 기준과 국내 ELF 기준에서 모두 간섬유화 단계의 유의한 차이를 보였다(각각, P =0.004; P =0.023). 결론: ELF 점수 기준에서 signifi¬cant fibrosis에 해당하는 비율이 한국인보다 몽골인에서 더 높은 빈도로 나타났다. 몽골 이주민들을 대상으로 한 간 질환에 특히 초점을 맞춘 건강검진 프로그램이 필요하다.
Abstract
Background: The incidence and mortality rate of liver cancer in Mongolians are known to be the highest in the world, and liver cancer in Mongolians is mainly caused by chronic hepatitis B and C. The aim of this study was to analyze the results of liver function, viral hepatitis, and liver fibrosis tests in Mongolian immigrants and compare them with those of Koreans. Methods: Eighty Mongolian immigrants older than 40 years of age volunteered for screening programs including serological markers of hepatitis B and C and liver fibrosis. Hepatitis B surface antigen(HBsAg) and antibody, anti-hepatitis C virus(anti-HCV), AST, ALT, gamma-glutamyltransferase(GGT), and enhanced liver fibrosis(ELF) scores were determined. The results of the Mongolians were compared with those of 40 Koreans. Results: The frequency of significant liver fibrosis (ELF ≥8.5) was higher in Mongolians than in Koreans (66.3% vs. 47.5%, P =0.048). Moreover, there were significant differences in fibrotic stages estimated based on global and domestic ELF criteria between the groups positive and negative for anti-HCV or HBsAg among Mongolians (P =0.004 and P =0.023, respectively). Conclusions: The frequency of significant liver fibrosis based on ELF scores was higher in Mongolian immigrants than in Koreans. A health screening program specifically focused on liver disease is needed for Mongolian immigrants.
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