폐경 후 여성에서 대사증후군과 골밀도와의 연관성
Relationship between metabolic syndrome and bone mineral density in the postmenopausal women
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목적: 대사증후군은 복부비만, 고혈압, 지질 대사이상, 공복혈당장애 등에 의한 심혈관계 질환의 위험도가 높아지는 대사 이상이다. 폐경 후 여성에서 대사증후군 및 위험 요소들과 골밀도와의 연관성에 대하여 알아보고자 하였다. 연구 방법: 2006년 1월부터 2007년 12월까지 가톨릭 의과대학 성빈센트병원 산부인과를 방문한 폐경 후 여성 중 대사증후군을 진단받은 여성 66명, 그렇지 않은 여성 85명을 대상으로 하였으며, 대사증후군 및 허리 엉덩이둘레비율, 총 중성지방, HDL 콜레스테롤, 공복 혈당, 혈압 등의 위험 요소들과 골밀도와의 상관관계를 회귀분석 및 ANCOVA를 이용하여 분석하였다. 결과: 대사증후군이 있는 여성에서 그렇지 않은 여성에 비해 요추부 및 대퇴 경부 골밀도의 유의하게 높았으나 나이와 체질량지수를 보정한 뒤에는 유의한 차이는 없었다. HDL 콜레스테롤과 요추부 골밀도와는 통계적으로 유의한 양의 상관관계가 있었으며, 공복혈당과 요추부, 대퇴 경부의 골밀도와 양의 상관관계가 있었다. 복부비만 및 혈압, 총 중성지방과 골밀도와는 유의한 상관관계는 없었다. 대사증후군 위험인자의 양성수와 골밀도와 양의 상관관계를 보였으나 나이와 체질량지수를 보정한 뒤에는 유의한 차이는 없었다. 결론: 대사증후군은 체질량지수의 증가 등으로 골량의 증가 효과를 가질 것으로 생각할 수 있지만 저HDL 콜레스테롤혈증 등의 지질대사에 의해 골량이 감소되며, 체질량지수를 보정할 경우 대사증후군 자체의 골보호 효과는 없는 것으로 생각된다.
Abstract
Objective: Observational studies suggest that osteoporosis is associated with cardiovascular disease, although another study found that metabolic syndrome (MS) has protective effects on bone. Therefore, this study examined the relationship between metabolic syndrome and bone mineral density (BMD) in postmenopausal women. Methods: We divided postmenopausal women who visited St. Vincent Hospital of the Catholic University of Korea in 2006 and 2007 into groups with and without MS and measured their body mass index (BMI), waist–hip ratio (WHR), blood pressure, serum fasting glucose, lipid profile, and BMD of the lumbar spine and femoral neck. Results: Of the 151 subjects, 66 (43%) had MS and 85 (57%) did not. The women with MS had a higher BMD at the lumbar spine and femoral neck, although after adjusting for age and BMI, this correlation was lost. Significant positive correlations were observed between BMD of the lumbar spine and both high-density lipoprotein (HDL) cholesterol and serum fasting glucose, and BMD of the femoral neck was positively correlated with serum fasting glucose level. The components of MS were not correlated with BMD in these postmenopausal women after adjusting for age and BMI. Conclusion: In our study, the higher BMD in MS was explained by the higher BMI in postmenopausal women. After adjusting for age and BMI, however, MS had no protective effect on bone mass. MS may be another risk factor for postmenopausal osteoporosis.
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