폐경여성에서 이중에너지 방사선 흡수 계측법 (DEXA)으로 측정된 신체 체성분 변화에 연령과 폐경 기간이 미치는 영향
Relative influence of age and menopause on total and regional Body composition changes measured by DEXA in Postmenopausal Women
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목적: 폐경/주폐경 여성에서 체성분 변화에 연령과 폐경 기간이 미치는 영향에 대하여 알아보고자 하였다. 연구 방법: 2001년 1월부터 2002년 4월까지 모병원 산부인과와 가정의학과 외래로 내원한 호르몬요법을 받은 적이 없는 40세에서 69세의 폐경 여성 115명을 대상으로 하였다. 총 신체와 체간, 상지, 하지의 부위별 체성분량을 체지방 측정에 정확도와 예민도가 높은 DEXA를 이용하여 측정하였다. 하지부위 체지방량을 총 체지방량으로 나눈 백분율을 여성형지방 (gynoid fat)으로 체간부위 체지방량을 나눈 것은 남성형지방 (android fat)으로 정의하였다. 결과: 폐경 주변기 여성군과 젊은 폐경 여성, 나이가 많은 폐경 여성군 별 평균 총 골량 수치가 2.41±0.31 kg, 2.12±0.33 kg, 2.05±0.24 kg으로 유의한 차이가 있었고 (p<0.001) 평균 총 골밀도치도 1.16±0.06 gm/cm2, 1.09±0.10 gm/cm2, 1.05±0.08 gm/cm2로 유의한 차이가 있었다 (p<0.001). 각 군별 평균 총 제지방량과 상지, 체간 제지방량에서는 유의한 차이가 없었으나 평균 하지 제지방량은 11.81±1.45 kg, 11.05±1.15 kg, 11.28±0.59 kg으로 유의한 차이가 있었다 (p<0.05). 평균 총 체지방량과 각 부위별 평균 국소 체지방량은 각 군 간에 유의한 차이는 없었고 그 외 여성형지방에서는 유의한 차이를 볼 수 있었으나 (p<0.01) 남성형지방에서는 유의한 차이를 볼 수 없었다. 다중회귀분석결과 연령이 전체, 체간, 하지 골량 감소와 전체, 요추부, 대퇴골부위 골밀도 감소에 의미 있는 예측변수이었고 (p<0.01) 그 외에 전체, 상지, 체간 체지방백분율증가와 체간 국소지방백분율증가에 의미 있는 예측변수이었다 (p<0.05). 이와는 달리 폐경 기간으로는 어떤 변수도 예측할 수 없었다. 결론: 폐경 여성에서의 골량, 골밀도 감소와 전체, 상지, 체간 체지방백분율증가와 체간 국소지방백분율증가 등 복부비만으로의 체지방분포변화는 에스트로겐감소에 영향을 받는 폐경 기간보다 연령에 따른 노화와 관련성이 있는 것으로 생각된다.
Abstract
Objective: In Korea, only a few reports were introduced about body fat mass of women with using the Dual energy X-ray absorptiometry (DEXA), highly sensitive and specific measurement for fat mass analysis. This study was carried out to determine whether total and regional body composition changes measured by DEXA were more related to age or to menopause. Methods: One hundred fifteen postmenopausal women who had never received estrogen replacement therapy were enrolled in Menopausal Clinic from January 2001 to April 2002. BMD and body composition were measured by DEXA. The proportions of android and gynoid fat were calculated in all women and differences were sought by ANOVA test, Pearson correlation and multiple linear regression. Results: They were classified as perimenopausal women (n=31), young postmenopausal women (n=60) or old postmenopausal women (n=24). Bone mineral content (BMC), BMD, leg lean body mass and gynoid fat were significant differences among three groups. In multiple linear regression, age was a predictor of total, trunk and leg BMC (p<0.01), total, L2-4 and proximal femur BMD (p<0.01), total, arm and trunk fat percentage of total body mass and trunk regional fat percentage of regional tissue (p<0.05), whereas years since of age was not a predictor of any of the body composition variables. Conclusion: The findings of this study suggest that BMC, BMD and body fat distribution with a shift toward a more central location in postmenopausal women. This change appears to be more related to age than to menopause.
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