무증상 한국인에서 대장 용종과 대사증후군의 관계
The Association Between Colon Polyp and the Metabolic Syndrome in Asymptomatic Korean Adults
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초록
연구배경: 최근 한국에서 대장암 발생이 증가되고 있으며 이는 대사증후군 증가와 관련되어 있다는 몇몇 연구 결과들이 보고되고 있다. 이와 관련하여 본 연구는 대사증후군과 대장암의 전구병변인 대장 용종 유병에 관한 연관성에 대해 알아보고자 한다. 방법: 2010년 2월부터 2011년 2월까지 순천향대학교 천안병원 건강증진센터를 방문하여 전 대장 내시경검사를실시한 1,630명의 수검자를 대상으로 성별, 연령, 체질량지수, 허리둘레, 혈압, 공복혈당, 총 콜레스테롤, 중성지방, 고밀도 지단백 콜레스테롤, 대장 용종 여부를 조사하고 설문조사와 문진을 통해 음주, 흡연, 운동에 관해 조사하였다. 대장 내시경검사 시행 결과에 따라 대장 용종군과 대조군으로 나누어 NCEP ATPIII에 제시된 대사증후군 인자들과의 연관성을 평가하였다. 결과: 본 연구에서는 전체 대상자 1,630명 중 대장 용종유병률은 354명으로 21.7%였으며 대사증후군은 260명으로 16.0%였다. 대장 용종 발생 위험성에 대해 흡연, 운동,음주, 대사증후군 관련 인자 중에서는 체질량지수, 총 콜레스테롤, 혈압, 공복혈당, 중성지방, 고밀도 지단백 콜레스테롤과의 연관성은 유의한 차이가 나타나지 않았다. 연령과성별을 보정한 상태에서 대장 용종은 대사증후군(odds ratio [OR]=1.72, 95% confidence interval [CI] 1.05-2.82, P=0.031)과 허리둘레(OR=1.04, 95% CI 1.01-1.06, P=0.009)는 관련이있는 것으로 나타났다. 결론: 무증상 성인에서 대사증후군은 대장 용종의 유병과 연관되어 있으며, 특히 허리둘레와 관련이 있는 것으로나타났다.
Abstract
Background: Recently, the prevalence of colorectal cancer related with metabolic syndrome is increasing in Korea. The aim of this study was to reveal a relationship between components of metabolic syndrome and the development of colon polyp. Methods: Among the subjects who visited a health promotion center of one university hospital and underwent colonoscopic examination from February 2010 to February 2011, a total of 1,630 (males 1,156, females 474)asymptomatic adults were included for the study. Sex, age, body mass index, waist circumference, blood pressure,fasting blood glucose, total cholesterol, triglyceride, HDL-cholesterol levels and the presence of colorectal polyps were measured. Alcohol consumption, smoking and exercise were assessed by a self-administered questionnaire. Metabolic syndrome was defined by criteria of 2004 American Heart Association/Updated NCEP Adult Treatment Panel III. Results: The prevalence of colon polyps and metabolic syndrome was 21.7% and 16.0% respectively among study subjects. After adjustment for sex and age, metabolic syndrome (odds ratio [OR]=1.72, 95% confidence interval [CI] 1.05-2.82, P=0.031) and waist circumference (OR=1.04, 95% CI 1.01-1.06, P=0.009) were associated with increased risk of colorectal polyps. Conclusion: Metabolic syndrome and waist circumference were associated with increased risk of colon polyps in asymptomatic Korean adults.
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