청소년 여자운동선수에서 비만, 혈청 지질, 초경 연령에 관한 분석

The Prevalence of Obesity, Serum Lipid Levels and Age at Menarche in Adolescent Female Athletes

  • 강보영 (인하대학교 의과대학 소아과학교실) ;
  • 김양경 (인하대학교 의과대학 소아과학교실) ;
  • 홍영진 (인하대학교 의과대학 소아과학교실) ;
  • 손병관 (인하대학교 의과대학 소아과학교실) ;
  • 장경자 (인하대학교 식품영양학교실) ;
  • 김순기 (인하대학교 의과대학 소아과학교실)
  • Kang, Bo Young (Department of Pediatrics, College of Medicine, Inha University) ;
  • Kim, Yang Kyong (Department of Pediatrics, College of Medicine, Inha University) ;
  • Hong, Young Jin (Department of Pediatrics, College of Medicine, Inha University) ;
  • Son, Byong Kwan (Department of Pediatrics, College of Medicine, Inha University) ;
  • Chang, Kyung Ja (Department of Food and Nutrition, College of Human Ecology, Inha University) ;
  • Kim, Soon Ki (Department of Pediatrics, College of Medicine, Inha University)
  • 투고 : 2004.08.18
  • 심사 : 2004.09.21
  • 발행 : 2005.01.15

초록

목 적 : 우리나라의 청소년들은 식생활의 변화와 과다한 학습활동, 운동 부족으로 인해 비만에 대한 위험이 높아짐에 따라 청소년기 운동의 중요성이 대두되고 있다. 저자들은 청소년기의 운동이 비만과 혈청 지질 및 초경 연령에 미치는 영향에 관하여 알아보았다. 방 법 : 12세에서 18세까지 연령의 여자운동선수 107명을 대상으로 하였고, 대조군은 규칙적인 운동을 하지 않는 동일 연령대의 여학생 650명을 대상으로 하였다. 각각 신체 계측과 체지방률을 측정하였고, 설문지를 통해 초경의 유무와 시작 연령을 조사하였으며, 혈청 지질을 알아보기 위한 혈액검사를 함께 시행하였다. 비만은 비만도 20% 이상, 체지방률 30% 이상, BMI가 85 백분위수 이상으로 정의하였다. 고지혈증은 총 콜레스테롤은 200 mg/dL 이상, 중성지방은 150 mg/dL 이상, LDL은 130 mg/dL 이상, HDL은 40 mg/dL 이하의 기준을 사용하였다. 결 과 : 1) 운동선수군과 대조군의 평균 연령은 $14.9{\pm}1.7$세, $14.7{\pm}1.5$세로 비슷하였다. 2) 체중은 운동선수군 $53.3{\pm}7.3kg$ 대조군 $54.3{\pm}8.0kg$으로 비슷하였으나, 신장은 운동선수군 $161.4{\pm}5.4cm$, 대조군 $158.9{\pm}5.3cm$로 운동선수군에서 더 컸다. 3) 체지방, 비만도, 및 BMI 모두에서 운동선수군이 대조군보다 유의하게 낮았다. 4) 비만의 빈도는 체지방, 비만도, 그리고 BMI를 기준으로 하였을 경우 모두 대조군에서 더 많았으며, 각 군 간에 유의한 차이를 보였다. 5) 초경을 시작한 평균연령은 운동선수군에서 $12.6{\pm}1.3$세, 대조군에서 $12.9{\pm}1.2$세로 통계적 차이는 없었다. 6) 총 콜레스테롤, HDL 콜레스테롤, LDL 콜레스테롤은 운동선수군에서 더 높았으며 중성지방은 대조군에서 더 높은 평균치를 보였다. 모든 혈청지질의 평균은 각 군 간에 유의한 차이를 보였다. 7) 고 콜레스테롤혈증과 고 LDL 콜레스테롤혈증 수치의 빈도는 운동선수군에서 더 높았고, 저 HDL 콜레스테롤혈증과 고중성지방혈증을 보이는 빈도는 대조군에서 더 높았으며, 각각은 모두 통계적으로 유의하였다. 결 론 : 청소년 여자운동선수군은 대조군과 비교하여 체중은 차이가 없었으나, 신장이 더 컸고, 체지방률, 비만도, BMI 및 비만의 빈도가 유의하게 낮았다. 이는 운동의 영향 때문이라고 생각된다. 초경 연령은 운동선수군과 대조군에서 통계적인 차이는 없어서, 본 연구에서는 운동이 초경 연령에 주는 영향은 없었다. 혈청 지질의 분석에서 운동선수군이 낮은 중성지방과 높은 HDL 콜레스테롤 수치를 보였으나, 총콜레스테롤과 LDL 콜레스테롤이 높아져 있어서, 청소년기의 혈청 지질이 성인에서와는 다른, 여러 가지 요인에 의해서 영향을 받을 것으로 생각되고, 운동선수군에서 혈청 지질과 지방질 섭취 등의 식이 습관, 성 호르몬, 성장 호르몬 등과의 연관성, 신장과의 상관관계 등을 포함한 광범위한 연구가 필요할 것으로 사료된다.

Purpose : The aim of this study is to find the prevalence of obesity, the serum lipid levels and the age at menarche in adolescent female athletes and to examine the effects of exercise in adolescent stage. Methods : With a questionnaire regarding their age at menarche, physical measurement, body fat, and blood samples of the serum lipid levels to evaluate the hyperlipidemia were obtained from adolescent female athletes(n=107) and general adolescent students(n=650) who didn't exercise at regular intervals, aged 12 to 18 years. Results : The mean weight in the athletes' group was $53.3{\pm}7.3kg$ which was similar with $54.3{\pm}8.0kg$ in the control group. The mean height in the athletes' group was $161.4{\pm}5.4cm$, which was taller than $158.9{\pm}5.3cm$ in the control group. The prevalence of obesity by obesity index, body fat, and BMI in the athletes' group were significantly lower than in control group. There was no significant difference in age at menarche between two groups($12.6{\pm}1.3$, $12.9{\pm}1.2$). The levels of cholesterol, LDL cholesterol, and HDL cholesterol in the athletes' group were higher than in the control group. The levels of triglyceride in the athletes' group was lower than in control group. Conclusion : These data suggest the importance of exercise in adolescents for the prevention of obesity since it may reduce body fat and increase the height. There was no negative effect of exercise on the age at menarche. We think that more controlled assessment of nutrition, diet habit, hormonal effect and height are warranted to find the correlation with hyperlipidemia and exercise at the adolescent stage.

키워드

참고문헌

  1. Kim MJ, Kang JS, Ko JY, Hong YJ, An DH, Beak DM, et al. The percentiles of body mass index and trend of obesity in schoolage children in Seoul. J Korean Pediatr Soc 1999;42:756-64
  2. Jo KB, Park SB, Park SC, Lee DH, Lee SJ, Seo SJ. The prevalence and trend of obesity in children and adolescents. J Korean Pediatr Soc 1989;32:597-605
  3. Kang YJ, Hong CH, Hong YJ. The prevalence of childhood and adolescent obesity over the last 18 years in Seoul area. Korean J Nutr 1997;30:832-9
  4. Lee DH. Assessment and treatment of childhood obesity. J Korean Pediatr Soc 1996;39:1055-65
  5. Kim MH, Kim TW, Hong YJ, Son BK, Pai SH, Kim SK. The prevalence of obesity and underweight in adolescents in Incheon area and the relationship between serum cholesterol level and obestiy. J Korean Pediatr Soc 2002;45:101- 10
  6. Epstein LH, Wing RR, Valoski A. Childhood obesity. Pediatr Clin North Am 1985;32:365-79
  7. Lee DH, Lee C, Lee CG, Hwang YS, Cha SH, Choi Y. The incidence of complications in severely obese children. J Korean Pediatr Soc 1991;34:445-53
  8. Grunbaum JA, Kann L, Kinchen SA, Williams B, Ross JG, Lowry R, et al. Youth risk behavior surveillance in United States, 2001. MMWR Surveill Summ 2002;51:1-62
  9. Williams CL, Campanaro LA, Squillace M, Bollella M. Management of childhood obesity in pediatric practice. Ann N Y Acad Sci 1997;817:225-40 https://doi.org/10.1111/j.1749-6632.1997.tb48209.x
  10. Durninn JV, Rahahman MM. The assessment of the amount of fat in the human body from measurement of skin thickness. Br J Nutr 1967;21:316-9
  11. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States; Prevalence and trends. 1960-1994. Int J Obes 1998;22:39-47
  12. Terjung RL. Muscle adaptations to aerobic training. Sports Sci Exchange 1995;8:1
  13. Saltin B, Rowell LB. Functional adaptations to physical activity and inactivity. Fed Proc 1980;39:1506
  14. Foster C. Central circulatory adaptations to exercise training in health and disease. Clin Sports Med 1986;5:589
  15. Fagard RG, Tipton CM. Physical activity, fitness, and hypertension. Champaign 1994, p633
  16. Keast D, Cameron K, Morton AR. Exercise and the immune response. Sports Med 1988;5:248 https://doi.org/10.2165/00007256-198805040-00004
  17. Mayer-Davis EJ, D'Agostino R Jr, Karter AJ, Haffner SM, Rewers MJ, Saad M, et al. Intensity and amount of physical activity in relation to insulin sensitivity : The insulin resistance atherosclerosis study. JAMA 1998;279:669-74 https://doi.org/10.1001/jama.279.9.669
  18. Choen MS, Sagong M, Lee SH. The influence of exercise to cardiovascular risk factors in health adults. J Korean Acad Family Med 1999;20:139-46
  19. Park YW. The associations of regular exercise habit and cardiovascular disease risk factors among middle-aged women. Korean J Sports Med 1999;17:19-24
  20. Erdelyi GJ. Gynecological survey of female athletes : AMA Proceedings of the Second National Conference on the Medical Aspects of Sports, November, 1960. J Sports Med 1962;2:174
  21. Warren MP. The effect of exercise on pubertal progression and reproductive function in girls. J Clin Endocrinol Metab 1980;51:1150-7 https://doi.org/10.1210/jcem-51-5-1150
  22. Sim JS, Jin YS, Lim KS, Kim HN. The effects of exercise of menarche and menstruation. Korean J Obst Gynecol 1990;33:1223-35
  23. Shin JC, Lee C, Joon M, Oh MJ, Kim T, Ku PS, et al. Menarche in Korean adolescent girls. Korean J Obst Gynecol 1996;39:865-79
  24. Wood PD, Stefanick ML, Williams PT, Haskell WL. The effects on plasma lipoproteins of a pruduct weight-reducing diet, with or without exercise, in overweight men and women. N Engl J Med 1991;325:461-6 https://doi.org/10.1056/NEJM199108153250703
  25. Williams PT, Stefanick ML, Vranizan KM, Wood PD. The effects of weight loss by exercise or by dieting on plasma high-density lipoprotein(HDL) levels in men with low, intermediate, and normal-to-high HDL at baseline. Metabolism 1994;43:917-24 https://doi.org/10.1016/0026-0495(94)90277-1
  26. Freedman DS, Burke GL, Harsha DW, Srinivasan SR, Cresanta JL, Webber LS, et al. Relationship of changes in obesity to serum lipid and lipoprotein in childhood and adolescence. JAMA 1985;254:515-20 https://doi.org/10.1001/jama.254.4.515
  27. Choe YH, Park KY, Ha IS, Cheong HI, Choi Y. A statistical study on obesity, blood pressure, serum total cholesterol, serum apolipoprotein B and urine sodium and potassium in middle school children. J Korean Pediatr Soc 1992;35:1546-57
  28. Whoang GE, Rhee KS, Chung YH. The normal serum total cholesterol level in children. J Korean Pediatr Soc 1992;35:1559-65
  29. Ju HS, Koo ES, Jung TH, Bae CY, Sin DH. A survey of serum cholesterol in healthy children and adolescence. J Korean Acad Family Med 1994;15:547-53
  30. Sung TJ, Kim DH, Hong YJ, Son BK, Chang KJ, Kim SK. Effective screening test for obesity in obese adolescents and the correlation among obesity index, body mass and serum lipid profile. J Korean Pediatr Soc 2003;46:217-23
  31. Miller DJ, Miller NE. Plasma high density lipoprotein concentration and development of ischemic heart disease. Lancet 1075;1:16-9 https://doi.org/10.1016/S0140-6736(02)95332-8
  32. Craig SR, Amin RV, Russell DW, Paradise NF. Blood cholesterol screening influence of fasting state on cholesterol results and management desicions. J Gen Intern Med 2000; 15:395 https://doi.org/10.1046/j.1525-1497.2000.03509.x
  33. Cooper GR, Myers GL, Smith SJ, Schlant RC. Blood lipid measurements. Variations and practical utility. JAMA 1992; 267:1652-60 https://doi.org/10.1001/jama.267.12.1652
  34. US Preventive Services Task Force. Guide to clinical preventive services, 2nd ed. Williams and Wilkins, Baltimore, 1996, p15
  35. Bachorik PS, Cloey TA, Finney CA, Lowery DR, Becker DM. Lipoprotein-cholesterol analysis during screening : Accuracy and reliability. Ann Intern Med 1991;114:741-7 https://doi.org/10.7326/0003-4819-114-9-741