청소년 건강증진교육을 위한 비만여부에 따른 당뇨병 관련 건강행태

Health Behavior Factors Related Type 2 Diabetes by Obesity for Health Promotion in Adolescents

  • 백경원 (백석대학교 사회복지학부 노인복지) ;
  • 전기홍 (아주대학교 의과대학 예방의학교실/보건대학원)
  • 발행 : 2008.12.01

초록

Purpose: Several health behavior factors affect the incidence of type 2 diabetes. Especially, obesity, which causes insulin resistance, is the most important determinant of diabetes. Therefore, we expect the risk factors associated with insulin resistance and type 2 diabetes are affected by obesity and, additionally, the related factors with diabetes caused by obesity can be controlled. Methods: This study used data collected from the 2001 Korea National Health and Nutrition Examination Survey (KNHANES). A stratified multistage probability sampling method was applied and the final sample included 5,500 subjects over 30 years old who had completed necessary health examinations and health behaviors survey. Results: The risk factors associated with type 2 diabetes are affected by obesity. According to logistic regression model stratified by body mass index (BMI) and sex, abdominal obesity and age were the significant risk factors of diabetes regardless of sex and BMI. However, drinking, smoking, total energy consumption, and protein consumption were risk factors for women with normal BMI, while carbohydrate consumption was a risk factor for man with normal BMI. Sleeping hours affected diabetes for women with obesity and fiber consumption was a risk factor for both women and men with obesity. In addition, statistically the family history of diabetes was a significant risk factor only in the group with normal weight, not in the group with obesity. Conclusion: The study results will provide information for implementing a regional initiative of type 2 diabetes prevention by BMI.

키워드

참고문헌

  1. 강희철, 김상만, 윤방부 , 국승래, 박영수, 고완규, 이득주(1997). 정상군과 비만군에서 허리- 둔부 둘레비에 따른 체지방, 고지혈증, 혈압, 혈당과의 관계. 가정의학회지, 18(3), 317-327
  2. 권숙정, 김은경(2002). 공복혈당장애군 및 당뇨군의 비만도, 혈압, 혈청 지질 농도 및 영양소 섭취 상태. 한국영양학회지, 35(3), 303-313
  3. 김영택, 오경원, 장명진, 박진경, 이정미, 이연경 (2006). 2005년 국민건강영양조사-검진조사부문. 보건복지부, 질병관리본부
  4. 김우경, 이경애(1999). 정상 성인의 혈청 인슐린 농도에 따른 비만지수, 혈청 지질 , 혈압 및 영양소 섭취 상태 비교. 한국영양학회지, 32(1), 10-16
  5. 김초일, 계승희, 장영애, 김복희, 이행신, 서희재 (2002). 2001년 국민건강영양조사-영양조사부문. 보건복지부, 한국보건산업진흥원
  6. 민헌기(1992). 한국인 당뇨병의 임상적 특성. 당뇨병, 16(3), 163-174
  7. 박혜순(1997). 청소년 비만과 체중조절. 대한 가정의학회지, 18(11), 1171-1182
  8. 백경원, 홍윤미(2006). 복부비만의 지표인 허리둘레 에 영향을 미치는 건강행태요인. 예방의학회지, 39(1), 59-66
  9. 양윤정, 김진옥(2000). 내당능장애 가능성이 있는 중년 남성의 신체적 특성 , 영양소 섭취상태 및 혈중 지질농도 양상. 한국영양학회지, 33(1). 59-67
  10. 장상아, 손호영, 차봉연, 문성대, 송기호, 유순집, 윤건호, 강무일, 이광우, 강성구(1997). 한국 정상성인에서 연령, 신체질량지수 및 포도당 농도에 따른 공복 인슐린 농도. 당뇨병, 21(4), 433-443
  11. 통계청(2007). 2006년 사망원인 통계연보
  12. 한국영양학회(2001). 한국인 영양 권장량(제7차 개정)
  13. Colditz G.A., Willett W.C., Rotnitzky A, Manson J.E.(1995). Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med, 122(7), 481-486 https://doi.org/10.7326/0003-4819-122-7-199504010-00001
  14. Diabetes Prevention Program Research Group(2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med, 346(6), 393-403 https://doi.org/10.1056/NEJMoa012512
  15. Eastwood M.A., Morris E.R.(1992). Physical properties of dietary fiber that influence physiological function-a model for polymers along gastrointestinal tract. Am J Clin Nutr, 55(2), 436-442 https://doi.org/10.1093/ajcn/55.2.436
  16. Eliasson B., Attvall S., Taskinen M.R., Smith U (1994). The insulin resistance syndrome in smokers is related to smoking habits. Arterioscler Thromb, 14(12), 1946-1950 https://doi.org/10.1161/01.ATV.14.12.1946
  17. Freedman D.S., Dietz W.H., Srinivasan S.R., et al. (1999) The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics, 103(6), 1175-1182 https://doi.org/10.1542/peds.103.6.1175
  18. Han D.H., Hansen P.A., Host H.H., Holloszy J.O. (1997). Insulin resistance of muscle glucose transport in rats fed a high-fat diet-a reevaluation. Diabetes, 46(11), 1761-1767 https://doi.org/10.2337/diabetes.46.11.1761
  19. Hu F.B., Sigal R.J., Rich-Edwards J.W., Colditz G.A., Solomon C.G., Willett W.C., et al(1999). Walking compared with vigorous physical activity and risk of type 2 diabetes in women-a prospective study. JAMA, 282(15), 1433-1439 https://doi.org/10.1001/jama.282.15.1433
  20. Hu F.E., Manson J.E., Stampfer M.J., Colditz G., Liu S., Solomon C.G., et al.(2001). Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med, 345(11), 790-797 https://doi.org/10.1056/NEJMoa010492
  21. Inoue S., Zimmet P., Caterson I., Chunming C., Ikeda Y., Khalid A.K., et al(2000). The Asiapacific perspective: redefining obesity and its treatment
  22. Jeffery R.W., Drewnowski A., Epstein L.H., Stunkard A.J., Wilson G.T., Wing R.R., et al.(2000). Longterm maintenance of weight loss: current status. Health Psychol, 19(1), S5-S16 https://doi.org/10.1037/0278-6133.19.Suppl1.5
  23. Kanazawa M., Yoshiike N., Osaka T., Numba Y., Zimmet P., Inoue S.(2002). Criteria and classification of obesity in Japan and Asia-Oceania. Asia Pac J Clin Nutr, 11(8), S732-S737 https://doi.org/10.1046/j.1440-6047.11.s8.19.x
  24. Kaplan G.A., Keil J.E.(1993). Socioeconomic factors and cardiovascular disease-a review of the literature. Circulation, 88(4), 1973-1998 https://doi.org/10.1161/01.CIR.88.4.1973
  25. Lynch J., Helmrich S.P., Lakka T.A., Kaplan G.A., Cohen R.D., Salonen R., et al(1996). Moderately intense physical activities and high levels of cardiorespiratory fitness reduce risk of non-insulin -dependent diabetes mellitus in middle-aged men. Arch Intern Med, 156(12), 1307-1314 https://doi.org/10.1001/archinte.156.12.1307
  26. Marshall J.A., Hamman R.F., Baxter J.(1991). High-fat, low-carbohydrate diet and the etiology of non-insulin-dependent diabetes mellitus-The San Luis Valley Diabetes Study. Am J Epidemiol, 134(6), 590-603 https://doi.org/10.1093/oxfordjournals.aje.a116132
  27. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)(2001). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19), 2486-2497 https://doi.org/10.1001/jama.285.19.2486
  28. Rimm E.B., Ascherio A., Giovannucci E., Spiegelman D., Stampfer M.J., Willett W.C..(1996). Vegetable, fruit, and cereal fiber intake and coronary heart disease among men. JAMA, 275(6), 447-451 https://doi.org/10.1001/jama.275.6.447
  29. Rimm E.B., Stampfer M.J., Giovannucci E., Ascherio A., Spiegelman D., Colditz G.A., et al.(1995). Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol, 141(12), 1117-1127 https://doi.org/10.1093/oxfordjournals.aje.a117385
  30. Salmeron J., Manson J.E., Stampfer M.J., Colditz G.A., Wing A.L., Willett W.C.(1997). Dietary fiber, glycemic load, and risk of non insulin-dependent diabetes mellitus in women. JAMA, 277(6), 472-427 https://doi.org/10.1001/jama.277.6.472
  31. Tuomilehto J., Lindstrom J., Eriksson J.G., Valle T., Hamalainen H., Ilanne-Parikka P.(2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl Med, 344(18), 1343-1350 https://doi.org/10.1056/NEJM200105033441801
  32. Wei M., Gibbons L.W., Mitchell T.L., Kampert J.B., Blair S.N.(2000). Alcohol intake and incidence of type 2 diabetes in men. Diabetes Care, 23(1), 18-22 https://doi.org/10.2337/diacare.23.1.18