백내장과 대사증후군의 관련성 - 2005, 2007년 국민건강영양조사 이용

Relations of Cataract to Metabolic Syndrome and its Components - Based on the KNHANES 2005, 2007

  • 박상신 (서울대학교 보건대학원 역학교실) ;
  • 이은희 (극동대학교 안경광학과)
  • Park, Sang-Shin (Department of Epidemiology, School of Public Health, Seoul National University) ;
  • Lee, Eun-Hee (Department of Visual Optics, Far East University)
  • 투고 : 2009.07.27
  • 심사 : 2009.09.08
  • 발행 : 2009.09.30

초록

목적: 백내장에 대사증후군 및 그 구성요소가 어떠한 영향을 미치는지 알아보고자 본 연구를 수행하였다. 방법:2005, 2007년의 국민건강영양조사 자료를 이용하여 대사증후군 및 구성요소와 백내장과의 관계를 분석하였다. 이를 위해 본 연구에서는, 60세 이상의 성인 2,120 명을 대상으로 대사증후군 이상인자의 수(${\leq}$1, 2, 3, ${\geq}$4) 에 따른 백내장 발생의 위험도(Odds ratio: OR)를 살펴보고, 대사증후군 관련치료제가 백내장에 미치는 영향 또한 다중 로지스틱 회귀분석으로 분석하였다. 결과: 대사증후군의 구성요소를 하나도 가지지 않은 대상자를 기준으로 하고, 성, 연령, 생활습관변수 및 사회경제적 변수를 보정했을 때 보유하고 있는 대사증후군의 구성요소가 늘어날수록 백내장의 위험도는 더욱 커지는 경향을 보였다(p for trend < 0.0001). 또한, 대사증후군 요소 중 혈압(OR(95% Confidence Interval): 1.32(1.05,1.65))과 공복혈당(1.35(1.09,1.67))에 이상이 있는 경우는 성과 연령을 보정한 후에도 백내장의 위험을 유의하게 증가시키는 것으로 나타났다. 그 중 공복혈당장애의 경우는 앞서 보정한 변수에 사회경제적 변수를 함께 보정하여도 백내장 발생에 유의미한 위험도(1.35(1.09,1.67))를 나타내었다. 대사증후군이 있는 경우에도 동일한 보정 후에 백내장에 대한 유의한 위험도(1.26(1.01,1.58))를 보였다. 마지막으로 높은 혈압이 있는 대상자들을 대상으로 시행된 분석에서, 고혈압 치료제의 경우 백내장의 위험도(1.49(1.14,1.96))를 증가시키는 것으로 나타났다. 결론: 대사증후군 및 그 구성요소는 백내장 발생의 위험을 높이는 것으로 확인되었고, 고혈압 치료제의 경우도 백내장의 위험도를 높이는 것으로 추정된다.

Purpose: This study was performed to assess the effects of metabolic syndrome and its components to cataract. Methods: We investigated the relation of metabolic syndrome and its components to cataract using data for 2,120 adults, aged 60 years or older, from the Korean National Health and Nutrition Examination Survey 2005, 2007. Using multiple logistic regression analysis, we presented significant odds ratio (OR) increase of cataract according to the number of metabolic abnormalities ${\leq}$1, 2, 3, ${\geq}$4). We also analyzed OR by the prevalence of metabolic components, and analyzed the effects of metabolic medication intakes to cataract prevalence using multiple logistic regression analysis. Results: The risk of cataract development was significantly increased according to the number of metabolic abnormalities, after adjusting for age, sex, life style, and social economic status variables (p for trend < 0.0001). In metabolic components, the disturbances of blood pressure (OR(95% Confidence Interval): 1.32(1.05,1.65)) and fasting glucose (1.35(1.09,1.67)) significantly increased the prevalence of cataract after adjusting for age and sex. Among these metabolic components, the significance of fasting glucose (1.26(1.01, 1.58)) was remained after adjusting for the other variables. Medication intake of hypertensive also increased the risk of cataract (1.49(1.14,1.96)). Conclusions: Metabolic syndrome and its components increased the risk of cataract, and some medication for treating hypertension was also associated with the cataract incidence.

키워드

참고문헌

  1. Kahn H. A., Leibowitz H. M., Ganley J. P., Kini M. M., Colton T., Nickerson R. S., and Dawber T. R., "The Framingham Eye Study. II. Association of ophthalmic pathology with single variables previously measured in the Framingham Heart Study", Am. J. Epidemiol., 106(1):33-41(1977). https://doi.org/10.1093/oxfordjournals.aje.a112429
  2. Meigs J. B., "Invited commentary: insulin resistance syndrome? Syndrome X? Multiple metabolic syndrome? A syndrome at all? Factor analysis reveals patterns in the fabric of correlated metabolic risk factors", Am. J. Epidemiol., 152(10):908-911;discussion912(2000). https://doi.org/10.1093/aje/152.10.908
  3. Meigs J. B., "Definitions and mechanisms of the metabolic syndrome", Current Opinionin Endocrinology, Diabetes and Obesity, 13(2):103(2006).
  4. Tan J. S., Wang J. J., and Mitchell P., "Influence of diabetes and cardiovascular disease on the long-term incidence of cataract: the Blue Mountains eye study", Ophthalmic Epidemiol., 15(5):317-327(2008). https://doi.org/10.1080/09286580802105806
  5. Leske M. C., Wu S. Y., Hennis A., Connell A. M., Hyman L., and Schachet A., "Diabetes, hypertension, and central obesity as cataract risk factors in a black population. The Barbados Eye Study", Ophthalmology, 106(1):35-41(1999). https://doi.org/10.1016/S0161-6420(99)90003-9
  6. Lindblad B. E., Hakansson N., Philipson B., and Wolk A., "Metabolic syndrome components in relation to risk of cataract extraction: a prospective cohort study of women", Ophthalmology, 115(10):1687-1692(2008). https://doi.org/10.1016/j.ophtha.2008.04.004
  7. Bojarskiene F., Cerniauskiene L. R., Paunksnis A., and Luksiene D. I., "Association of metabolic syndrome components with cataract", Medicina (Kaunas), 42(2):115-122(2006).
  8. Hiller R., Sperduto R. D., Reed G. F., D'Agostino R. B., and Wilson P. W., "Serum lipids and age-related lens opacities: a longitudinal investigation: the Framingham Studies", Ophthalmology, 110(3):578-583(2003). https://doi.org/10.1016/S0161-6420(02)01762-1
  9. Goodrich M. E., Cumming R. G., Mitchell P., Koutts J., and Burnett L., "Plasma fibrinogen and other cardiovascular disease risk factors and cataract", Ophthalmic Epidemiol, 6(4):279-290(1999). https://doi.org/10.1076/opep.6.4.279.4188
  10. Younan C., Mitchell P., Cumming R., Rochtchina E., Panchapakesan J., and Tumuluri K., "Cardiovascular disease, vascular risk factors and the incidence of cataract and cataract surgery: the Blue Mountains Eye Study", Ophthalmic Epidemiol. 10(4):227-240(2003). https://doi.org/10.1076/opep.10.4.227.15905
  11. Janghorbani M. and Amini M., "Cataract in type 2 diabetes mellitus in Isfahan, Iran: incidence and risk factors", Ophthalmic Epidemiol., 11(5):347-358(2004). https://doi.org/10.1080/09286580490888753
  12. Schaumberg D. A., Glynn R. J., Christen W. G., Hankinson S. E., and Hennekens C. H., "Relations of body fat distribution and height with cataract in men", Am. J. Clin. Nutr., 72(6):1495-1502(2000). https://doi.org/10.1093/ajcn/72.6.1495
  13. Paunksnis A., Bojarskiene F., Cimbalas A., Cerniauskiene L. R., Luksiene D. I., and Tamosiunas A., "Relation between cataract and metabolic syndrome and its components", Eur. J. Ophthalmol., 17(4):605-614(2007). https://doi.org/10.1177/112067210701700420
  14. The Third Korea National Health and Nutrition Examination Survey (KNHANES III) Seoul: Korea Centers for Disease Control and Prevention; 2005.
  15. The Third Korea National Health and Nutrition Examination Survey (KNHANES IV) Seoul: Korea Centers for Disease Control and Prevention; 2007.
  16. Antonopoulos S., "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) final report", Circulation. 106:3143-3421(2002).
  17. Lee S. Y., Park. H. S., Kim D. J., Han J. H., Kim S. M., Cho G. J., Kim D. Y., Kwon H. S., Kim S. R., Lee C. B., Oh S. J., Park C. Y., and Yoo H. J., "Appropriate waist circumference cutoff points for central obesity in Korean adults", Diabetes Res. Clin. Pract., 75(1):72-80(2007). https://doi.org/10.1016/j.diabres.2006.04.013
  18. Szmyd L., Jr. and Schwartz B., "Association of systemic hypertension and diabetes mellitus with cataract extraction. A case-control study", Ophthalmology, 96(8):1248-1252(1989). https://doi.org/10.1016/S0161-6420(89)32759-X
  19. Schaumherg D. A., Glynn R. J., Christen W. G., Ajani U. A., Sturmer T., and Hennekens C. H., "A prospective study of blood pressure and risk of cataract in men", Ann. Epidemiol., 11(2):104-110(2001). https://doi.org/10.1016/S1047-2797(00)00178-2
  20. de Luca, C. and Olefsky J. M., "Inflammation and insulin resistance", FEBSLett. 582(1):97-105(2008). https://doi.org/10.1016/j.febslet.2007.11.057
  21. Schaumberg D. A., Ridker P. M., Glynn R. J., Christen W. G., Dana M. R., and Hennekens C. H., "High levels of plasma C-reactive protein and future risk of age-related cataract", Ann. Epidemiol., 9(3):166-171(1999). https://doi.org/10.1016/S1047-2797(98)00049-0
  22. Klein B. E., Klein R., Lee K. E., Knudtson M. D., and Tsai M. Y., "Markers of inflammation, vascular endothelial dysfunction, and age-related cataract", Am. J. Ophthalmol., 141(1):116-122(2006). https://doi.org/10.1016/j.ajo.2005.08.021
  23. Evans J. L., Goldfine I. D., Maddux B. A., and Grodsky G. M., "Are oxidative stress-activated signaling pathways mediators of insulin resistance and beta-cell dysfunction?", Diabetes, 52(1):1-8(2003). https://doi.org/10.2337/diabetes.52.1.1
  24. Klein B. E., Knudtson M. D., Brazy P., Lee K. E., and Klein R., "Cystatin C, other markers of kidney disease, and incidence of age-related cataract", Arch. Ophthalmol., 126(12):1724-1730(2008). https://doi.org/10.1001/archophthalmol.2008.502
  25. Kanthan G. L., Wang J. J., Rochtchina E., and Mitchell P., "Use of antihypertensive medications and topical betablockers and the long-term incidence of cataract and cataract surgery", Br. J. Ophthalmol., 93(9):1210-1214(2009). https://doi.org/10.1136/bjo.2008.153379