Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

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Associations of Serum Lipid Profiles with Incidence of Ischemic Heart Diseases in Korean Adults: Retrospective Cohort Study

우리나라 성인에서 혈청 지질성분비가 허혈성 심장질환 발생에 미치는 위험도 평가: 코호트 연구

  • Shin, Sook-Hee (Department of Clinical Laboratory Science, Daejeon Health Sciences College) ;
  • Lee, Tae-Yong (Department of Preventive Medicine & Public Health, School of Medicine, Chungnam National University)
  • 신숙희 (대전보건대학교 임상병리과) ;
  • 이태용 (충남대학교 의학전문대학원 예방의학교실)
  • Received : 2012.03.09
  • Accepted : 2012.05.10
  • Published : 2012.05.31
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Abstract

This study conducted to investigate incidence rate and association of serum lipid profiles with incidence of ischemic heart disease. Study subjects consisted of 417,642 adults aged 30 years and over, who underwent physical examination and responded to questionnaire from health examination center of 19 university general hospitals. Hazard ratio of risk factor for ischemic heart disease (IHD) were calculated by Cox's proportional hazard regression model adjusted for ages, BMI and lifestyle (drinking, smoking and exercising). For TC/HDL ratio, hazard ratio of IHD in male increased from 1.21 times to 1.84 times increase with TC/HDL ratio, and that in female also increased from 1.26 times to 1.86 times. For TG/HDL ratio, hazard ratio of IHD in male increased from 1.17 times to 1.49 times increase with TG/HDL ratio, and that in female also increased from 1.42 times to 1.97 times. For LDL/HDL ratio, hazard ratio of IHD in male increased from 1.26 times to 1.82 times increase with LDL/HDL ratio, and that in female also increased from 1.26 times to 1.68 times. In conclusion serum lipid indexes are the significant risk factors for cardiovascular diseases. The higher the concentration of TC, LDL and TG is, the lower the concentration of HDL is, hazard ratio for IHD increased. Ratio of TC/HDL, TG/HDL and LDL/HDL were also verified to be significant risk factors for IHD.

본 연구에서는 우리나라 30세 이상 성인들의 허혈성심장질환(ischemic heart disease, IHD) 발생률을 계산하고, 지질지표(콜레스테롤, 중성지방, 고밀도지단백콜레스테롤, 저밀도지단백콜레스테롤)가 허혈성심장질환 발생에 미치는 위험도를 파악하고자 19개 대학 및 종합병원의 건강검진센터에서 검진을 받은 417,642명을 대상으로 1993년 9월부터 2009년 6월까지 평균 8.5년동안 허혈성심장질환의 발생을 추적관찰하였다. 자료수집은 검진자들에 대한 설문조사지를 이용하였고, 허혈성심장질환의 발생여부는 국민건강보험공단의 데이터베이스에서 확인하였다. 발생률은 발생밀도로 계산하였고, 혈청지질 지표에 따른 허혈성심장질환의 발생 위험도는 콕스의 비례위험 회귀모형을 이용하여 연령, BMI, 생활양식을 보정한 상태에서 성별에 따른 위험요인별 위험비와 95% 신뢰구간을 계산하였다. 연구결과 TC/HDL 비의 증가에 따라 IHD의 발생 위험비는 남자에서 1.21배에서 1.84배까지, 여자는 1.26배에서 1.86배까지 증가하였으며, TG/HDL 비의 증가에 따른 IHD의 발생 위험비는 남자에서 1.17배에서 1.49배까지, 여자는 1.42배에서 1.97배까지, LDL/HDL 비에 따라 IHD의 발생 위험비는 남자에서 1.26배에서 1.82배까지, 여자는 1.26배에서 1.68배까지 증가하였다. 결론적으로 혈청지질지표는 심혈관질환의 중요한 위험요인으로 총콜레스테롤, 저밀도지단백콜레스테롤, 중성지방은 혈중 농도가 높을수록, 고밀도지단백콜레스테롤은 낮을수록 IHD의 위험이 높아지는 것으로 나타났고, TC/HDL 비, TG/HDL 비, LDL/HDL 비에서 단독의 지질지표보다 위험도가 더 높게 나타나는 경향이 있었다. 따라서 추후 허혈성 심장질환의 예방 및 관리에는 혈청지질지표의 비도 감안하여야 한다.

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