농촌의학ㆍ지역보건 (Journal of agricultural medicine and community health)

한국농촌의학지역보건학회 (Korean Society for Rural Medicine and Community Health)
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C형 간염 바이러스 RNA 유무에 따른 지질, 인슐린저항성 및 대사증후군 지표 수준의 차이

Comparison of the Serum Cholesterol, Insulin Resistance and Markers of Metabolic Syndrome Based on Hepatitis C Virus RNA

  • 조성환 (부산대학교 의학전문대학원 가정의학교실) ;
  • 김윤진 (부산대학교 의학전문대학원 가정의학교실) ;
  • 이상엽 (부산대학교 의학전문대학원 의학교육실) ;
  • 조병만 (부산대학교 의학전문대학원 예방의학 및 산업의학교실) ;
  • 황혜림 (부산대학교 의학전문대학원 가정의학교실) ;
  • 이유현 (부산대학교 의학전문대학원 가정의학교실) ;
  • 조영혜 (부산대학교 의학전문대학원 가정의학교실) ;
  • 탁영진 (부산대학교 의학전문대학원 가정의학교실) ;
  • 정동욱 (부산대학교 의학전문대학원 가정의학교실) ;
  • 이승훈 (부산대학교 의학전문대학원 가정의학교실) ;
  • 이정규 (부산대학교 의학전문대학원 가정의학교실)
  • Cho, Sung-Hwan (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Kim, Yun-Jin (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Lee, Sang-Yeoup (Medical Education Unit, Pusan National University School of Medicine) ;
  • Cho, Byung-Mann (Department of Preventive medicine and Occupational Medicine, Pusan National University School of Medicine) ;
  • Hwang, Hye-Lim (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Yi, Yu-Hyeon (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Cho, Young-Hye (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Tak, Young-Jin (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Jeong, Dong-Wook (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Lee, Seung-Hun (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Lee, Jeong-Gyu (Department of Family Medicine, Pusan National University School of Medicine)
  • 투고 : 2016.11.21
  • 심사 : 2016.12.28
  • 발행 : 2016.12.31
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초록

본 연구에서는 한국인 성인에서 ant-HCV 양성인 군에서 HCV RNA 유무에 따른 지질, 인슐린저항성 및 대사증후군의 지표 수준의 차이를 알아보고자 하였다. 2004년 1월 1일부터 2010년 12월 31일까지 부산의 일개 대학병원 건강증진센터를 방문하여 검사한 효소면역측정법에서 anti-HCV 양성인 수진자 중 RT-PCR을 시행한 성인 222명을 대상으로 하였다. 이 중 HCV RNA가 양성인 사람이 85명, HCV RNA가 음성인 사람이 115명, HCV RNA의 음전이 확인된 사람이 22명이었다. 허리둘레, 체질량지수, 혈압과 총콜레스테롤, LDL 콜레스테롤, HDL 콜레스테롤, 중성지방, 인슐린저항성의 상관 관계를 분석하고, 나이, 성별을 보정한 후 세 군간의 콜레스테롤, 대사적 지표, 인슐린저항성의 차이를 알아보았다. HCV RNA 양성군에서 음성군 및 음전군과 비교하여 허리둘레, 체질량지수, 혈압, 중성지방, HDL 콜레스테롤, 인슐린저항성 등에 통계적으로 유의한 차이는 없었다. HCV RNA 양성군에서 음성군에 비해 총콜레스테롤과 LDL 콜레스테롤이 통계적으로 유의하게 낮았다($186.24{\pm}37.63$ vs $197.22{\pm}37.23mg/dl$ ($mean{\pm}SD$), p=0.041, $111.66{\pm}34.06$ vs $121.38{\pm}35.50mg/dl$ ($mean{\pm}SD$), p=0.042). 나이, 성별을 보정한 뒤, HCV RNA 양성군과 음성군 간에 고콜레스테롤혈증과 LDL 콜레스테롤혈증의 교차비는 0.51(95% 신뢰구간 0.28-0.94, p=0.03), 0.46(95% 신뢰구간 0.24~0.87, p=0.02)이다. HCV RNA 양성군에서 음성군에 비해 고콜레스테롤혈증, LDL 콜레스테롤혈증의 유병률이 통계학적으로 유의하게 낮았으나, HCV RNA 음전군은 양성군에 비하여 통계학적으로 유의한 차이가 없었다. C형 간염과 대사증후군의 관계를 보다 정확히 규명하기 위해서는 향후 보다 대규모 집단에서 전향적인 코호트 연구가 필요할 것으로 생각된다.

Objectives: We compared the difference of lipid, insulin resistance and metabolic markers based on HCV RNA in Korean adults.Methods: This was a cross-sectional study of 222 subjects visited the health promotion center of Pusan nationaluniversity hospital from 2004 to 2007. Subjects were anti-HCV antibody positive and were performed RT-PCR for HCV RNA. The HCV RNA (+) group were 85 subjects, HCV RNA (-) control group were 115 subjects, and the HCV RNA (-) but past positive group were 22 subjects. We performed anthropometry, anti-HCV, RT-PCR, plasma concentrations of insulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride.Results: BMI, waist circumference, blood pressure, fasting plasma glucose, triglyceride, HDL cholesterol, insulin resistance such as HOMA-IR and QUICKI were not significantly different between HCV RNA positive and negative groups. The serum total cholesterol and LDL cholesterol level were significantly lower in the HCV RNA positive group than in the negative group ($186.24{\pm}37.63$ vs $197.22{\pm}37.23$ mg/dl, p=0.041, $111.66{\pm}34.06$ vs $121.38{\pm}35.50$ mg/dl, p=0.042). After adjusting age and sex, high total cholesterol (${\geq}200mg/dl$) (adjusted OR=0.51, 95%CI 0.28-0.94, p=0.03) and high LDL cholesterol (${\geq}130mg/dl$) (adjusted OR=0.46, 95%CI 0.24~0.87, p=0.02) were inversely associated with being HCV RNA positive (p<0.05). Conclusion: The serum total cholesterol and LDL-cholesterol level were significantly lower in HCV RNA (+) group than in HCV RNA (-) group, but not in HCV RNA (-) but past positive group. Prospective cohort studies are needed to clarify the relationship between HCV RNA and metabolic markers.

키워드

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