Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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The Clinical Implications of Hepatic Enzymes in Metabolically Healthy Obese Men

대사적으로 건강한 비만남성에서 간 효소의 임상적 의의

  • Shin, Kyung-A (Department of Clinical Laboratory Science, Shinsung University)
  • Received : 2017.06.29
  • Accepted : 2017.08.03
  • Published : 2017.09.30
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Abstract

Increased hepatic enzymes are associated with insulin resistance, metabolic complications, and type 2 diabetes mellitus. Metabolically healthy obese (MHO) phenotype is not accompanied by metabolic complications and maintains insulin sensitivity, despite excessive body fat. The purpose of this study was to evaluate the clinical implications of hepatic enzymes in MHO men. The diagnostic criteria for MHO were based on NCEP-ATP III and obesity in adults was defined using WHO Asian-Pacific criteria. We used the data from 9,683 obese men aged between 20 and 70 years. The subjects were divided into three groups according to the diagnostic criteria: The metabolically healthy non-obese (MHNO, N=2,878), metabolically healthy obese (MHO, N=5,427), and metabolically abnormal obese (MAO, N=1,378). Obesity criteria were classified according to the standards set forth by WHO Asia-Pacific Criteria. AST, ALT, and GGT were significantly lower in the MHO group than in the MAO group (p<0.001, respectively). However, the hepatic enzyme levels were higher in the MHO group than in the MHNO group (p<0.001). Liver enzymes were associated with metabolic syndrome risk factors. Waist circumference, fasting glucose, total cholesterol, triglyceride, and HDL-C were risk factors for metabolic syndrome affecting liver enzymes. In conclusion, hepatic enzymes were found to predict metabolic abnormalities in metabolically healthy obese men.

대사적으로 건강한 비만인(metabolically healthy obese, MHO)은 대사적 합병증을 동반하지 않으며, 과도한 체지방에도 불구하고 인슐린 감수성을 유지하는 비만의 표현형이다. 이 연구는 20세 이상 70세 이하의 남성을 대상으로 비만과 대사적 이상 유무에 따라 MHNO, MHO와 MAO군으로 분류하여 간 효소의 차이를 알아보고 대사적으로 건강한 비만남성에서 간 효소가 대사적 이상을 예측할 수 있는 지표인지 그 임상적 의의를 확인하고자 하였다. Executive Summary of The Third Report of The National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) 진단기준으로 대사적 이상을 평가하였으며, 비만 진단기준은 WHO에서 제시하는 아시아인의 기준을 따라 세 군으로 분류하였다. 최종 연구 대상자 9,683명 중 대사적으로 건강한 정상체중군(metabolically healthy non obese, MHNO) 2,878명, 대사적으로 건강한 비만군(metabolically healthy obese, MHO) 5,427명, 대사적으로 이상이 있는 비만군(metabolically abnormal obese, MAO) 1,378명 이었다. AST, ALT, GGT는 MAO군보다 MHO군에서 통계적으로 유의하게 낮았으나(각각 p<0.001), MHO군은 MHNO군보다는 간 효소치가 높게 나타났다(각각 p<0.001). 또한 간 효소는 대사증후군 위험요인과 관련이 있으며, 허리둘레, 공복혈당, 총콜레스테롤, 중성지방, HDL-C은 AST, ALT, GGT에 영향을 미치는 위험요인으로 나타났다. 결론적으로 대사적으로 건강한 비만남성에서 간 효소가 대사적 이상을 예측할 수 있는 지표인 것을 확인하였다.

Keywords

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