Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Relationship between health behaviors and high level of low density lipoprotein-cholesterol applying cardiovascular risk factors among Korean adults: based on the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), 2013 ~ 2015

성인의 심혈관계 위험인자를 적용한 고저밀도지단백-콜레스테롤혈증과 건강행태의 관련성 연구 : 국민건강영양조사 제6기 (2013 ~ 2015) 자료 이용

  • Received : 2018.11.12
  • Accepted : 2018.12.18
  • Published : 2018.12.31
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Abstract

Purpose: This study was designed to determine the relationship between health behaviors and high levels of low-density lipoprotein-cholesterol (LDL-cholesterol) according to cardiovascular risk factors among Korean adults. Methods: This cross-sectional study was based on the sixth Korea national health and nutrition examination survey (KNHANES VI). Participants were 13,841 adults aged 19 years and older. Cardiovascular risk factors were stroke, myocardial infarction or angina, diabetes mellitus, smoking, hypertension, aging, high density lipoprotein-cholesterol (HDL-cholesterol) under 40 mg/dL and HDL-cholesterol over 60 mg/dL. Cardiovascular risk groups were classified as very high risk (stroke, myocardial infarction or angina), high risk (diabetes mellitus), moderate risk (over 2 risk factors), and low risk (below 1 risk factor). The prevalence of high LDL-cholesterol was calculated using the LDL-cholesterol target level according to cardiovascular risk group. Results: The prevalence of high LDL-cholesterol was 25.5% in males and 21.7% in females. Complex sample cross tabulation demonstrated that the high LDL-cholesterol and normal groups differed significantly according to age, education, body mass index, percentage of energy from carbohydrate, fat, saturated fat and n-6 in males and females. These two groups were also significantly different according to smoking in males and the percentage of energy from n-3 in females. Complex sample multiple logistic regression analysis adjusted for multiple confounding factors demonstrated that the probability of high LDL-cholesterol was significantly associated with current smoking (OR: 1.66, 95% CI: 1.40-1.99), obesity (OR: 1.95, 95% CI: 1.64-2.31) in males, and current smoking (OR: 1.73, 95% CI: 1.19-2.52), obesity (OR: 1.63, 95% CI: 1.39-1.90), percentage of energy from n-3 (quartile 1 vs. quartile 2; OR: 0.77, 95% CI: 0.62-0.96; quartile 1 vs. quartile 3; OR: 0.73, 95% CI: 0.56-0.94; quartile 1 vs. quartile 4: OR: 0.67, 95% CI: 0.51-0.87) in females. Conclusion: This study reveals the impact of smoking, obesity, energy percentage of nutrient intake on LDL-cholesterol.

본 연구는 국민건강영양조사 제6기 (2013 ~ 2015) 원시자료를 이용하여 심혈관계 위험인자를 적용한 고LDL-콜레스테롤혈증과 건강행태의 관련성을 조사하기 위해 수행되었으며, 19세 이상 남자 5,939명, 여자 7,902명의 총 13,841명을 대상으로 하였다. 심혈관계 위험인자는 뇌졸중, 심근경색증 또는 협심증, 당뇨병, 고혈압, 흡연, 저HDL-콜레스테롤 (40 mg/dL 미만), 연령 (남자 45세 이상, 여자 55세 이상), 고HDL-콜레스테롤 (60 mg/dL 이상)을 포함하였다. 뇌졸중이나 심근경색증 또는 협심증은 초고위험군, 당뇨병은 고위험군, 이외 위험인자가 2개 이상은 중등도위험군, 1개 이하는 저위험군으로 구분하였다. 각 위험군 별 목표 수치를 기준으로 한 고LDL-콜레스테롤혈증 유병자는 남자 25.5%, 여자 21.7%이었다. 건강행태와 고LDL-콜레스테롤혈증 유무의 연관성을 복합표본 교차분석으로 분석한 결과, 남녀 모두 연령, 교육수준, 결혼상태, 체질량지수, 탄수화물 에너지 섭취 비율, 지방의 에너지 섭취비율, 포화지방 에너지 섭취비율, n-6 지방산의 에너지 섭취 비율에 따라 고LDL-콜레스테롤혈증 유무는 유의한 연관성이 있었다. 그리고 흡연은 남자에서, n-3계 지방산의 에너지 섭취 비율은 여자에서 고LDL-콜레스테롤혈증 유무와 각각 유의한 연관성이 있었다. 건강행태와 고LDL-콜레스테롤혈증 발생 위험과의 관련성을 확인하기 위해 복합표본 다중 로지스틱 회귀분석을 실시한 결과, 교란인자 보정 후 남자에서는 현재 흡연 (OR: 1.66, 95% CI: 1.40-1.99), 비만 (OR: 1.95, 95% CI: 1.64-2.31) 에서 고LDL-콜레스테롤혈증 유병 오즈비가 유의하게 높았다. 여자의 경우 현재 흡연 (OR: 1.73, 95% CI: 1.19-2.52), 비만 (OR: 1.63, 95% CI: 1.39-1.90)에서 고LDL-콜레스테롤혈증 유병 오즈비가 유의하게 높았고, n-3 지방산 에너지 섭취 비율이 '하'(Q1)에 비해 '중 하' (Q2) (OR: 0.77, 95% CI: 0.62-0.96), '중 상' (Q3) (OR: 0.73, 95% CI: 0.56-0.94), '상' (Q4) (OR: 0.67, 95% CI: 0.51-0.87) 에서 고LDL-콜레스테롤혈증 유병 오즈비가 유의하게 낮았다. 따라서 고LDL-콜레스테롤혈증 개선을 위한 전략 수립에 금연, 정상 체중 유지가 필요하며, 영양소별 적정한 에너지 섭취 비율 유지를 고려해야 한다.

Keywords

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