• 농촌의학ㆍ지역보건
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• 제36권4호
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• pp.264-279
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• 2011

이 연구는 서울시 1개 보건소를 대상으로 대사증후군 관리프로그램 등록자의 등록 당시와 6개월 후의 생활습관 및 대사증후군 위험인자의 변화를 비교 분석함으로써 대사증후군 관리사업의 효과를 평가하는 것을 목적으로 하였다. 최종 분석대상자는 처음 사업을 시작한 2009년 6월부터 2010년 8월까지 서울시 1개 보건소에 등록하고, 6개월 후 재방문하여 설문과 재검사를 마친 430명 중 자료에 결측치가 없는 381명이었다. 연구 자료는 이들이 보건소에서 등록 관리 받으면서 작성한 설문지와 검사기록을 통해 수집되었다. 최종 분석대상자를 관리유형에 따라 분류하면 적극적 상담군이 110명(28.9%), 동기부여 상담군 A가 133명(35.0%), 동기부여 상담군 B가 138명(36.2%) 이었다. 연구결과는 다음과 같다. 첫째, 등록자의 생활습관의 변화는 적극적 상담군에서 신체활동이 유의하게 증가되었다. 식습관은 0.7점 증가하였으며, 음주, 흡연은 감소하였으나 통계적으로 유의하지 않았다. 동기부여 상담군 A에서는 중등도 신체활동과 흡연, 음주에서 통계적으로 유의한 변화가 있었으나 식습관은 거의 변화가 없었다. 동기부여 상담군 B에서는 신체활동이 통계적으로 유의하게 감소하였으며, 식습관은 변화가 없었고, 음주, 흡연은 감소하였으나 통계적으로 유의하지 않았다. 둘째, 대사증후군 위험인자 변화는 적극적 상담군에서 수축기 혈압, 이완기 혈압, TG는 통계적으로 유의하게 감소하였으며(P<0.05), (P<0.01), (P<0.01), HDL-C는 증가하였으나 통계적으로 유의하지 않았고 허리둘레, 식전혈당은 오히려 증가하였으나 통계적으로 유의하지 않았다. 동기부여 상담군 A는 허리둘레, 수축기 혈압, 이완기 혈압, 중성지방은 감소하였고, HDL-C 또한 증가하였으나 통계적으로 모두 유의하지 않았으며, 식전혈당은 오히려 증가하였다. 동기부여 상담군 B는 TG만 통계적으로 유의하게 감소하였고, HDL-C는 증가하였으나 통계적으로 유의하지 않았다. 수축기 혈압, 이완기 혈압은 낮아졌으나 식전혈당, 허리 둘레는 오히려 통계적으로 유의하게 증가하였다. 셋째, 주관적 건강상태는 관리군(적극적 상담군, 동기부여 상담군 A, 동기부여 상담군 B) 모두에서 통계적으로 유의하게 긍정적으로 변화하였다. 넷째, 대사증후군 등록자의 6개월 후 재검율은 전체 19.0%이며, 적극적 상담군 29.4%, 동기부여 상담군 A는 19.0%, 동기부여 상담군 B는 14.5%로 나타났다. 등록경로별로 보면 직접 방문하여 대사증후군 관리사업에 등록된 경우가 이동검진이나 건강검진을 통해 등록한 경우보다 높았다. 등록 관리 6개월간 월1회 방문하게 하여 적극적으로 관리서비스를 제공한 적극적 상담군에서 생활습관 및 위험인자들의 변화가 있었으며, 동기부여 상담군에서는 변화가 미미하였다. 즉 제공된 관리서비스의 양과 질에 따라 생활습관과 대사증후군 위험인자 변화에는 차이가 있었다. 하지만 전체적으로는 보건소 대사증후군 관리 사업은 사업목표 달성을 위해 보다 더 효과적인 사업전략 개발이 필요하다 하겠다.

• Nutrition Research and Practice
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• 제6권1호
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• pp.78-85
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• 2012

Whether the $FTO$ polymorphisms interact with environmental factors has not yet been evaluated in associations with metabolic syndrome (MS) risk. The present study investigated the association of the $FTO$ rs9939609 genotypes, body mass index (BMI), and lifestyle-related factors including smoking, alcohol drinking, physical activity, and diet with MS incidence. A population-based prospective cohort study comprised 3,504 male and female Koreans aged 40 to 69 years. At the beginning of the study, all individuals were free of MS and known cardiovascular disease. Incident cases of MS were identified by biennial health examinations during a follow-up period from April 17, 2003 to April 15, 2009. Pooled logistic regression analysis was applied to obtain relative odds (RO) of MS with its 95% confidence interval (CI). After controlling for potential MS risk factors, we observed no association between the rs9939609 genotypes and MS incidence. In analysis stratified by BMI, however, carriers with the $FTO$ risk allele whose BMI is $29kg/m^2$ or greater showed an approximately 6-fold higher RO (95% CI: 3.82 to 9.30) compared with non-carriers with BMI less than $25kg/m^2$. In particular, the association between the rs9939609 variants and MS risk was significantly modified by high BMI (P-value for interaction < 0.05). Such significant interaction appeared in associations with central obesity and high blood pressure among the MS components. Because carriers of the $FTO$ risk alleles who had BMI of $29kg/m^2$ or greater are considered a high risk population, we suggest that they may need intensive weight loss regimens to prevent MS development.

• 지역사회간호학회지
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• 제23권1호
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• pp.13-21
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• 2012

Purpose: The purpose of this study was to estimate the effects of lifestyle factors on metabolic syndrome (MS) among Korean adults ($age{\geq}20$). Methods: A total of 7,798 subjects (weighted subjects=37,215,961) were recruited from the 2009 Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-3). Data were analyzed by t-test, ${\chi}^2$-test, and logistic regression in consideration of strata, cluster and weight as national data using the SAS 9.1 program. Results: The prevalence of MS by definition of AHA/NHLBI and waist circumference cutoff points for Koreans was 22.4%. The mean clinical MS score for MS patients was 3.4, but the mean score for the non-MS group was 1.2 out of 5.0. Among the lifestyle factors, smoking (OR=1.024), stress ($0.546{\leq}OR{\leq}0.587$) and drinking (OR=1.005) had significant influence on the MS risk and MS scores, but exercise did not. Conclusion: The results of this study indicate that further research is necessary on the effect of lifestyle factors on MS risk and nurses should focus on effective programs about smoking, stress and drinking for the prevention and reduction of MS risk.

• Clinical and Experimental Pediatrics
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• 제62권8호
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• pp.317-323
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• 2019

Purpose: Investigating the prevalence of hyperuricemia and its association with metabolic syndrome (MetS) and cardiometabolic risk factors (CMRFs) in Korean children and adolescents. Methods: This cross-sectional survey used data from the 7th Korea National Health and Nutrition Examination Survey (2016-2017); 1,256 males and females aged 10-18 years were included. Hyperuricemia was defined as serum uric acid levels were >6.6 mg/dL at 10-11 years of age (both sexes), >7.7 mg/dL for males at 12-18 years of age and >5.7 mg/dL for females at 12-18 years of age. MetS was defined by the International Diabetes Federation criteria. Logistic regression analysis was used to analyze hyperuricemia-associated risk factors. Results: The prevalence of hyperuricemia was 9.4% (male, 8.4%; female, 10.5%) (P<0.281). After adjusting for sociodemographic factors and health behaviors in multivariate analysis (model 1), the odds ratio (OR) for hyperuricemia of MetS was 3.05 (95% confidence interval [CI], 1.17-7.92; P=0.022). After adjusting for the same variables in model 1 plus obesity and all MetS components (model 2), only abdominal obesity was significant, and the OR for hyperuricemia was 3.38 (95% CI, 1.72-6.63; P<0.001) After adjusting for the same variables in model 1 plus body mass index (BMI) z scores and all MetS components except abdominal obesity (model 3), only BMI z scores was significant, and the OR for hyperuricemia was 1.59 (95% CI, 1.34-1.89; P<0.001). Conclusion: MetS, abdominal obesity, and BMI z scores were CMRFs significantly associated with hyperuricemia in Korean children and adolescents. Therefore, attention should be paid to hyperuricemia in patients with obesity or MetS.

• 대한임상검사과학회지
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• 제50권1호
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• pp.44-53
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• 2018

WHtR과 ABSI는 기존 비만지표의 단점을 보완하기 위해 개발된 복부비만을 반영한 지표이다. 이 연구는 성인남녀를 대상으로 ABSI와 WHtR의 인슐린저항성과 대사증후군에 대한 예측능력을 허리둘레, WHR과 비교하여 알아보고자 하였다. 이 연구는 횡단면 조사에 기초하여 2017년 1월부터 2017년 9월까지 경기지역 일개 종합병원에서 건강진단을 받은 20세 이상 4,395명을 대상으로 하였다. 대사증후군은 AHA/NHLBI (American Heart Association/National Heart, Lung, and Blood Institute)의 진단기준에 따라 정의하였다. 인슐린저항성은 HOMA-IR값이 3.0 이상인 경우 인슐린저항성으로 판정하였다. WHtR 및 ABSI와 대사적 위험요인간에 상관계수를 비교한 결과 남성과 여성 모두에서 ABSI보다 WHtR과 대사적 위험요인간의 상관성이 더 높았다. 대사증후군을 예측하기 위한 WHtR의 AUC 값은 0.849, ABSI의 AUC 값은 0.676 이었다(각각 p<0.001). 인슐린저항성을 예측하기 위한 WHtR의 AUC 값은 0.818, ABSI의 AUC 값은 0.641 이었다(각각 p<0.001). 결론적으로, 한국인을 대상으로 ABSI가 허리둘레, WHR, WHtR 지표보다 인슐린저항성과 대사증후군에 대한 예측력이 낮은 지표였으며, WHtR은 인슐린저항성 및 대사증후군 위험 예측력이 가장 높은 지표임을 확인하였다.

• Kidney Research and Clinical Practice
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• 제36권1호
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• pp.48-57
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• 2017

Background: Hepatic steatosis measured with controlled attenuation parameter (CAP) using transient elastography predicts metabolic syndrome in the general population. We investigated whether CAP predicted metabolic syndrome in chronic kidney disease patients. Methods: CAP was measured with transient elastography in 465 predialysis chronic kidney disease patients (mean age, 57.5 years). Results: The median CAP value was 239 (202-274) dB/m. In 195 (41.9%) patients with metabolic syndrome, diabetes mellitus was more prevalent (105 [53.8%] vs. 71 [26.3%], P < 0.001), with significantly increased urine albumin-to-creatinine ratio (184 [38-706] vs. 56 [16-408] mg/g Cr, P = 0.003), high sensitivity C-reactive protein levels (5.4 [1.4-28.2] vs. 1.7 [0.6-9.9] mg/L, P < 0.001), and CAP (248 [210-302] vs. 226 [196-259] dB/m, P < 0.001). In multiple linear regression analysis, CAP was independently related to body mass index (${\beta}=0.742$, P < 0.001), triglyceride levels (${\beta}=2.034$, P < 0.001), estimated glomerular filtration rate (${\beta}=0.316$, P = 0.001), serum albumin (${\beta}=1.386$, P < 0.001), alanine aminotransferase (${\beta}=0.064$, P = 0.029), and total bilirubin (${\beta}=-0.881$, P = 0.009). In multiple logistic regression analysis, increased CAP was independently associated with increased metabolic syndrome risk (per 10 dB/m increase; odds ratio, 1.093; 95% confidence interval, 1.009-1.183; P = 0.029) even after adjusting for multiple confounding factors. Conclusion: Increased CAP measured with transient elastography significantly correlated with and could predict increased metabolic syndrome risk in chronic kidney disease patients.

• Nutrition Research and Practice
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• 제10권4호
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• pp.411-417
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• 2016

BACKGROUND/OBJECTIVES: Metabolic syndrome (MetS) is a set of interrelated metabolic risk factors that increase the risk of cardiovascular morbidity and mortality. Studies regarding the specificity and sensitivity of serum levels of leptin and uric acid as predictors of MetS are limited. The aim of this study was to evaluate the serum levels of leptin and uric acid in terms of their specificity and sensitivity as predictors of MetS in the studied Jordanian group. SUBJECTS/METHODS: In this cross sectional study, 630 adult subjects (308 men and 322 women) were recruited from the King Hussein Medical Center (Amman, Jordan). The diagnosis of MetS was made according to the 2005 International Diabetes Federation criteria. Receiver operating characteristic curves were used to determine the efficacy of serum levels of leptin and uric acid as predictors of MetS in the studied Jordanian group. RESULTS: Study results showed that for identification of subjects with MetS risk, area under the curve (AUC) for leptin was 0.721 and 0.683 in men and women, respectively. Serum uric acid levels in men showed no significant association with any MetS risk factors and no significant AUC, while uric acid AUC was 0.706 in women. CONCLUSION: Serum leptin levels can be useful biomarkers for evaluation of the risk of MetS independent of baseline obesity in both men and women. On the other hand, serum uric acid levels predicted the risk of MetS only in women.

• 한방안이비인후피부과학회지
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• 제34권3호
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• pp.70-79
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• 2021

Objectives : The purpose of this study is to investigate the possibility of using herbal medicine for the management of psoriasis focusing on lipid metabolism. Methods : We reviewed studies about pathophysiology, and medical treatment of psoriasis, the relationship between psoriasis and metabolic syndrome and lipid metabolism, and herbal medicine on Pubmed and Google scholar. Results : Psoriasis is a chronic multi-organ inflammatory disease not limited to skin, and steroids, immuno-suppressants, and biological agents are used. It is known that psoriasis and metabolic syndrome act as mutual risk factors, and lipid metabolism are involved in psoriasis. The effects of various single herbal preparations and complex herbal extract, decoction on improving lipid metabolism have been consistently reported, and there was an improvement of psoriatic skin lesions and improvement of blood lipid levels through herbal medicine. Conclusions : Herbal medicine research in psoriasis has focused on the anti-inflammatory effect and the suppression effect of certain immune mediators. However, considering that psoriasis is affected by lipid metabolism and side effects of Western medicines, the use of herbal medicines for the purpose of controlling lipid metabolism in psoriasis is useful in aspects of reducing side effects of concurrent Western medicine, improving the severity of psoriasis, and managing metabolic risk factors.

• 대한간호학회지
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• 제47권6호
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• pp.817-827
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• 2017

Purpose: This study aimed to identify latent classes based on major modifiable risk factors for coronary artery disease. Methods: This was a secondary analysis using data from the electronic medical records of 2,022 patients, who were newly diagnosed with coronary artery disease at a university medical center, from January 2010 to December 2015. Data were analyzed using SPSS version 20.0 for descriptive analysis and Mplus version 7.4 for latent class analysis. Results: Four latent classes of risk factors for coronary artery disease were identified in the final model: 'smoking-drinking', 'high-risk for dyslipidemia', 'high-risk for metabolic syndrome', and 'high-risk for diabetes and malnutrition'. The likelihood of these latent classes varied significantly based on socio-demographic characteristics, including age, gender, educational level, and occupation. Conclusion: The results showed significant heterogeneity in the pattern of risk factors for coronary artery disease. These findings provide helpful data to develop intervention strategies for the effective prevention of coronary artery disease. Specific characteristics depending on the subpopulation should be considered during the development of interventions.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.150-159
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• 2008

목 적: 소아청소년의 생활양식은 성인이 되어서도 지속되므로 소아청소년기에 건강한 생활습관을 길들이는 것이 중요하다. 소아청소년기에 일상적인 생활습관과 대사위험인자와의 연관성을 파악하여 중재한다면 대사증후군을 조기에 예방할 수 있을 것이다. 소아청소년 비만에서 대사증후군의 조기 예방 및 중재를 위하여 대사증후군과 생활습관과의 연관성을 알아보고자 하였다. 방 법: 이화여자대학교 목동병원 소아청소년과 비만클리닉을 방문한 비만한 소아청소년 109명을 대상으로, 의무기록과 혈액검사를 후향적으로 검토하였다. 비만한 소아청소년은 대한소아과학회 영양위원회에서 생활습관을 파악하기 위하여 구성한 설문지를 작성하였으며, 12시간 금식 후 혈액검사를 받았다. 대사증후군은 대사위험인자 6개 중 3개 이상으로 정의하였다. 대사위험인자는 비만; 2007년 소아청소년 신체발육 표준치에 따른 체질량지수 ${\geq}95$ 백분위수, 고혈압; 연령별 성별 수축기 혹은 이완기 혈압 ${\geq}90$ 백분위수, 공복시 혈청 중성지방 ${\geq}90$110 mg/dL, HDL-콜레스테롤 ${\leq}$40 mg/dL, 혈당 ${\geq}$110 mg/dL, 인슐린 ${\geq}20{\mu}g/dL$이었다. 결 과: 비만한 소아청소년을 대상으로 하였으므로 모두 대사위험인자가 적어도 1개 이상 있었다. 대사위험인자가 2개 이상 군집을 이룬 경우는 63%, 3개 이상 32%, 4개 이상 10%였다. 고중성지방혈증은 36%, 고혈압은 32%, 고인슐린혈증은 24%, HDL-저콜레스테롤혈증은 20%였다. 공복 시 혈당은 모두 정상이었다. 부모중 적어도 한 명이 비만한 가정의 비만 자녀에서 고인슐린혈증이 유의하게 많았다(p<0.05). 편식을 하는 비만한 소아청소년에서 고혈압이 유의하게 많았다 (p<0.05). 다변량 로지스틱 회귀분석에서 오후 8시 이후에 저녁이나 야식을 먹는 비만한 소아청소년은 고혈압 위험이 2.5배(95% 신뢰구간: 1.0~6.1) 높았다. 운동을 좋아하지 않는 비만한 소아청소년은 고인슐린혈증 위험이 10.4배(95% 신뢰구간: 2~54.1), 하루에 3시간 이상 TV시청하는 비만한 소아청소년은 대사증후군에 걸릴 위험이 4.8배(95% 신뢰구간: 1.2~18.8) 높았다. 결 론: 소아청소년 비만에서 저녁이나 야식을 늦게 먹는 습관, 운동을 선호하지 않음, 하루 3시간 이상 TV 시청하는 일상 생활습관이 대사증후군과 연관이 있었다.