과천지역 초등학생의 Leptin 수준과 열량섭취, 체중 및 비만도 변화와의 관계

Serum Leptin Levels and Changes in Body Weight and Obesity Index in Gwacheon Elementary School Children

  • 김인경 (국립보건연구원 생명의과학센터 대사영양질환팀) ;
  • 강재헌 (인제대학교 서울백병원 가정의학과) ;
  • 송지현 (국립보건연구원 생명의과학센터 대사영양질환팀)
  • Kim, In-Kyoung (Division of Metabolic Diseases, Center for Biomedical Sciences, National Institute of Health) ;
  • Kang, Jae-Heon (Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University) ;
  • Song, Ji-Hyun (Division of Metabolic Diseases, Center for Biomedical Sciences, National Institute of Health)
  • 발행 : 2007.12.30

초록

과천에서 진행되고 있는 소아 코호트의 1차년도와 2차년도 조사에 모두 참여했던 소아 375명(남아 : 195명, 여아 : 180명)을 연구 대상으로 leptin 수준을 삼분위수로 나누어 leptin 수준에 따른 신체조성 성분 변화를 관찰한 결과에 대한 요약은 다음과 같다. 1) 1차년도 비만 유병률은 남학생이 경도비만 8.7%, 중등도 비만 3.6%였고, 여학생은 경도비만이 1,7%로 관찰되었다. 2) 1, 2차년도의 비만지수(OI), BMI, 허리둘레 수치와 2차년도 leptin, 체지방률, 체지방량 수치들 상호간의 관계를 보았을 때, 남학생의 혈중 leptin 수준과 신체지수와의 관계는 체지방량, 체지방률, BMI 허리둘레, 제지방량의 순으로 양의 상관관계를 보였으며, 특히 leptin의 농도가 높을수록 현재의 체중, 체질량지수, 비만도, 허리둘레, 체지방률이 높았다(p<0.001). 이는 여학생의 경우에도 유사한 상관관계를 나타냈다. 3) leptin과 지방섭취량, 탄수화물 섭취량과의 관계는 유의적인 상관관계를 보이지 않았다. 4) 혈중 leptin 수준을 삼등분하여 그 수준이 최상위 삼분위에 포함되는 어린이 집단의 비만 유병률은 남 34.3%, 여 5% 이었으나 최하위군 에서는 0%이었다. 최상위군의 경우 1년 전의 비만유병률도 유사하였다(남 34.3%, 여 5%). 이상의 결과를 종합해보면 소아의 leptin 수준은 현재의 비만도를 반영할 수 있을 뿐 아니라, 1년 전의 비만상태도 예측이 가능하다. 비만도가 높은 소아의 경우 적극적 개선이 행해지지 않으면 체중 및 비만상태가 1년간 지속되므로 대사증후군 및 심혈관계 질환의 위험이 증가될 것으로 판단되며 이들을 조기에 예측, 관리하는 체계가 필요하다.

Leptin, as an adipocyte-derived hormone, is an important regulator of food intake and energy expenditure. In the cross-sectional study, leptin was shown to be positively related to body adiposity and metabolic disorders in adults. However, there were very few studies which reported the leptin as a predictor of weight gain over time. We examined whether serum leptin can be used as an indicator of the present and 1-year past weight status in very young children. First grade students from elementary schools in Gwacheon City were enrolled in the study since 2005. The study subjects(total 375 students; 195 boys and 180 girls) participated in the investigation of both 2005 and 2006. Physical examinations including height, weight, waist circumference were done. To examine the prevalence of obesity, obesity index was used. Serum leptin was measured, and their nutritional status was also evaluated based on 3-Day dietary records. Serum leptin levels were strongly positively related with the value of the present BMI and with the value of the BMI one year before. We found no association with leptin levels and amount of energy intake and macronutrient intake in this children population. Children were divided into three groups according to leptin tertiles. The highest leptin tertile group showed highest prevalence of obesity in year 2006 as well as in year 2005. Serum leptin levels can reflect the weight status now and as well as 1-year before. Possibly serum leptin levels can predict the weight gain of year later. Without an action against the obesity on children with high leptin level, those children would maintain the excess adiposity growth and progress into the obesity-related metabolic disorders. Further studies are needed to predict the obesity as early as possible and preventive system then after.

키워드

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