대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)

  • 제50권3호
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  • Pages.345-353
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  • 2018
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  • 1738-3544(pISSN)
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  • 2288-1662(eISSN)
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)
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대학생들의 흡연 및 음주에 따른 목동맥 두께의 상관성

Relationship of Thickness of Carotid Artery according to Smoking and Drinking in University Students

  • 김대식 (동남보건대학교 임상병리과) ;
  • 성현호 (동남보건대학교 임상병리과) ;
  • 조은경 (동남보건대학교 임상병리과) ;
  • 이종우 (고려대학교 안산병원 신경과)
  • Kim, Dae-Sik (Department of Clinical Laboratory Science, Dongnam Health University) ;
  • Sung, Hyun-Ho (Department of Clinical Laboratory Science, Dongnam Health University) ;
  • Cho, Eun-Kyung (Department of Clinical Laboratory Science, Dongnam Health University) ;
  • Lee, Jong-Woo (Department of Neurology, Korea University Ansan Hospital)
  • 투고 : 2018.06.04
  • 심사 : 2018.07.12
  • 발행 : 2018.09.30
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초록

이 연구의 목적은 대학생의 CIMT (목동맥 내막-중막 두께)와 흡연 습관, 음주 습관 및 두 가지 연관성을 조사하는 것이다. 이 연구는 CAGE (음주 관련: 절주, 비판에 대한 반감, 죄책감, 해장) 설문지, FTND (Fagerstrom Test for Nicotine Dependence) 설문지, 대학생들의 CIMT에 대하여 수행되었다. 세 군으로 분류 된 각 음주 수준에 따른 CIMT 결과 간에는 통계적으로 유의 한 차이가 없었다. FTND 흡연 분류에 따른 CIMT의 결과는 흡연 군이 비 흡연 군보다 높았다(P<0.01). 흡연과 음주는 좌우 CIMT 간에는 통계적으로 유의 한 차이가 있었다(P<0.01). 음주의 위험만 있는 군에서 왼쪽 CIMT (19.84 순위)는 낮은 순위를 보였다. 왼쪽(42.38 순위)과 오른쪽(42.81 순위)의 CIMT는 흡연 위험만 있는 집단에서 높은 순서를 보였다(P<0.01). 이 연구 결과 흡연자와 음주자 사이의 평균 CIMT, 특히 흡연 상태가 높은 사람들 사이에 뚜렷한 차이가 있음을 시사한다. 이 연구에는 몇 가지 제한 점이 있다. 첫째, 작은 연구 대상 두번째, 대상자가 어리고, 셋째, 흡연, 음주 및 CIMT에만 중점을 두었다. 결론적으로, 흡연은 젊은 성인에서 무증상 아테롬성 동맥 경화 위험인자에 대한 부작용과 CIMT를 현저하게 악화 시키며 젊은 성인에서 금연의 중요성이 강화되어야 한다.

This study examined the associations of smoking, alcohol drinking habits and both with the carotid intima-media thickness (CIMT) in university students. This study was performed using a CAGE (test for alcohol: cutting down, annoyance by criticism, guilty feeling, and eye-openers) questionnaire, FTND (the Fagerstrom test for nicotine dependence) questionnaire, and CIMT of university students. No statistically significant differences were observed among the CIMT results according to each CAGE level classified into 3 groups. The results of CIMT according to the FTND smoking categorization showed that the smoking group was higher than nonsmoking group (P<0.01). A statistically significant difference was observed between the left and right CIMT regarding smoking and drinking (P<0.01). In the only drink risk group, the left CIMT (19.84 rank) showed a low-ranking. The CIMT on the left (42.38 rank) and right (42.81 rank) showed high scores in the group with only the risk of smoking (P<0.01). These results suggested that there are distinct differences in CIMT and relevant risk factors between smokers and drinkers, particularly among those with a high smoking status. This study had several limitations: the study population was small; the relatively young age of the study subjects; and limited of focus on smoking, drinking and CIMT. In conclusion, cigarette smoking significantly exacerbates the adverse effects and higher CIMT on the subclinical atherosclerosis risk in young adults, which underscores the importance of prevention and cessation of cigarette smoking in young adults.

키워드

참고문헌

  1. Hart CL, Davey Smith G, Gruer L, Watt GC. The combined effect of smoking tobacco and drinking alcohol on cause-specific mortality: a 30 year cohort study. BMC Public Health. 2010; 10:789. https://doi.org/10.1186/1471-2458-10-789.
  2. You R, McNeil JJ, O'Malley HM, Davis SM, Donnan GA. Risk factors for lacunar infarction syndromes. Neurology. 1995;45:1483-1487. https://doi.org/10.1212/WNL.45.8.1483
  3. Tell GS, Howard G, McKinney WM, Toole JF. Cigarette smoking cessation and extracranial carotid atherosclerosis. JAMA. 1989;261:1178-1180. https://doi.org/10.1001/jama.1989.03420080098040
  4. O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr, et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med. 1999;340:14-22. https://doi.org/10.1056/NEJM199901073400103
  5. Brien SE, Ronksley PE, Turner BJ, Mukamal KJ, Ghali WA. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and metaanalysis of interventional studies. BMJ. 2011;342:d636. https://doi.org/10.1136/bmj.d636.
  6. Fernandez-Sola J. Cardiovascular risks and benefits of moderate and heavy alcohol consumption. Nat Rev Cardiol. 2015;12:576-587. https://doi.org/10.1038/nrcardio.2015.91.
  7. Mathews MJ, Liebenberg L, Mathews EH. The mechanism by which moderate alcohol consumption influences coronary heart disease. Nutr J. 2015;14:33. https://doi.org/10.1186/s12937-015- 0011-6.
  8. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380:2095-2128. https://doi.org/10.1016/S0140-6736(12)61728-0.
  9. Kim DS, Sung HH, Lee JW, Cho EK. The relationship between perceived stress scale and carotid intima-media thickness using ultrasonography in university students. Korean J Clin Lab Sci. 2017;49:308-315. https://doi.org/10.15324/kjcls.2017.49.3.308
  10. Gersh BJ, Sliwa K, Mayosi BM, Yusuf S. Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications. Eur Heart J. 2010;31:642-648. https://doi.org/10.1093/eurheartj/ehq030
  11. Hong YM. Atherosclerotic cardiovascular disease beginning in childhood. Korean Circ J. 2010;40:1-9. https://doi.org/10.4070/kcj.2010.40.1.1
  12. US Department of Health and Human Services. The health consequences of smoking: 50 years of progress: A report of the surgeon general. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014 [cited 2018 June 2]. Available from: https://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf.
  13. Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and metaanalysis. BMJ. 2011;342:d671. https://doi.org/10.1136/bmj.d671.
  14. Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part II. Circulation. 2003;108:1772-1778. https://doi.org/10.1161/01.CIR.0000087481.55887.C9
  15. Onut R, Balanescu AP, Constantinescu D, Calmac L, Marinescu M, Dorobantu PM. Imaging atherosclerosis by carotid intima-media thickness in vivo: how to, where and in whom?. Maedica (Buchar). 2012;7:153-162.
  16. Dogan S, Duivenvoorden R, Grobbee DE, Kastelein JJ, Shear CL, Evans GW, et al. Ultrasound protocols to measure carotid intima-media thickness in trials; comparison of reproducibility, rate of progression, and effect of intervention in subjects with familial hypercholesterolemia and subjects with mixed dyslipidemia. Ann Med. 2010;42:447-464. https://doi.org/10.3109/07853890.2010.499132.
  17. Kawase Ishihara K, Kokubo Y, Yokota C, Hida E, Miyata T, Toyoda K, et al. Effect of plasma fibrinogen, high-sensitive C-reactive protein, and cigarette smoking on carotid atherosclerosis: the suita study. J Stroke Cerebrovasc Dis. 2015;24: 2385-2389. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.06.039.
  18. Zyriax BC, Lau K, Klahn T, Boeing H, Volzke H, Windler E. Association between alcohol consumption and carotid intima-media thickness in a healthy population: data of the STRATEGY study (Stress, Atherosclerosis and ECG Study). Eur J Clin Nutr. 2010;64:1199-1206. https://doi.org/10.1038/ejcn.2010.144.
  19. Ewing JA. Detecting alcoholism. the CAGE questionnaire. JAMA. 1984;252:1905-1907. https://doi.org/10.1001/jama.1984.03350140051025
  20. Heatherton T, Kozlowski LT, Frecker RC, Fagerstrom KO. The fagerstrom test for nicotine dependence: a revision of the fagerstrom tolerance questionnaire. Br J Addict. 1991;86:1119-1127. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x
  21. Britton A, Hardy R, Kuh D, Deanfield J, Charakida M, Bell S. Twenty-year trajectories of alcohol consumption during midlife and atherosclerotic thickening in early old age: findings from two British population cohort studies. BMC Med. 2016: 14:111. https://doi.org/10.1186/s12916-016-0656-9.
  22. Freedman DS, Dietz WH, Tang R, Mensah GA, Bond MG, Urbina EM, et al. The relation of obesity throughout life to carotid intima-media thickness in adulthood: the bogalusa heart study. Int J Obes Relat Metab Disord. 2004;28:159-166. https://doi.org/10.1038/sj.ijo.0802515
  23. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children : a prospective study. Lancet. 2001;358:1400-1404. https://doi.org/10.1016/S0140-6736(01)06525-4
  24. Colak Y, Senates E, Yesil A, Yilmaz Y, Ozturk O, Doganay L, et al. Assessment of endothelial function in patients with nonalcoholic fatty liver disease. Endocrine 2013;43:100-107. https://doi.org/ 10.1007/s12020-012-9712-1.
  25. Dogru T, Genc H, Tapan S, Aslan F, Ercin CN, Ors F, et al. Plasma fetuin-A is associated with endothelial dysfunction and subclinical atherosclerosis in subjects with nonalcoholic fatty liver disease. Clin Endocrinol (Oxf). 2013;78:712-717. https://doi.org/ 10.1111/j.1365-2265.2012.04460.x.
  26. Brea A, Mosquera D, Martin E, Arizti A, Cordero JL, Ros E, et al. Nonalcoholic fatty liver disease is associated with carotid atherosclerosis: a case-control study. Arterioscler Thromb Vasc Biol. 2005;25:1045-1050. https://doi.org/10.1161/01.ATV.0000160613.57985.18
  27. Li S, Yun M, Fernandez C, Xu J, Srinivasan SR, Chen W, et al. Cigarette smoking exacerbates the adverse effects of age and metabolic syndrome on subclinical atherosclerosis: the bogalusa heart study. PLoS One. 2014;9:e96368. https://doi.org/10.1371/ journal.pone.0096368.

피인용 문헌

  1. Stenosis of Carotid Arteries and Concentration of Some Blood Lipid Parameters amongst Tobacco Smokers in Abha: A Case-Control Study vol.11, pp.5, 2018, https://doi.org/10.3390/app11052001