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한국 성인의 비만이 인슐린, 공복혈당 및 당화혈색소에 미치는 영향

Obesity as associated factors for Insulin, Fasting blood sugar, and Hemoglobin A1c in Korean adults

  • 투고 : 2019.08.19
  • 심사 : 2019.10.20
  • 발행 : 2019.10.28

초록

본 연구의 목적은 체질량지수가 인슐린, 혈당 및 당화혈색소에 미치는 영향을 확인하는 것이다. 연구방법은 국민건강영양조사 2015년 자료를 분석하여, 서술적 통계, t-test, ANOVA, Pearson correlation coefficient과 단계적 다중회귀분석을 적용하였다(SPSS WIN 25.0). 주요결과는, 체질량지수는 인슐린(r=0.397, p<0.001), 공복혈당(r=0.241, p<0.001) 및 당화혈색소(r=0.237, p<0.001)와 양의 상관관계를 나타내었다. 인슐린에 영향요인은 과체중(${\beta}=.130$, t=8.193, p<0.001),비만(${\beta}=.390$, t=24.390, p<0.001), 연령이며 설명력은13.1% (F=53.584, p<0.001)였다. 공복혈당에 영향요인은 과체중(${\beta}=.072$, t=4.478, p<0.001), 비만(${\beta}=.186$, t=11.485, p<0.001), 연령이며 설명력은 10.6%(F=42.351, p<0.001)였다. 당화혈색소에 영향요인은 과체중(${\beta}=.059$, t=3.712, p<0.001), 비만(${\beta}=.190$, t=11.895, p<0.001), 연령, 성별이며 설명력은 14.1% (F=58.134, p<0.001)였다. 본 연구결과를 바탕으로 당뇨병 예방 및 관리프로그램에 비만관련 중재가 포함되어야 한다.

The purpose of this study was to investigate the effects of body mass index(BMI) on insulin. fasting blood sugar(FBS), and hemoglobin A1c(HbA1c). This study analyzed the data of 2015, The Sixth KNHANES, and it was included to 4554 subject over 20 years old. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression analysis(SPSS 25.0). The major findings, BMI was positively correlated with insulin(r=0.397, p<0.001), FBS(r=0.241, p<0.001), and HbA1c(r=0.237, p<0.001). Factors affecting insulin are overweight(${\beta}=.130$, t=8.193, p<0.001), obesity(${\beta}=.390$, t=24.390, p<0.001) and age. the explanatory power is 13.1% (F=53.584, p<0.001). Factors affecting FBS were overweight(${\beta}=.072$, t=4.478, p<0.001), obesity(${\beta}=.186$, t= 11.485, p<0.001), age, the explanatory power was 10.6% (F=42.351, p<0.001). Factors affecting HbA1c were overweight(${\beta}=.059$, t=3.712, p<0.001), obesity(${\beta}=.190$, t=11.895, p<0.001) age and sex, the explanatory power is 14.1% (F=58.134, p<0.001). Based on this study result, diabetes mellitus prevention and management programs should include interventions related to obesity.

키워드

참고문헌

  1. D. Haslam & W. James. (2005). Obesity. Lancet, 366(9492),1197-1209. DOI:10.1016/S0140-6736(05)67483-1
  2. K. E. Wellen & G. S. Hotamisligil. (2003). Obesity-induced inflammatory changes in adipose tissue. The Journal of clinical investigation, 112(12),1785-1788. DOI: 10.1172/JCI200320514.
  3. World Health Organization. (2002). Reducing Risks Promoting Healthy Life. Geneva: World Health Report.
  4. K. M. Flegal, J. A. Shepherd, A. C. Looker, B. I. Graubard, Lori G Borrud & C. L. Ogden et al. (2009).Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. The American journal of clinical nutrition, 89(2),500-508. DOI: 10.3945/ajcn.2008.26847
  5. S. Wild, G. Roglic, A. Green, Sicree, R & H. King. (2004). Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care, 27(5),1047-1053. DOI: 10.2337/diacare.27.5.1047
  6. Korea Centers for Disease Control and Prevention. (2017). The Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-2). Cheongju: Korea Centers for Disease Control and Prevention.
  7. J. P. Boyle, T. J. Thompson, E. W. Gregg, L. E. Barker & D. F. Williamson. (2010). Projection of the year 2050 burden of diabetes in the US adult population: Dynamic modeling of incidence, mortality, and prediabetes prevalence. Population health metrics, 8(29), 1-12. DOI:10.1186/1478-7954-8-29.
  8. T.A.Buchanan, A.H. Xiang, R.K. Peters, S.L. Kjos, A. Marroquin, J. Goico et al. (2002). Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk hispanic women. Diabetes, 51(9), 2796-2803. DOI: 10.2337/diabetes.51.9.2796
  9. H. J. Yoon, Y. H. Lee & B. S. Cha. (2014). Causal Relationship of Non-alcoholic Fatty Liver Disease with Obesity and Insulin Resistance. The Journal of Korean Diabetes, 15(2), 76-81. DOI:10.4093/jkd.2014.15.2.76
  10. R. Akter, A. Nessa, M. F. Husain, F. Wahed, N. Khatun, M. Yesmin. (2017). Effect of Obesity on Fasting Blood Sugar. Mymensingh medical journal, 26(1),7-11.
  11. B. G. Vittal, G. Praveen & P. Deepak. (2010). A Study Of Body Mass Index In Healthy Individuals And Its Relationship With Fasting Blood Sugar. Journal of Clinical and Diagnostic Research, 4(6), 3421-3424.
  12. American Diabetes Association. (2010). Standards of medical care in diabetes 2010. Diabetes Care, 33(Supplement 1), S11-S61. DOI: 10.2337/dc10-S011
  13. S. I. Sherwani, H.A. Khan, A. Ekhzaimy, A.M & M. K.Sakharkar. (2016). Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights, 11, 95-104. DOI: 10.4137/BMI.S38440
  14. Q. Ma, H. Liu, G. Xiang, W. Shan, & A. Xing. (2016). Association between glycated hemoglobin A1c levels with age and gender in Chinese adults with no prior diagnosis of diabetes mellitus. Biomedical Reports, 4(6), 737-740. DOI: 10.3892/br.2016.643
  15. G. Bicescu. (2010). Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. Mædica, 5(1), 80-81.
  16. T. Nakagami, M. Tominaga, R. Nishimura, M. Daimon, T. Oizumi, N. Yoshiike et al. (2007). The combined use of fasting plasma glucose and glycated haemoglobin A1c in a stepwise fashion to detect undiagnosed diabetes mellitus. The Tohoku journal of experimental medicine, 213(1), 25-32. DOI: 10.1620/tjem.213.25
  17. M. K. Song, J. W. Bae, Y. H. Kim & S. H. Chung. (2012). Hemoglobin A1c in the Screening of Obesity Related Diseases in Children and Adolescents 2012. Annals Pediatric Endocrinology & Metabolism, 17(2),92-99. DOI: 10.6065/apem.2012.17.2.92
  18. World Health Organization Western Pacific Region. (2000).The Asia-pacific perspective: Redefining obesity and its Treatment. Australia: WHO Western Pacific Region.
  19. K. W. Sim, S.H. Lee & H. S. Lee. (2001). The relationship body mass index and morbidity in Korea. Journal of Korean Society for the Study of Obesity, 10(2),147-155.
  20. G. Assmann, J.R. Nofer & H. Schulte, (2004).Cardiovascular risk assessment in the metabolic syndrome: view from PROCAM. Endocrinology and metabolism clinics of North America, 33(2), 377-392. DOI:10.1016/j.ecl.2004.03.017
  21. J. G. Salway. (2004). Metabolism at a Glance(3rd ed). Oxford: Wiley-Blackwell.
  22. G. I. Shulman. (2000). Cellular mechanisms of insulin resistance. The Journal of Clinical Investigation, 106(2), 171-176. DOI: 10.1172/JCI10583
  23. H. Xu, G.T.Barnes, Q. Yang, G. Tan, Yang D, C. J. Chou et al. (2003). Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. The Journal of clinical investigation, 112(12), 1821-1830. DOI: 10.1172/JCI19451
  24. K. Morino, K.F. Petersen, S.Dufour, D.Befroy, J. Frattini, N. Shatzkes et al. (2005). Reduced mitochondrial density and increased IRS-1 serine phosphorylation in muscle of insulin-resistant offspring of type 2diabetic parents. The Journal of Clinical Investigation, 115(12), 3587-3593. DOI: 10.1172/JCI25151
  25. K. F. Petersen, S. Dufour, D.Befroy, M.Lehrke, R.E.Hendler & G.I. Shulman. (2005). Reversal of nonalcoholic hepatic steatosis, hepatic insulin resistance, and hyperglycemia by moderate weight reduction in patients with type 2 diabetes. Diabetes, 54, 603-608. https://doi.org/10.2337/diabetes.54.3.603
  26. H. J. Kim, T. Higashimori, S.Y. Park, H. Choi, J. Dong, Y. J. Kim. (2004). Differential effects of interleukin-6 and -10 on skeletal muscle and liver insulin action in vivo. Diabetes, 53, 1060-1067. https://doi.org/10.2337/diabetes.53.4.1060
  27. C. S. Choi. (2009). PotentialPotential Therapeutic Strategies for Fat Induced Insulin Resistance. Journal of Korean Society of Endocrinology, 24(2), 65-74. DOI: 10.3803/jkes.2009.24.2.65
  28. J.K.Kim, Y.J. Kim, J.J. Fillmore, Y. Chen, I. Moore, J. Lee et al. (2001). Prevention of fat-induced insulin resistance by salicylate. The Journal of Clinical Investigation, 108(3), 437-446. DOI:10.1172/JCI11559.
  29. R. Weiss & S. Caprio. (2005). The metabolic consequences of childhood obesity. Best Practice & Research: Clinical Endocrinology & Metabolism, 19(3), 405-419. DOI:10.1016/j.beem.2005.04.009
  30. V.A. Diaz, A.G. Mainous, R. Baker, M. Carnemolla & A. Majeed. (2007). How does ethnicity affect the association between obesity and diabetes? Diabetic medicine : a journal of the British Diabetic Association, 24(11), 1199-1204. DOI:10.1111/j.1464-5491.2007.02244.x
  31. G. I. Shulman. (2000). Cellular mechanisms of insulin resistance. The Journal of clinical investigation, 106(2),171-176. DOI:10.1172/JCI10583
  32. M. S. D'souza, R. Venkatesaperumal, S.N. Karkada & A.D. Amirtharaj. (2013). Determinants of Glycosylated Haemaglobin among Adults with Type 2, Diabetes Mellitus. Journal of Diabetes & Metabolism, 4(5), 265-270. DOI:10.4172/2155-6156.1000265
  33. D. Hou, X. Zhao, J. Liu, F. Chen, Y. Yan, H. Cheng et al. (2016). Association of childhood and adolescents obesity with adult diabetes. Chinese journal of preventive medicine, 50(1), 23-27. DOI:10.3760/cma.j.issn.0253-9624.2016.01.005
  34. M. D. Llorente & V. Urrutia. (2006). Diabetes, Psychiatric Disorders, and the Metabolic Effects of Antipsychotic Medications. Clinical Diabetes, 24(1), 18-24. DOI:10.2337/diaclin.24.1.18
  35. N. J. Kellow, G. S. Savige & H. Khalil. (2011).Predictors of poor glycaemic control during the initial five years post-diagnosis in rural adults with type 2 diabetes. The Australian journal of rural health, 19(5), 267-274. DOI:10.1111/j.1440-1584.2011.01222.
  36. J. E. Gerich. (2003). Contributions of insulin-resistance and insulin secretory defects to the pathogenesis of type 2 diabetes mellitus. Mayo Clinic proceedings, 78(4),447-456. DOI:10.4065/78.4.447
  37. T. Fulop, A. Larbi & N. Douziech. (2003). Insulin receptor and ageing. Pathologie-biologie, 51(10), 574-580. https://doi.org/10.1016/j.patbio.2003.09.007
  38. L. N. Pani, L. Korenda, J.B. Meigs, C. Driver, S. Chamany & C.S. Fox. (2008). Effect of aging on A1C levels in individuals without diabetes: Evidence from the Framingham Offspring Study and the National Health and Nutrition Examination Survey 2001-2004. Diabetes Care, 31(10), 1991-1996. DOI:10.2337/dc08-0577
  39. D. B. Sacks, M. Arnold, G. L. Bakris, D. E. Bruns, A.R. Horvath & M. S. Kirkman et al. (2011). Guideline and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care, 34(6), e61-e99. DOI:10.2337/dc11-9998