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오세진,강상중,송수근,임동현,김성만,최영식,박요한,차형수 고신대학교 의학부 2000 高神大學校 醫學部 論文集 Vol.15 No.1
Background Obesity is the prevalent disorder and is a serious public health concern because it is a significant forerunner of major chronic debilitating metabolic disease including diabetes, hypertension, lipid disorders and coronary artherosclerosis. Recently many studies shows that upper-body obesity, particulary increased visceral, abdominal fat, is most strongly associated with metaboloc risk factors. The aims of this study were to establish the relationship of body fat and its distribution to metaboloc risk factors and the clinical usefulness of waist circumference as a new indices of intraabdominal fat distribution. Methods Forty-one non-diabetic patients who visited to the health promotion center of Kosin Medical Center from March, 1998 to June, 1998 were divided into two groups according to the body mass index (BMI) : obese group (BMI≥25㎏/m^(2)) and non obese group (BMI<25㎏/m^(2)) also were divided into two group according to the waist circumference (W) : center obese group (W>94㎝ in men and W>80㎝ in women) and central non onese group (W≤94㎝ in men and W≤80㎝ in women). The amount of body fat was measured by bioelectrical impedence method. Insulin resistance was calculated by homeostasis model assessment. Results The result were as follows. 1) In obese group W and waist/hip ratio (WHP). basal insulin level in men and Smin, C-peptide and atherogenic index in women of obese group were higher than those of non-obese group (p<0.05). Insulin resistance, fat weight and lean body mass in the obese group were higher than those of non-obese group in both sexes (p<0.05). 2) In central obese group BMI, basal insulin level, insulin resistance, fat weight and lean body mass in men and atherogenic index in women were higher than those of central non-obese group. WHR in the central obese type group was higher than of central non-obese group in both sexes (p<0.05). 3) BMI was positively correlated with systolic blood pressure (r=0.32, p<0.05), diastolic blood pressure (r=0.36, p<0.05), insulin resistance (r=0.39, p<0.05), waist circumference (r=0.61, p<0.05), percentage of body fat (r=0.32, p<0.05), fat weight (r=0.61, p<0.01) and lean body mess (r=0.54, p<0.01), but negatively correlated with HDL-cholesterol (r=0.76, p<0.01). 4) Waist circumference was positively correlated with systolic blood pressure (r=0.46, p<0.01), diastolic blood pressure (r=0.37, p<0.05), fat weight (r=0.37, p<0.05), lean body mass (r=0.37, p<0.05), and WHR (r=0.82, p<0.01). 5) WHR was not significantly correlated with other metabolic risk factors except systolic blood pressure (r=0.39, p<0.05). 6) Fat weight was positively correlated with diastolic blood pressure (r=0.36, p<0.05), insulin resistance (r=0.53, p<0.01), basal insulin level (r=0.53, p<0.01),and percentage of body fat. Percentage of body fat was positively correlated with diastolic blood pressure (r=0.33, p<0.05), and insulin resistance (r=0.44, p<0.01). Conclusion Conclusively body fat, waist circumference and WHR were positively correlated with metabolic risk factors and waist circumference appeared more useful than WHR.