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LDL Cholesterol 또는 Total Cholesterol의 적용에 따른 Framingham Risk Score와 10년 내 심혈관질환 발생 위험도 평가
권세영 ( Se Young Kwon ),나영악 ( Young Ak Na ) 대한임상검사과학회 2016 대한임상검사과학회지(KJCLS) Vol.48 No.2
증가하고 있는 심혈관질환을 예방하기 위한 연구와 함께 심혈관질환 위험도를 예측할 수 있는 평가도구에 대한 연구도 꾸준히 진행되고 있다. 가장 널리 알려져 있는 Framingham risk score (FRS)는 여러 선행 연구에서 그 타당성이 검증되었다. 본 연구에서는 연구 대상자들의 LDL 콜레스테롤과 총 콜레스테롤의 적용에 따른 FRS의 점수 차이를 살펴보고, 두 변수의 선택 적용에 따른 10년 내심혈관질환 발생 위험도의 판정에 대한 일치도를 평가해 보고자 하였다. 2011 국민건강영양조사 데이터 중 심혈관질환 진단을 받은 자를 제외한 1,530명(남성 755명, 여성 775명)의 자료를 이용하였다. LDL 콜레스테롤 또는 총 콜레스테롤 중에 어떤 항목을 적용하느냐에 따라 FRS와 심혈관질환의 10년 예측위험도는 차이가 있었다. 남녀 모두 FRS는 LDL 콜레스테롤 적용 점수 보다 총콜레스테롤적용 점수가 더 높았다. 위험도 10% 미만의 저위험군, 10∼19%의 중등도 위험군, 20% 이상의 고위험군 분류에서 남성 106명, 여성26명의 판정이 일치하지 않았다. 코헨의 카파 계수는 남성의 경우 0.718, 여성의 경우 0.884로 나타나 여성의 경우 더 높은 일치성을 보였다. 심혈관질환의 10년 예측위험도와의 관련성에서도 LDL 콜레스테롤을 포함한 회귀식 보다 총 콜레스테롤을 포함한 회귀식에서 남녀 모두 설명력이 더 높아 총 콜레스테롤을 반영한 FRS 산출과 10년 예측 위험도의 평가가 더 상관성이 더 높고, 더불어 남성 보다는 여성에서 더 일치하는 결과가 나타남을 알 수 있었다. Studies on assessment tools for predicting cardiovascular disease risk (CDR), along with the studies to prevent CDR have been consistently reported. The validity of the Framingham risk score (FRS), a commonly known tool, has been verified through the precedent studies. In this study, we examined the differences of FRS according to the application of categories of LDL cholesterol (LDL-C) or Total cholesterol (TC), and attempted to evaluate the agreement of 10 yr CHD risk judgment based on the above-mentioned application. Excluding those diagnosed as cardiovascular diseases, data on subjects (755 men and 775 women) from the 2011 Korean National Health and Nutrition Examination Survey were used. We found differences of FRS and 10 yr CHD risk depending on the application of categories of LDL cholesterol (LDL-C) or Total cholesterol (TC). FRS of TC points were higher than those of LDL-C in both men and women. In classification of low risk (<10%), intermediate risk (10∼19%), and high risk (≥20%), there were disagreements for 106 men and 26 women. Women showed almost perfect agreement from Coefficient of Cohen’s Kappa (0.718 in men, and 0.884 in women). In assessment of 10 yr CHD risk, R-squared value from regression including TC was higher than that of LDC-C in both men and women (0.972 vs 0.885). From this result, we can draw a conclusion that correlation coefficients of FRS and CHD risk including TC were higher than those of LDC-C, and women showed a greater degree of agreement than men.
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연령과 성별에 따른 정상 혈청 Gamma-glutamyltransferase와 관상동맥질환 위험인자와의 관계
권세영 ( Se Young Kwon ),나영악 ( Young Ak Na ) 대한임상검사과학회 2016 대한임상검사과학회지(KJCLS) Vol.48 No.1
Serum gamma-glutamyltransferase (GGT) has been widely used as a marker of alcohol intake and liver failure. Recently, the relativity between GGT and various diseases has been identified with growing interest. In this study, we examined relativity between GGT value and risk factors of coronary heart diseases among those with normal GGT value, excluding heavy drinkers. Specifically, we compared the differences based on age and gender. Data from the 2011 KNHNES were used (N=3,619). When the subjects were categorized according to quartile based on the serum GGT levels, there was 10∼20, 21∼27, 28∼38, 39∼71 IU/L in men, and 6∼12, 13∼16, 17 ∼22, 23∼42 IU/L in women. The mean of most variables was the highest in the 4th quartile (Q4), however age and LDL Cholesterol were the highest in the 2nd quartile (Q2) in men. The FRS and 10-year CHD risk was the highest in the 2nd quartile in men, and the highest in the 4th quartile in women. Increased GGT was correspondingly linked with age in women but age was the highest in GGT in the 2nd quartile in men. In the 70’s, the highest Q1 and Q2 was in men and the highest Q3 and Q4 in women. Although GGT value was within the normal range, increased GGT showed correlation with various risk factors. The FRS and 10-year CHD risk showed different patterns according to age and gender along with increased GGT value.
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일부지역 생애전환기 건강대상자들의 혈청 총콜레스테롤과 중성지질농도 비교 -40세와 66세를 대상으로-
신현규 ( Hyun-gyu Shin ),나영악 ( Young-ak Na ) 대한임상검사과학회 2010 대한임상검사과학회지(KJCLS) Vol.42 No.2
The National Health Insurance Corporation (NHIC) was performed population health checkup surveyprogram with especially two target ages, 40 years and 66 years old that were called as "life transition period" for national collective prophylaxis of cardiovascular diseases in Korea. We were investigated and compared between two age groups with the serum levels of cholesterol and triglyceride from data of the survey in Daegu province, Korea at April, 2007. Data of one hundred persons per each age (40 years and 66 years old) were collected and investigated for risk factors for chronic degenerative diseases including serum lipid concentration, health habits of drinking, smoking, exercise etc. In spite of the definite difference of life transition of the each age, the transition from adolescence to adulthood at 40 years old, and from adulthood to senescence at 66 years old, there were no significant difference of total cholesterol and triglyceride between two age groups.
ScienceON
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