갱년기 과체중과 비만여성의 신체활동량에 따른 스트레스, 우울, 자존감의 차이 연구

황미자,송미연,Hwang, Mi-Ja,Song, Mi-Yeon 척추신경추나의학회 2007 척추신경추나의학회지 Vol.2 No.2

Objectives : Physical activity is known as beneficial to mental health like decreasing depression and stress. In this study, we tried to find out the relationship between body composition, stress, depression, and self-esteem with physical activity level. Methods : International Physical Activity Questionnaire(IPAQ)-short form, SRRS(Social readjustment rating scale), SRI(Stress response index), and BDI(Beck's depression index), SES(Self-esteem scale) were given to peri-menopausal women aged 45-55 and BMI$\geq$23kg/m2. They were given written consent and this study is performed under the permission of institutional review board of Kyung Hee East-west Neo Medical Center. Results : The mean of physical activity of total subjects was 2406MET-min/week(n=42). The physical activity of overweight(23kg/m2$\leq$BMI<25kg/m2) and obese(BMI$\geq$25kg/m2) permimenopausal women was 1428MET-min/week and 2970MET-min/week(p<0.05) respectively. When three levels of physical activity pattern(inactive, minimally active, and HEPA(Health-enhancing physical activity) active) was analyzed, all of them were heavily relied on the activity intensities of walking. The scores of BDI, SRRS, and SRI were lower and that of SES were higher in HEPA active group, not showing statical significance. Anger(subscale of SRI) measures were lower and SES measures were higher in HEPA active group than others among overweight women(p<0.05). Conclusions : The level of physical activity of peri-menopausal women was on the average, but the vigorous activity is thought to be necessary. The HEPA active group showed lower depression, stress and higher self-esteem than minimally active and inactive group.

2000년 이후 비만치료에 사용되는 처방(處方) 및 본초(本草)에 대한 문헌연구 -마황(麻黃)을 중심으로

황미자 ( Mi Ja Hwang ),신현대 ( Hyun Dae Shin ),송미연 ( Mi Yeon Song ) 한방비만학회 2007 한방비만학회지 Vol.7 No.1

This study has been done to know which herbs and herbal formulae are frequently used for the treatment of obesity in Korea and overseas since 2000. Methods : We conducted a computerized literature search in KISS (Korean studies Information Service System), Pubmed, Journal of Oriental Association for Study of Obesity ,and Journal of Oriental Rehabilitation Medicine(2000 -Apr. 2006) using search key words obesity, obese, weight loss, weight control combined with herb, herbal formula. Result and conclusion : Seventy-two studies have been identified(50 Korean papers and 22 pubmed papers) and 81 herbs have been found. In USA it was mainly used as single herb for food, but in Korea it was mainly used as herbal formula. For single herb, ephedra(麻黃) was the most studied single herb both in Korea and the USA. For herbal formulae, Sasang Constitutional Medicine(SCM, 19times) was the most frequently used herbal formula, in which the herbs for Tae-eum type person like Taeyeumjowui-tang(太陰調胃湯, 7times) and Choweseungcheng- tang(調胃升淸湯, 5times) were mainly prescribed. The next was Chegameuiin-tang(體減薏苡仁湯, 11times) and Bangpungtongsungsan( 防風通聖散, 3times). Calculating each herb consisted in each herbal formula, Coicis Semen(薏苡仁), Angelicae gigantis Radix(當歸), and Glycyrrhizae Radix(甘草), Raspberry Ketone(蘿복子), Cnidii Rhizoma(川芎), and Ephedra Herba(麻黃) turned out to be the most frequently used herb.

폐경전 비만여성에서 내장지방과 자존감의 연관성

황미자 ( Mi Ja Hwang ),이아라 ( A Ra Lee ),황덕상 ( Deok Sang Hwang ),정원석 ( Won Suk Chung ),송미연 ( Mi Yeon Song ) 한방비만학회 2008 한방비만학회지 Vol.8 No.1

Obesity is not only a matter of accumulation of adipose tissue but also a projection of self-cognition. This study examined the association between low self-esteem and visceral obesity; visceral adipose tissue (VAT) and visceral adipose tissue /subcutaneous adipose tissue ratio (VSR). Methods This cross-sectional study was performed in pre-menopausal obese(BMI ≥ 25 kg/m2) women in Seoul, from 2007 to 2008 (n=54). Simple anthropometry including BMI and waist circumference and Computed Tomography (CT) including VAT and VSR were done. To measure self-esteem, Rosenberg self-esteem scale (SES) questionnaire was administered. Subjects were given written consent and this study was performed under the permission of institutional review board of Kyung-Hee East-west Neo Medical Center. Results There was a significant relationship self esteem (SES score) with visceral obesity (VAT and VSR). 1. SES was correlated with VAT (r=-0.377, p<0.01) and VSR (r= -0.400, p<0.01) significantly by Pearson Correlation. 2. VAT and VSR could be predicted from SES by Simple linear regression. VAT = -1.701 x (SES score) +161.191 (R2=0.142) VSR = -1.09x10-2 x (SES score) +0.858 (R2=0.160) Conclusions This study proves that low self-esteem might contribute to visceral obesity in Korean pre-menopausal obese women. Self-esteem and psychological factor should be considered in treatment of visceral obesity in adult-women.

한국 갱년기 여성의 간울과 내장비만의 상관성

황미자 ( Mi Ja Hwang ),정석희 ( Seok Hee Chung ),황덕상 ( Deok Sang Hwang ),송미연 ( Mi Yeon Song ) 한방재활의학과학회 2008 한방재활의학과학회지 Vol.18 No.2

목적 : 갱년기 여성은 내장비만의 위험이 높으며 또한 심리적 변화를 겪는 시기이다. 갱년기 여성의 복부지방, 내장지방, 피하지방 및 이와 관련된 단순비만지표, 간울증, 스트레스, 우울, 자존감 등을 조사하여 갱년기 건강의 위협이 되는 신체 심리 인자를 알아보고자 이 연구를 시행하였다. 방법 : 병원공고를 통해 체질량지수 23 kg/m2 이상 비흡연자인 만 45세 이상 55세 이하의 폐경 전후의 갱년기 여성 환자를 모집하여 2007년 8월 20일부터 24일까지 47명이 모집되었으며 이중 체질량지수 25 kg/m2 이상이면서 복부 전산화 단층촬영 상 내장지방이 100 cm2 이상인 20명의 단순비만지표, 체성분검사, 혈액검사, 복부 전산화 단층촬영 및 한방비만변증 (간울) 및 스트레스, 우울, 자존감 설문검사 결과의 상관성을 분석하였다. 본 연구는 경희대학교 동서신의학병원의 임상연구심사위원회의 승인을 받았다. 결과 : 1. 갱년기 비만여성에서 복부지방 면적, 피하지방 면적은 체질량지수, 체지방률, 허리둘레/신장비 등의 단순비만지표와 유의한 상관성을 보인 반면 (p < 0.01), 내장지방 면적은 단순비만지표와 상관성을 보이지 않았다. 2. 내장지방 면적은 사회 재적응 평가척도 (γ = 0.577, p < 0.01)와 유의한 상관성이 있었고, 선형회귀분석에서 유의한 결과를 나타냈다. VAT (cm2) = 116.1 + 0.101 x (SRRS score) (γ2 = 0.332) 3. 피하지방은 식이태도 점수와, 총복부지방은 식이태도 점수 및 갱년기지수 중 혈관운동증상과 상관성이 있었다. 4. 간울증은 스트레스 반응척도, 우울지수, 갱년기지수 및 그 하부항목 중 혈관운동, 정신, 운동, 소화, 전신증상과 양의 상관성을, 자존감척도와는 음의 상관성을 나타냈으며, 내장지방과 직접적인 상관성을 보이지 않았다. 결론 : 간울증은 높은 스트레스, 우울, 갱년기 증상 및 낮은 자존감과 관련되는 것으로 나타났다. 폐경전후 비만여성에서 내장지방 면적은 간울증과 유의한 상관성을 보이지 않았으나, 생활 스트레스 사건이 많을수록 높아지는 것으로 나타나 갱년기 여성 내장비만에서 스트레스에 대한 대처가 중요할 것으로 사료된다. 추후 임상적 연계성 및 설문 보완에 대한 연구가 필요하리라 생각된다.

원저 : 과체중 및 비만 성인 여성의 비만변증 설문 결과 분석

황미자 ( Mi Ja Hwang ),문진석 ( Kyoung Su Park ),박경수 ( Mi Yeon Song ),송미연 ( Jin Seok Moon ) 한방비만학회 2008 한방비만학회지 Vol.8 No.2

Objectives We aimed to explore obesity pattern among overweight and obese Korean adult women using oriental obesity pattern identification questionnaire. Methods This survey was performed using data of 83 overweight and obese women aged from 20 to 55 yrs (BMI ≥ 23 kg/m² : n=18, BMI ≥ 25 kg/m² :n=65) in Seoul, from 2007 to 2008. Subjects were given written consent and this study was performed under the permission of institutional review board of Kyung-Hee East-west Neo Medical Center. Results 1. The distribution of oriental obesity pattern identification did not show any differences between obese and overweight group(p>0.05). 2. The ratio of significantly-scored oriental pattern identification was ordered by Stagnation of the liver Qi(肝鬱, 21.7%) > Indigestion(食積, 18.1%) > Spleen deficiency(脾虛, 16.9%) > Yang deficiency(陽虛, 14.5%) (n=83). 3. The frequency of top-scored oriental obesity pattern was ordered by Stagnation of the liver Qi(肝鬱, 36.1%) > Indigestion(食積, 24.1%) > Yang deficiency (陽虛, 15.7%) (n=83). 4. The frequency of oriental obesity pattern identification was ordered by Stagnation of the liver Qi(肝鬱, 41.7%) > Indigestion(食積, 29.2%) > Yang deficiency(陽虛, 12.5%) > Stagnation of the liver Qi and Yang deficiency(肝鬱兼陽虛, 8.3%) (n=24). Conclusions In Korean adult overweight and obese women, Stagnation of the liver Qi(肝鬱), Indigestion(食積), and Yang deficiency (陽虛) were found to be the main pathology based on oriental obesity pattern identification questionnaire. It suggests that not only physical status but also general condition and emotional problem should be concerned in treatment of obesity. This study could play a role as a preliminary data of oriental obesity pattern identification.

한국에서 비만치료에 쓰이는 한약에 대한 문헌 연구 -2000년 이후 발표된 논문을 중심으로

황미자 ( Mi Ja Hwang ),신현대 ( Hyun Sae Shin ),송미연 ( Mi Yeon Song ) 한방재활의학과학회 2006 한방재활의학과학회지 Vol.16 No.3

목적: 비만은 단지 용모 손상뿐만 아니라 당뇨나 고혈압과 같은 질환을 유발하고 지속시키는 만성적인 질환으로 인식되고 있다. 비만을 치료하기 위한 한약의 사용이 증가되고 있다. 2000년 이후에 나온 국내 한방 논문 및 pubmed 논문에 실린 비만 치료 한약을 분석함으로써 한국에서 비만에 주로 연구되는 한약에 대해 알고자 하였다. 방법: KSI 한국 학술정보 및 MEDLINE을 ‘비만`, ‘체중조절`, ‘체중감량`, ‘한약`으로 검색하고, 한방재활의학과학회지, 대한 한방비만학회지에 게재된 논문 중 비만에 한약을 사용한 논문을 대상으로 하여 빈도를 계산한 후, 처방에 포함된 한약을 참고하여 실제 한약물의 빈도를 계산하였다. 결과: 분석 대상 논문 총 72편, 이 중 한국어 논문 50편, pubmed 논문 22편 중 미국 14편 한국 3편 일본 5편이었다. 한국에서 가장 빈용되는 한약은 사상처방(太陰調胃湯 8회, 調胃升淸湯 5회) 및 體感薏苡仁湯(11회)이었으며, 방제구성을 고려할 때 빈용 약물은 薏苡仁, 當歸, 甘草, 蘿.子, 川芎, 麻黃, 桔梗, 熟地黃, 枸杞子, 黃. 순으로 나타났다. 단미로는 麻黃이 빈도가 제일 높았다. 미국에서는 주로 단미로 연구가 이뤄지고 있었으며, 麻黃이 제일 많고 人蔘, 枳實, 生薑 등이 연구되고 있었다. 결론: 한국에서 비만에 빈용되는 처방은 四象醫學에 기초한 처방으로 나타났다. 四象醫學은 사람을 네 체질로 나누고, 이 중 太陰人이 비만해지기 쉽고 체중감량은 어렵다고 하였으며, 태음인 처방에 麻黃이 포함된 것이 많았다. 이는 단미로써 사용될 때 문제시되는 麻黃의 부작용이 적절한 대상 선택과 적절한 한약 혼합을 통해 줄어들 수 있음을 시사한다.

한국 과체중 갱년기 도시 여성의 비만도,일상생활 스트레스, 자존감, 식이태도, 우울증,스트레스 반응척도와 갱년기 증상의 연관성

정원석 ( Won Suk Chung ),황미자 ( Mi Ja Hwang ),김성수 ( Sung Soo Kim ),황덕상 ( Deok Sang Hwang ),송미연 ( Mi Yeon Song ) 한방비만학회 2008 한방비만학회지 Vol.8 No.1

Obesity and climacteric symptom are affected by various cultural, social and psychological factors. This study is performed to recognize the relationship between obesity, climacteric symptom, and other social and psychological factors such as self-esteem, depression, eating attitude, stress response and social readjustment rating. Methods SRRS(social readjustment rating scale), SES(self-esteem scale), SRI(stress response inventory), BDI(Beck depression inventory), KEAT-26 (Korean Eating Attitude Test-26) and Kuperman index were given to 43 peri-menopausal women aged 45-55 and BMI ≥23. They were given written consent and this study is performed under the permission of institutional review board of Kyung Hee East-west Neo Medical Center. And height, body weight, waist circumference were measured. These variables were treated by correlation and regression analysis for finding effect factors of climacteric symptom. Result BMI and WC were not related to climacteric symptom. There were significant correlation between KEAT-26(r=0.4388, p=0.004), SES (r=-0.4748, p=0.001), SRI(r=0.6941, p<0.001), BDI(r=0.6354, p<0.001) and Kuperman index. In multiple regression, SRI was find to be a prediction factor of Kuperman index.(Kuperman index=19.033+0.7SRI(R2=0.490)). Conclusion Climacteric symptom is related to self-esteem, eating attitude, depression and stress response. And the most important prediction factor of climacteric symptom is stress response. So managing of stress response may be essential to treating climacteric syndrome. And it is necessary to study about climacteric symptom with many other effective factors of various peri-menopausal subjects.

폐경 전과 폐경 후 비만 여성의 심박변이도에 관한 연구

황덕상 ( Deok Sang Hwang ),황미자 ( Mi Ja Hwang ),이윤재 ( Yoon Jae Lee ),이경섭 ( Kyung Sub Lee ),송미연 ( Mi Yeon Song ) 한방비만학회 2008 한방비만학회지 Vol.8 No.1

To investigate the relationship between Heart Rate Variability and menopause among obese middle-aged women in Korea. Subjects and Methods Forty middle-aged women (age 49.05 ± 2.64 years) with BMI > 23㎏/㎡ were recruited by local advertisement. Blood profiles of estrogen, FSH, LH, glucose, total cholesterol, HDL-cholesterol, and triglyceride were measured. Autonomic Nervous System (ANS) was estimated by short-term spectral analysis of heart rate variability (HRV). Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were accessed using Computerized Tomography (CT), Bioimpedance Analysis (BIA), and anthropometry. To scrutinize the influence of ANS on obesity-related factors, we divided the subjects into pre- and post-menopausal women. Results The total cholesterol, FSH and LH were significantly higher in post-menopausal obese women group. The estradiol and standard deviation of all normal R-R intervals (SDNN), high-frequency components (HF) of the HRV were significantly lower in postmenopausal obese women group (P<0.05). Adipose tissue distribution and blood profiles were not significantly different between two groups. Conclusion Menopause induced a decrease in SDNN and HF values and increase in total cholesterol level in obese women although the VAT itself was not related with ANS in obese women.

갱년기 비만 여성의 식사태도와 복부지방과의 상관성

이아라 ( A Ra Lee ),황미자 ( Mi Ja Hwang ),정원석 ( Won Seok Jung ),정석희 ( Seok Hee Chung ),송미연 ( Mi Yeon Song ) 한방재활의학과학회 2008 한방재활의학과학회지 Vol.18 No.4

Objectives : This study was performed to find out the relationships between abdominal fat and eating attitude in obese climacteric women. Methods : 42 obese climacteric women were recruited in August 2007. Anthropometry has been done and abdominal fat distribution had been assessed by CT scan at the level of L4-5 and eating attitude was measured using Korean Eating Attitude Test-26. Results : There were significant correlations between body mass index, percent of body fat and eating attitude. Total abdominal fat and visceral fat also increased with KEAT-26. Conclusions : There were relationships among eating attitude total fat, abdominal fat and visceral fat in obese climacteric women.

원저 : 폐경전 및 갱년기 과체중 한국 성인 여성의 변증 지표 차이에 대한 연구

정원석 ( Won Suk Chung ),황미자 ( Mi Ja Hwang ),이아라 ( A Ra Lee ),문진석 ( Mi Yeon Song ),최선미 ( Jin Seok Moon ),송미연 ( Sun Mi Choi ) 한방비만학회 2008 한방비만학회지 Vol.8 No.2

Objectives The aim of the study was to investigate the difference between pattern identification of premenopausal(n=39) and climacteric(n=40) korean obese and overweight women using Syndrome Differentiation Questionaire. Methods 39 premenopausal obese women(BMI≥25kg/m2) and 40 climacteric overweight and obese women(BMI≥23kg/m2) were recruited from October 2007 to March 2008 in Seoul, Korea. Subjects who had other disease were rejected. Basic anthropometry and body composition were measured. Every subjects were given and filled out the Syndrome Differentiation Questionaire, and we analyzed that using Fisher`s exact test. Results 1. Premenopausal women showed high frequency of food accumulation pattern(43.6%), but in climacteric women, liver qi depression pattern was frequent(57.5%, p=0.021). 2. In weighted Syndrome Differentiation Questionaire score, Premenopausal women showed high frequency of food accumulation pattern(43.6%), but in climacteric women, liver qi depression pattern was frequent(47.5%, p=0.004). 3. There were no correlation between anthropometry and scores of the each patterns. Conclusions In this study, we can find out that the dietary factors play major roles in obesity of premenopausal women and emotional factors in obese climacteric women in the view of oriental pattern identification diagnosis. But it seemed that there lacked of consideration that reflected the degree of obesity in this Syndrome Differentiation Questionaire.