심혈관 질환 합병증이나 당뇨병이 없는 성인에서 인슐린 저항성과 Monocyte Chemoattractant Protein？1과의 연관성 = Relationship between Insulin Resistance and Circulating Levels of Monocyte Chemoattractant Protein-1 in Healthy Adults

다국어 초록 (Multilingual Abstract)

Relationship between Insulin Resistance and Circulating Levels of Monocyte Chemoattractant Protein1 in Healthy AdultsJoo Ho Yoon, M.D., Hee Jeong Choi, M.D., Ph.D., Kyung Sun Yoon, M.D., Sang Hwan Kim, M.D., M.P.H.
Background: Insulin resistance is one of the underlying causes for atherosclerosis. The monocyte chemoattractant protein-1 (MCP-1) plays a crucial role in initiating atherogenesis by recruiting monocytes/macrophages to vessel wall. In this study, we investigated the relationship between homeostasis model assessment-estimated insulin resistance (HOMA-IR) and circulating level of MCP-1 in healthy adults.
Methods: By reviewing the medical records of 171 healthy adults, we determined the circulating level of MCP-1, body mass index, systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, LDL- cholesterol, HDL-cholesterol, fasting glucose, fasting insulin level and HOMA-IR. We studied the relationship between the variables by Pearson correlation coefficients and multiple linear regression analysis.
Results: MCP-1 correlated positively with HOMA-IR (r=0.28; P＜0.01). Age, systolic blood pressure, diastolic blood pressure, triglycerides, LDL-cholesterol, fasting glucose and insulin level also showed stastically significant correlation. Age, gender, HOMA-IR were the variables which affected MCP-1 by multiple regression analysis adjusting for body mass index, systolic blood pressure, triglycerides, and LDL-cholesterol.
Conclusion: In our study, circulating levels of MCP-1 were associated with insulin resistance. These findings support the potential role of MCP-1 as a biomarker for subclinical atherosclerosis. (J Korean Acad Fam Med 2008;29:189-194)

국문 초록 (Abstract)

연구배경: 인슐린저항성이 초래하는 죽상경화증은 심혈관 질환의 합병증을 유발하는 주요 요인이다. 또한 죽종 형성은 만성 염증에 의해 유발되며, 이러한 과정의 초기에 monocyte chemoattractant protein-1 (MCP-1)이 중요한 역할을 하는 것으로 알려져 있다. 이 연구는 심혈관 질환의 합병증이나 당뇨병이 없는 성인을 대상으로 인슐린저항성과 MCP-1의 연관성에 대해 알아보고자 하였다.
방법: 이 연구는 2006년 4월부터 2006년 11월까지 건강검진을 위해 일개 병원을 방문한 성인 남녀 중 당뇨병이나 심근경색, 관상동맥질환, 뇌졸중의 병력이 있는 사람을 제외한 171명을 대상으로 하였다. 대상자들의 공복혈당과 공복인슐린을 측정하여 homeostasis model assessment-estimated insulin resistance (HOMA-IR)을 계산한 후, HOMA-IR을 삼분위로 나누어 이들 군 간에 MCP-1 측정치에 차이가 있는지를 알아보았다. 또한 MCP-1과 나이, 체질량지수, 수축기혈압, 이완기혈압, 중성지방, 총콜레스테롤, LDL 콜레스테롤, HDL 콜레스테롤, 공복 혈당, 공복 인슐린, HOMA-IR 등과의 상관관계를 살펴보고, 이를 토대로 MCP-1과 관련이 있는 변수를 찾기 위해 다중회귀분석을 하였다.
결과: MCP-1은 HOMA-IR과 양의 상관관계를 보였으며(r=0.28; P＜0.01), HOMA-IR이 상위 삼분위 군으로 갈수록 MCP-1의 평균 측정치는 유의하게 높았다(Ptrend＜0.01). MCP-1은 나이, 수축기혈압, 이완기혈압, 중성지방, 공복 혈당 및 인슐린 등과 양의 상관관계를 보였으며, 다중회귀분석에서는 HOMA-IR과 나이, 성별만이 MCP-1 측정치에 영향을 줄 수 있는 독립적인 요인으로 나타났다.
결론: 당뇨병이나 심혈관 질환이 없는 성인에서 인슐린 저항성은 죽상경화증 발생 초기에 중요한 역할을 하는 MCP-1의 혈중 농도와 관련되어 있다.

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