한국 성인의 체성분과 동맥경직도의 상관관계 = Relationship between Body Composition and Arterial Stiffness in Korean Adults

국문 초록 (Abstract)

연구배경: 한국 성인을 대상으로 근감소증 및 근감소성비만이 동맥경화에 미치는 영향을 확인하고자 본 연구를 수행하였다.
방법: 2019년 7월부터 2020년 12월까지 건강검진을 목적으로 일개 대학병원 건강증진센터에 내원한 수검자 7,177명을 대상으로 하였다. 연구 대상자들의 ASM 및 VFA을 체성분 분석기로 측정한 후 남녀 각각 ASMI와 VFA에 따라 정상(normal), 근감소(sarcopenia), 비만(obesity) 및 근감소성비만(sarcopenic obesity)으로 나누어 집단 간의 동맥경화도 차이를 알아보기 위하여 baPWV를 측정하여 분산분석(ANOVA)을 하였다. 나이, 흡연, 운동 유무 및 질환으로 보정하기 위해 공분산분석(ANCOVA)을 하였다. 체성분지표와 baPWV의 관계는 Pearson 상관계수를 구하여 분석하였다.
결과: 남녀 모두에서 네 집단 간 평균 baPWV는 유의한 차이를 보였으며(P<0.05) 근감소성비만군의 baPWV값이 유의하게 높았다(P<0.05). 남성에서 근감소성비만군의 baPWV는 나이, 흡연 상태, 운동 유무, 고혈압, 당뇨병, 고지혈증 등의 질환으로 보정한 후에 1,487.2 cm/s로 가장 높았다(P<0.05). 여성에서 나이로 보정한 후 baPWV값을 비교하면 비만군의 baPWV가 1,293.1 cm/s로 근감소성비만군의 baPWV (1,279.6 cm/s)보다 높았다. 생활 습관 및 질환으로 보정 후에도 그 경향성이 유지된다.
결론: 본 연구는 심혈관질환의 위험인자로 알려진 근감소성비만과 baPWV의 증가가 독립적인 상호 연관성이 있음을 보여주었고 임상에서 비침습적인 방법으로 근감소성비만을 진단하고 생활습관교육에 적극 활용할 수 있는 계기를 마련하였다. 향후 근감소증 및 근감소성비만이 건강에 미치는 영향에 대한 추가적 연구가 더 필요할 것으로 생각된다.

다국어 초록 (Multilingual Abstract)

Background: This study is aimed to evaluate the relationship between sarcopenic obesity and atherosclerosis in Korean adults.
Methods: We studied 7,177 participants who visited the health promotion center of a university hospital between July 2019 and December 2020. Weassessed the brachial-ankle pulse wave velocity (baPWV) to analyze the relationships between skeletal muscle mass index and visceral fat area toatherosclerosis and atherosclerotic risk factors. The participants were divided into four groups according to appendicular skeletal mass index (ASMI)and visceral fat area (VFA): normal, sarcopenia, obesity, and sarcopenic obesity. The baPWV values were compared among the male and femaleseparately using analysis of variance. Analysis of covariance was performed to correct for age, smoking, exercise status, and disease. The relationshipbetween body composition index and baPWV was analyzed using Pearson correlation coefficient.
Results: The mean baPWV of the four groups were significantly different for male and female (P<0.05), and the sarcopenic obesity group had asignificantly higher baPWV (P<0.05). Among the male, the baPWV of the sarcopenic obesity group (1,487.2 cm/s) was highest after the adjustmentfor age, smoking status, exercise status, hypertension, diabetes, and hyperlipidemia (P<0.05). In female however, after the adjustment for age, thebaPWV of the obesity group was 1,293.1 cm/s, higher than that of the sarcopenic obesity group (1,279.6 cm/s). The tendency was maintained afterthe adjustment for lifestyle and disease.
Conclusion: This study showed that sarcopenic obesity, a known risk factor for cardiovascular disease, and increased baPWV were independentlycorrelated. Further studies are required to evaluate the effect of increased muscle mass on the prevention of atherosclerosis or cardiovascular events.
Finally, we suggest using a bioimpedance method to diagnose sarcopenic obesity in the primary care setting.

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