The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Insulin resistance can predict the risk of metabolic syndrome

대사증후군의 위험예측인자로서 인슐린저항성

Lee, Si-Hoon;Kang, Eun-Seok;Lee, Kwang-Eun;Jin, He-Dong;Choi, Seung-Hee;Kim, Dae-Jung;Ahn, Chul-Woo;Cha, Bong-Soo;Lim, Sung-Kil;Lee, Hyun-Chul;Huh, Kap-Bum
이시훈;강은석;이광은;김하동;최성희;김대중;안철우;차봉수;임승길;이현철;허갑범

  • Published : 20020000
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Abstract

Background : This study was initiated to evaluate the prevalence of metabolic syndrome and its components as risk factors for cardiovascular disease according to insulin resistance in the Korean adult population. Methods : This study was conducted as a branch of the Korean Metabolic Syndrome (KMS) Study: 1,091 individuals aged 30-79 years participating in medical check-up in Korea Association of Health (KAH) were included in this study. We checked fasting blood sugar, fasting insulin, proinsulin, lipid profiles (total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol), body mass index, waist circumference, blood pressure, carotid intima-media thickness (IMT) and abdominal ultrasonography. We divided all of the examinees into three groups (insulin sensitive, intermediate, resistant tertiles) according to their degree of insulin resistance and correlated this with the prevalence of metabolic syndrome. Results : The relative risk of metabolic syndrome was 84.1-fold higher in the insulin resistant tertile group compared to the insulin sensitive tertile group. Diabetes mellitus or impaired fasting glucose (IFG) was 10.2-fold; hypertension, 1.8-fold; dyslipidemia, 2.8-fold; hypercholesterolemia, 2.5-fold; fatty liver, 3.0-fold. Abdominal obesity rather than general obesity was more contributory to insulin resistance. Conclusion : Although this is a cross-sectional study, we can show that insulin resistance is one of the most-striking risk factors in metabolic syndrome and can be used as a predictor of cardiovascular diseases. Furthermore, we should monitor the healthy insulin-resistant population to prevent ongoing cardiovascular diseases. More prolonged data should be gained to refine the correlations of insulin resistance to metabolic syndrome.

목적 : 본 연구는 한국인 성인에서 인슐린저항성에 따른 대사증후군과 그 구성요소들의 유병률을 분석하기 위하여 수행하였다. 대상 및 방법 : 한국건강관리협회에서 건강검진을 받은 30세 이상 성인 남녀 1,091명을 무작위로 추출하여 혈당, 혈청 인슐린, 총콜레스테롤, HDL-콜레스테롤, 중성지방, 체질량지수, 허리둘레, 혈압, 경동맥 내막중막두께 및 복부초음파를 시행하였고, 대상군을 인슐린저항성 정도에 따라 인슐린감수성군, 중간군, 인슐린저항성군으로 삼등분하여 그들의 임상 및 검사결과에 따라 대사증후군의 발병률을 분석하였다. 결과 : 인슐린감수성군과 비교할 때, 인슐린저항성군에서 대사증후군의 상대위험도는 84.1배 증가하였고, 당뇨병 및 내당능장애는 10.2배, 고혈압은 1.8배, 이상지혈증은 2.8배, 고콜레스테롤혈증은 2.5배, 지방간은 3배 증가하였고, 전신성비만보다 복부비만이 인슐린저항성에 더 기여하는 것으로 나타났다. 결론 : 본 연구는 단면적으로 수행되었으나, 인슐린저항성이 대사증후군의 중요한 위험인자이고, 심장혈관질환을 비롯한 성인병의 예측인자로써 큰 의미가 있음을 시사한다. 따라서 성인병의 예방을 위해서 앞으로는 건강검진에 인슐린저항성을 평가하는 항목을 도입할 것을 권장한다.

Keywords

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