The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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The impact of metabolic syndrome and its components on pulse wave velocity

대사증후군 및 그 구성요소가 맥파속도에 미치는 영향

Kim, Young-Kwon
김영권

  • Published : 20050200
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Abstract

Background : Pulse wave velocity (PWV) reflects arterial stiffness and may represent an integrated index of vascular status and cardiovascular disease (CVD) risk. Although the individual components of the metabolic syndrome (MS) are well established cardiovascular risk factors, the impact of the MS and its components on PWV has not been well defined. Methods : With an automatic wave form analyzer, heart-femoral (hf) and brachial-ankle (ba) PWVs were measured simultaneously in 364 subjects (age, 44.8$\pm$9.3 years). None of the subjects had clinical CVD except hypertension, diabetes and systemic disease. The associations between PWVs and the features of the MS -individual and clustered- were analyzed. Results : In univariate analysis, the individual components of the MS except a low HDL- cholesterol level were associated with increased hfPWV and baPWV. Hypercholesterolemia was also associated with increased both PWVs. A low HDL-cholesterol level was associated with increased baPWV. However, in multivariate analysis, none of the components of the MS except elevated blood pressure (BP) was the independent factor affecting hfPWV and baPWV. After controlling for age and gender, hfPWV and baPWV were increased according to the number of the components of the MS (p<0.001 for both). After controlling for age, gender and BP, the MS was associated with increased baPWV (p<0.05). Conclusion : The clustering of the components of the MS may interact to synergistically impact arterial stiffness, even though the individual components except elevated BP do not affect arterial stiffness independently.

목적 : 대사증후군을 구성하는 각각의 요소는 심혈관 질환의 위험인자이다. 동맥의 경직도를 반영하는 맥파속도는 심혈관 질환의 독립된 위험예측인자이다. 따라서 본 연구는 대사증후군 및 그 구성요소들이 맥파속도에 어떠한 영향을 미치는지 평가하고자 하였다. 방법 : 30-70대 연령군의 건강 검진자 및 외래 방문자에서 고혈압 이외의 임상적 심혈관 질환, 당뇨병, 전신 질환이 없는 364명(남:여=221:143, 연령 44.8$\pm$9.3세)을 대상으로 하였다. 자동파형분석기(automatic waveform analyzer: VP-2000, Colin Co, Komaki, Japan)로 hfPWV, baPWV를 측정하였다. 연령, 성별, 대사증후군의 구성요소(비만, 고중성지방혈증, 저고밀도지단백콜레스테롤혈증, 혈압 상승, 공복 혈당 이상), 고콜레스테롤혈증, 흡연 등 맥파속도에 영향을 미칠 수 있는 인자와 hfPWV, baPWV와의 관련성을 평가하였다. 결과 : 1) 단변량 분석에서 저고밀도지단백콜레스테롤혈증 유무에 따른 hfPWV는 차이가 없었으며, 흡연 유무에 따른 hfPWV와 baPWV는 차이가 없었다. 이외의 위험인자는 모두 hfPWV와 baPWV의 증가와 관련이 있었다. 2) 다변량 분석에서 대사증후군의 구성요소 중 혈압 상승을 제외한 다른 요소들은 모두 hfPWV 및 baPWV에 독립적 영향을 미치지 않았다. 3) 대사증후군의 구성요소의 보유 개수가 증가함에 따라 hfPWV와 baPWV는 모두 증가하였으며, 이는 연령, 성별을 보정한 상태에서 통계적으로 유의하였다. 4) 대사증후군은 연령, 혈압, 성별을 보정한 상태에서 hfPWV 증가와는 관련이 없었으며, baPWV 증가와는 유의한 관련이 있었다. 결론 : 대사증후군의 각 구성요소는 혈압 상승을 제외하고는 맥파속도에 독립적으로는 영향을 미치지 않는다. 그러나 군집성으로 존재하는 상태(대사증후군)에서는 각 요소가 상승 작용을 하며, 연령, 혈압, 성별의 영향을 고려하더라도 독립적으로 맥파속도를 증가시킬 수 있다.

Keywords

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