Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
권호 표지

Alcohol Consumption, Liver Enzymes, and Prevalence of Metabolic Syndrome in Korean Adult Men

한국 성인 남성에서 음주 및 간효소가 대사증후군의 유병률에 미치는 영향

Nam , Soo-Min;Yu, Ho-Yeol;Lee, Mi-Young;Koh, Jang-Hyun;Shin, Jang-Yel;Shin, Young-Goo;Chung, Choon-Hee
남수민;유호열;이미영;고장현;신장열;신영구;정춘희

  • Published : 20070500
⟨ Previous Next ⟩

Abstract

Background: Metabolic syndrome is associated with an increasing incidence of diabetes and cardiovascular disease. The relationship between the amount of alcohol consumption and the prevalence of metabolic syndrome is controversial. Our study was performed to evaluate the relationship between alcohol consumption and the prevalence of metabolic syndrome in Korean men. Also we examined the correlation of liver markers, including alanine transaminase (ALT) and γ-glutamyl transferase (GGT) with the development of metabolic syndrome.Methods: We enrolled 1,775 Korean men (mean age 40.0 ± 5.8 years) who were undergone health check-ups in our hospital. Each component of metabolic syndrome was measured by using the American Association of Clinical Endocrinologists (AACE) criteria. The subjects were divided into 4 subgroups according to the amount of alcohol consumption; Group 1: no consumption, 2 (mild): those consumed less than 200 g/week, 3 (moderate): those consumed 200~399 g/week, 4 (heavy): those consumed more than 400 g/week. Results: The prevalence of metabolic syndrome was 24.6%. There were significant positive correlations between the amount of alcohol consumption blood pressure, triglyceride, fasting blood glucose, GGT levels and HDL cholesterol levels. But the odds ratios for metabolic syndrome were not significantly increased in subjects with moderate alcohol consumption. The odds ratios for the metabolic syndrome significantly increased in proportion to the increasing levels of ALT and GGT.Conclusion: Although alcohol consumption didn't increase the prevalence of metabolic syndrome, the amount of alcohol consumption had significant positive correlation with components of metabolic syndrome in Korean men, and elevated ALT and GGT levels could strongly associate with the prevalence of metabolic syndrome. (J Kor Diabetes Assoc 31:253~260, 2007)

연구배경: 대사증후군은 당뇨병 및 심혈관질환의 증가와 연관되어 있으며, 음주가 대사증후군에 미치는 영향에 대해서는 논란이 많다. 본 연구에서는 음주와 최근 한국인에게서 증가하는 대사증후군의 유병률에 대한 영향에 대해 조사하고 간표지자 중 ALT, GGT와 대사증후군과의 관계에 대하여 연구하였다. 방법: 2003년 5월부터 2005년 3월까지 연세대학교 원주의과대학 부속 원주기독병원에서 건강검진을 시행한 20세-49세 남자 1,775명을 대상으로 횡단면적 연구를 시행하여 음주와 대사증후군의 관계를 알아보았다. American Association of Clinical Endocrinologists (AACE) criteria에 따라 대사증후군을 정의하였으며 음주량에 따라 대상자를 다음 4 개의 소그룹으로 나누었다. Group 1: 비음주자(0 g/주), Group 2: 소량의 음주자(200 g/주 미만), Group 3: 중등도의 음주자(200-399 g/주), Group 4: 다량의 음주자(400 g/주 이상)결과: 본 연구에서 대사증후군의 유병률은 24.6%이었으며 혈압, 중성지방, 공복 혈당, GGT 수치 및 고밀도지단백 콜레스테롤이 음주량과 의미있는 양의 상관관계를 나타내었고 대사증후군의 각 구성요소들의 교차비 또한 중등도 이상의 음주군에서 통계적으로 유의하게 증가하였으나 대사증후군의 교차비는 중등도의 음주군에서만 의미있게 증가하는 양상을 보였을 뿐 통계적으로 유의한 증가를 보이지 못하였다. 대사증후군의 교차비는 ALT와 GGT에 따라 의미있게 증가하였다.

Keywords

References

  1. Reaven GM: Role of insulin resistance in human disease. Diabetes 37:1595-607, 1988 https://doi.org/10.2337/diabetes.37.12.1595
  2. 이인규: 한국 성인에서의 NCEP-ATP 3 기준을 적용한 대사증후군 유병률과 임상적 특징. 대한내과학회지 68: 350-53, 2005
  3. 정찬희, 박정식, 이원영, 김선우: 한국 성인에서 흡연, 음주, 운동, 교육정도 및가족력이 대사증후군에 미치는 영향. 대한내과학회지 63:649-59, 2002
  4. Liese AD, Mayer-Davis EJ, Tyroler HA, Davis CE, Keil U, Schmidt MI, Brancati FL, Heiss G: Familial components of the multiple metabolic syndrome: the ARIC study. Diabetologia 40:963-70, 1997 https://doi.org/10.1007/s001250050775
  5. Hong Y, Pedersen NL, Brismar K, de Faire U: Genetic and environmental architecture of the features of the insulin-resistance syndrome. Am J Hum Genet 60:143-52, 1997
  6. Yoon YS, Oh SW, Baik HW, Park HS, Kim WY: Alcohol consumption and the metabolic syndrome in Korean adults: the 1998 Korean National Health and Nutrition Examination Survey. Am J Clin Nutr 80:217-24, 2004 https://doi.org/10.1093/ajcn/80.1.217
  7. Santos AC, Ebrahim S, Barros H: Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome. Prev Med 16: [Epub ahead of print], 2007
  8. Gigleux I, Gagnon J, St-Pierre A, Cantin B, Dagenais GR, Meyer F, Despres JP, Lamarche B: Moderate alcohol consumption is more cardioprotective in men with the metabolic syndrome. J Nutr 136:3027-32, 2006
  9. Pannier B, Thomas F, Eschwege E, Bean K, Benetos A, Leocmach Y, Danchin N, Guize L: Cardiovascular risk markers associated with the metabolic syndrome in a large French population: the 'SYMFONIE' study. Diabetes Metab 32:467-74. 2006 https://doi.org/10.1016/S1262-3636(07)70305-1
  10. Facchini F, Chen YD, Reaven GM: Light-to-moderate alcohol intake is associated with enhanced insulin sensitivity. Diabetes Care 17:115-9, 1994 https://doi.org/10.2337/diacare.17.2.115
  11. Gaziano JM, Buring JE, Breslow JL, Goldhaber SZ, Rosner B, VanDenburgh M, Willett W, Hennekens CH: Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 329:1829-34, 1993 https://doi.org/10.1056/NEJM199312163292501
  12. Dyer AR, Stamler J, Paul O, Berkson DM, Shekelle RB, Lepper MH, McKean H, Lindberg HA, Garside D, Tokich T: Alcohol, cardiovascular risk factors and mortality: the Chicago experience. Circulation 64:III 20-7, 1981
  13. Chrysohoou C, Panagiotakos DB, Pitsavos C, Skoumas J, Toutouza M, Papaionnou I, Toutouzas PK, Stefanadis C: Effects of chronic Alcohol consumption on lipid levels, inflammatory and haemostatic factors in the general population: the 'ATTICA' Study. Eur J Cardiovasc Prev Rehabil 10: 355-61, 2003 https://doi.org/10.1097/01.hjr.0000065928.57001.4d
  14. Keil U, Chambless L, Filipiak B, Hartel U: Alcohol and blood pressure and its interaction with smoking and other behavioural variables: results from the MONICA augsburg survey 1984-1985. J Hypertens 9:491-8, 1991 https://doi.org/10.1097/00004872-199106000-00003
  15. 문기원, 임정묵, 배상석, 이기만, 김석형, 채희복, 박선미, 윤세진: 비알코올성 지방간 환자에서 대사증후군의 유병률. 대한간학회지 10:197-206, 2004
  16. Saito T, Misawa K, Kawata S: Fatty liver and non-alcoholic steatohepatitis. Intern Med 46:101-3, 2007 https://doi.org/10.2169/internalmedicine.46.1784
  17. Kang H, Greenson JK, Omo JT, Chao C, Peterman D, Anderson L, Foess-Wood L, Sherbondy MA, Conjeevaram HS: Metabolic syndrome is associated with greater histologic severity, higher carbohydrate, and lower fat diet in patients with NAFLD. Am J Gastroenterol 101:2247-53, 2006 https://doi.org/10.1111/j.1572-0241.2006.00719.x
  18. 이미영, 원찬식, 고장현, 이병준, 이연, 김미진, 신영구, 정춘희: 혈청 감마지티(gamma-glutamyltransferase)와 당뇨병 유병률과의 상관관계. 대한내과학회지 67:498-505, 2004
  19. Lim JS, Yang JH, Chun BY, Kam S, Jacobs DR Jr, Lee DH: Is serum gamma-glutamyltransferase inversely associated with serum antioxidants as a marker of oxidative stress? Free Radic Biol Med 37:1018-23, 2004 https://doi.org/10.1016/j.freeradbiomed.2004.06.032
  20. Lee DH, Ha MH, Kim JH, Christiani DC, Gross MD, Steffes M, Blomhoff R, Jacobs DR: Gamma -glutamyltransferase and diabetes-a 4 year follow-up study. Diabetologia 46:359-64, 2003 https://doi.org/10.1007/s00125-003-1036-5
  21. Lee DH, Steffen LM, Jacobs DR Jr: Association between serum gamma-glutamyltransferase and dietary factors: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Am J Clin Nutr 79:600-5, 2004 https://doi.org/10.1093/ajcn/79.4.600
  22. Miranda PJ, DeFronzo RA, Califf RM, Guyton JR: Metabolic syndrome: definition, pathophysiology, and mechanisms. Am Heart J 149:33-45, 2005 https://doi.org/10.1016/j.ahj.2004.07.013
  23. Groop L, Orho-Melander M: The dysmetabolic syndrome. J Intern Med 250:105-20, 2001 https://doi.org/10.1046/j.1365-2796.2001.00864.x
  24. Alberti KG, Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabetic Med 15:539-53, 1998 https://doi.org/10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S
  25. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 285:2486-97, 2001 https://doi.org/10.1001/jama.285.19.2486
  26. Djousse L, Arnett DK, Eckfeldt JH, Province MA, Singer MR, Ellison RC: Alcohol consumption and metabolic syndrome: does the type of beverage matter? Obes Res 12:1375-85, 2004 https://doi.org/10.1038/oby.2004.174
  27. Tsumura K, Hayashi T, Suematsu C, Endo G, Fujii S, Okada K: Daily alcohol consumption and the risk of type 2 diabetes in Japanese men: the Osaka Health Survey. Diabetes Care 22:1432-7, 1999 https://doi.org/10.2337/diacare.22.9.1432
  28. Lee KS, Park CY, Meng KH, Bush A, Lee SH, Lee WC, Koo JW, Chung CK: The association of cigarette smoking and alcohol consumption with other cardiovascular risk factors in men from Seoul, Korea. Ann Epidemiol 8:31-8, 1998 https://doi.org/10.1016/S1047-2797(97)00113-0
  29. Greenfield JR, Samaras K, Hayward CS, Chisholm DJ, Campbell LV: Beneficial postprandial effect of a small amount of alcohol on diabetes and cardiovascular risk factors:modification by insulin resistance. J Clin Endocrinol Metab 90:661-72, 2005 https://doi.org/10.1210/jc.2004-1511
  30. Rumpler WV, Clevidence BA, Muesing RA, Rhodes DG: Changes in women's plasma lipid and lipoprotein concentrations due to moderate consumption of alcohol areaffected by dietary fat level. J Nutr 129:1713-7, 1999 https://doi.org/10.1093/jn/129.9.1713
  31. LaPorte R, Valvo-Gerard L, Kuller L, Dai W, Bates M, Cresanta J, Williams K, Palkin D: The relationship between alcohol consumption, liver enzymes and high-density lipoprotein cholesterol. Circulation 64:67-72, 1981
  32. Linn S, Carroll M, Johnson C, Fulwood R, Kalsbeek W, Briefel R: High-density lipoprotein cholesterol and alcohol consumption in US white and black adults: data from NHANES II. Am J Public Health 83:811-6, 1993 https://doi.org/10.2105/AJPH.83.6.811
  33. Sillanaukee P, Koivula T, Jokela H, Myllyharju H, Seppa K: Relationship of alcohol consumption to changes in HDL-subfractions. Eur J Clin Invest 23: 486-91. 1993 https://doi.org/10.1111/j.1365-2362.1993.tb00795.x
  34. 김미진, 심명숙, 김문규, 강동구, 박형석, 정상만, 황태선, 신영구, 진춘조, 정춘희: 인슐린비의존형 당뇨병 백서 모델에서 에탄올이 인슐린 분비능에 미치는 영향. 대한당뇨병학회지 26:366-76, 2002
  35. Istvan J, Murray R, Voelker H: The relationship between patterns of alcohol consumption and body weight. Lung Health Study Research Group. Int J Epidemiol 24:543-6, 1995 https://doi.org/10.1093/ije/24.3.543
  36. 이종호, 이현철, 허갑범, 장양수, 김오연, 권석주, 정남식: 남성에서 음주와 흡연이 동맥경화증 위험요소와 항 산화체계에 미치는 영향. 대한내과학회지 56:437-49, 1999
  37. Armellini F, Zamboni M, Frigo L, Mandragona R, Robbi R, Micciolo R, Bosello O: Alcohol consumption, smoking habits and body fat distribution in Italian men and women aged 20-60 years. Eur J Clin Nutr 47:52-60, 1993
  38. Vozarova B, Stefan N, Lindsay RS, Saremi A, Pratley RE, Bogardus C, Tataranni PA: High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes. Diabetes 51:1889-95, 2002 https://doi.org/10.2337/diabetes.51.6.1889
  39. Nannipieri M, Gonzales C, Baldi S, Posadas R, Williams K, Haffner SM, Stern MP, Ferrannini E: Mexico City diabetes study: Liver enzymes, the metabolic syndrome, and incident diabetes: the Mexico City diabetes study. Diabetes Care 28:1757-62, 2005 https://doi.org/10.2337/diacare.28.7.1757