Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
권호 표지
DOI QR코드

DOI QR Code

Health Behavior and Metabolic Syndrome

건강행위실천과 대사증후군

Oh, Jeong-Dae;Lee, Sang-Yeoup;Lee, Jeong-Gyu;Kim, Young-Joo;Kim, Yun-Jin;Cho, Byung-Mann
오정대;이상엽;이정규;김영주;김윤진;조병만

  • Published : 20090200
⟨ Previous Next ⟩

Abstract

Background: Life style has been shown to improve risk factors comprising the metabolic syndrome. Metabolic syndrome is a prime candidate for lifestyle modification utilizing the tools of exercise, nutritional therapy and so on. Therefore, we examined the prevalence of metabolic syndrome according to health behaviors. Methods: A total of 1,240 adults were recruited into this cross-sectional study. The subjects were examined on body mass index, waist circumference, blood pressure, and lipid profile. Medical history was reviewed and daily calorie intake was examined by food frequency questionnaire. Six healthy behaviors, sleeping hours, smoking, drinking, exercise, calorie intake and body weight of subjects, were examined. Each healthy behaviors were categorized into three groups. Metabolic syndrome as diagnosed by ATP III criteria. Results: The study subjects consisted of 57.1% men and 42.9% women. The prevalence of metabolic syndrome was 14.3%. The prevalence of metabolic syndrome was lower in the group with good healthy behaviors. The subjects with more good healthy behaviors had a lower prevalence of metabolic syndrome than those with less good healthy behaviors (0, 50.0%; 1, 41.0%; 2, 30.6%; 3, 13.8%; 4, 8.5%; 5, 5.3%; and 6, 4.3%). Relative to the subjects with high good health behavior score, those with low good health behavior score were at significantly increased risk of metabolic syndrome (odds ratio = 4.25, 95% CI 2.97-6.08). Conclusion: The subjects with much more good healthy behaviors had a substantially lower risk of being diagnosed with the metabolic syndrome compared to those with lesser good healthy behaviors. This finding suggests that lifestyle modification may be appropriate as the first-line intervention to metabolic syndrome.

연구배경: 대사증후군의 예방 및 치료에 생활습관 교정이 강조되고 있다. 이에 건강행위 실천 개수에 따른 대사증후군의 유병률 차이를 알아보았다. 방법: 2006년 1월부터 2006년 12월까지 일개 대학병원 건강증진센터를 방문한 수진자 중 20세 이상의 성인 1,240명을 최종 연구대상으로 하였다. 대사증후군의 진단기준은 modified AT III 정의를 사용하였고, 그 중 허리둘레 기준은 한국인의 기준에 따랐다. 생활습관은 수면시간, 흡연상태, 음주습관, 운동, 열량섭취, 체중의 6항목으로 설정하였다. 수면시간은 6시간 이하, 7-8시간, 9시간 이상으로, 흡연상태는 비흡연군, 과거 흡연군, 현재 흡연군으로, 음주는 비음주군, 적절음주군, 과음군으로, 운동은 하루 30분 이상씩 일주일에 3일 이상 규칙적으로 운동하는 군, 그 이하의 운동을 하는 군, 비운동군으로, 열량섭취는 권장열량 이하를 섭취하는 군, 권장열량보다 10% 이하를 초과 섭취하는군, 권장열량보다 10%를 초과하여 과잉 섭취하는 군으로, 체중은 정상 체중군, 과체중군, 비만군으로 건강행위 항목을 각각 3개의 그룹으로 분류하여 대사증후군의 유병률을 비교하였다. 결과: 비흡연군, 적절음주군 및 비음주군, 규칙적인 운동을 하는 군, 권장열량 이하를 섭취하는 군 및 비비만군에서 대사증후군의 유병률이 유의하게 낮았다. 건강행위 실천개수가 증가할수록 대사증후군의 유병률이 감소하였다(0개 50.0%, 1개 41.0%, 2개 30.6%, 3개 13.8%, 4개 8.5%, 5개 5.3% 및 6개 4.3%). 남자, 여자 및 전체에서 건강행위가 3개 이하인 군에 비해 건강행위가 4개 이상인 군에서 대사증후군을 가질 교차비는 각각 3.70 (95% 신뢰구간; 2.31-5.92), 3.54 (95% 신뢰구간; 1.91-6.59) 및 4.25 (95% 신뢰구간; 2.97-6.08)이었다. 결론: 평균 이상의 건강행위를 실천하는 군이 그렇지 않은 군에 비해 대사증후군의 유병률이 유의하게 낮았다.

Keywords

References

  1. Isomaa B, Almgren P, Tuomi T, Forse$\'{a}$n B, Lahti K, Nisse$\'{a}$n M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683-9 https://doi.org/10.2337/diacare.24.4.683
  2. Haner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes 1992; 41: 715-22 https://doi.org/10.2337/diabetes.41.6.715
  3. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-607 https://doi.org/10.2337/diabetes.37.12.1595
  4. DeFronzo RA, Ferrannini E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14: 173-94 https://doi.org/10.2337/diacare.14.3.173
  5. 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. Diabet Med 1998; 15: 539-53 https://doi.org/10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S
  6. 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 2001; 285: 2486-97 https://doi.org/10.1001/jama.285.19.2486
  7. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: ndings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356-9 https://doi.org/10.1001/jama.287.3.356
  8. Yamamoto A, Temba H, Horibe H, Mabuchi H, Saito Y, Matsuzawa Y, et al. Life style and cardiovascular risk factors in the Japanese population-from an epidemiological survey on serum lipid levels in Japan 1990 part 1: influence of life style and excess body weight on HDL-cholesterol and other lipid parameters in men. J Atheroscler Thromb 2003; 10: 165-75 https://doi.org/10.5551/jat.10.165
  9. Kim SW, Kim JY, Kim ES, Kim YI, Lee MS, Kim HH, et al. Prevalence of insulin resistance syndrome in subjects living in Jungup District, Korea. J Korean Diabetes Assoc 1999; 23: 70-8
  10. Kim BS. Prevalence of metabolic syndrome for Koreans: among the clients of comprehensive medical examination center in one university hospital. Korean J Health Promot Dis Prev 2001; 2: 17-26
  11. Lym YL, Hwang SW, Shim HJ, Oh EH, Chang YS, Cho BL. Prevalence and risk factors of the metabolic syndrome as dened by NCEP-ATP III. J Korean Acad Fam Med 2003; 24: 135-43
  12. Facchini FS, Hollenbeck CB, Jeppesen J, Chen YD, Reaven GM. Insulin resistance and cigarette smoking. Lancet 1992; 339: 1128-30 https://doi.org/10.1016/0140-6736(92)90730-Q
  13. Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K. Alcohol and coronary heart disease: a meta-analysis. Addiction 2000; 95: 1505-23 https://doi.org/10.1046/j.1360-0443.2000.951015056.x
  14. Shaper AG, Wannamethee SG. Alcohol intake and mortality in middle aged men with diagnosed coronary heart disease. Heart 2000; 83: 394-9 https://doi.org/10.1136/heart.83.4.394
  15. Jennings G, Nelson L, Nestel P, Esler M, Korner P, Burton D, et al. The effects of changes in physical activity on major cardiovascular risk factors, hemodynamics, sympathetic function, and glucose utilization in man: a controlled study of four levels of activity. Circulation 1986; 73: 30-40 https://doi.org/10.1161/01.CIR.73.1.30
  16. Weinstock RS, Dai H, Wadden TA. Diet and exercise in the treatment of obesity: effects of 3 interventions on insulin resistance. Arch Intern Med 1998; 158 :2477-83 https://doi.org/10.1001/archinte.158.22.2477
  17. Lim YT, Park YW, Kim CH, Shin HC, Kim JW. Effect of weight loss on health-related quality of life in obese patients. J Korean Acad Fam Med 2001; 22: 556-64
  18. Yaggi HK, Araujo AB, McKinlay JB. Sleep duration as a risk factor for the development of type 2 diabetes. Diabetes Care 2006; 29: 657-61 https://doi.org/10.2337/diacare.29.03.06.dc05-0879
  19. US Department of Agriculture. The report of the dietary guidelines advisory committee on dietary guidelines for Americans, 2005. Washington: US Department of Agriculture; 2005
  20. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Geneva: World Health Organization; 2000
  21. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52 https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  22. Lee S. Is new criteria of metabolic syndrome applicable in Korean? Korean J Obes 2005; 14 suppl.3: 3-8
  23. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, et al. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 2007; 75: 72-80 https://doi.org/10.1016/j.diabres.2006.04.013
  24. Schoenborn CA. Health habits of U.S. adults, 1985: the 'Alameda 7' revisited. Public Health Rep 1986; 101: 571-80
  25. Belloc NB, Breslow L. Relationship of physical health status and health practices. Prev Med 1972; 1: 409-21 https://doi.org/10.1016/0091-7435(72)90014-X
  26. Breslow L, Enstrom JE. Persistence of health habits and their relationship to mortality. Prev Med 1980; 9: 469-83 https://doi.org/10.1016/0091-7435(80)90042-0
  27. Cundiff DK. Diet and tobacco use: analysis of data from the diabetic control and complications trial, a randomized study. MedGenMed 2002; 4: 2
  28. Kim SM, Lee DJ, Cho NH. A cross-sectional study of association among smoking, alcohol drinking, and obese indices in men. Korean J Obes 1998; 7: 332-41
  29. Kim JH, Kim HY, Song CH, Lee KM, Jeung SP. The eects of cigarette smoking on abdominal fatness. J Korean Acad Fam Med 2000; 21: 1172-9
  30. Choi EY, Im YS, Kim KN, Park CY, Kim HJ, Cho BL, et al. Alcohol habits in Korea. J Korean Acad Fam Med 1998; 19: 858-69
  31. Hong WK, Kim JS, Jung JG, Kim SS, Park CI, Kim KB, et al. Alcohol and the metabolic syndrome in Korean women. J Korean Acad Fam Med 2007; 28: 120-6
  32. Peltonen P, Marniemi J, Hietanen E, Vuori I, Ehnholm C. Changes in serum lipids, lipoproteins, and heparin releasable lipolytic enzymes during moderate physical training in man: a longitudinal study. Metabolism 1981; 30: 518-26 https://doi.org/10.1016/0026-0495(81)90190-6
  33. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997; 20: 537-44 https://doi.org/10.2337/diacare.20.4.537
  34. Tuomilehto J, Lindstro$\"{o}$m J, Eriksson JG, Valle TT, Ha$\"{a}$ma$\"{a}$la$\"{a}$inen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343-50 https://doi.org/10.1056/NEJM200105033441801
  35. Bulwer BE. Sedentary lifestyles, physical activity, and cardiovascular disease: from research to practice. Crit Pathw Cardiol 2004; 3: 184-93
  36. Centers for Disease Control (CDC). Coronary heart disease attributable to sedentary lifestyle: selected states, 1988. MMWR Morb Mortal Wkly Rep 1990; 39: 541-4
  37. Muzio F, Mondazzi L, Sommariva D, Branchi A. Long-term effects of low-calorie diet on the metabolic syndrome in obese nondiabetic patients. Diabetes Care 2005; 28: 1485-6 https://doi.org/10.2337/diacare.28.6.1485
  38. Park YW, Kim CH, Shin HC. Is the cut-off value of body mass index (BMI) appropriate for identifying obesity in Korea? Korean J Health Promot Dis Prev 2002; 2: 10-6

Cited by

  1. 한 전자제품 연구소 남자 종사자들의 생활습관실천과 대사증후군의 관련성 vol.42, pp.5, 2009, https://doi.org/10.3961/jpmph.2009.42.5.331
  2. 흡연, 음주와 운동습관의 군집현상을 통한 건강행태의 고위험군: 국민건강영양 조사 vol.43, pp.1, 2009, https://doi.org/10.3961/jpmph.2010.43.1.73
  3. The Association between Helicobacter Pylori Infection and Metabolic Syndrome in Korean Men and Women vol.31, pp.2, 2010, https://doi.org/10.4082/kjfm.2010.31.2.124
  4. 주간근로자의 건강증진 실천행위와 대사증후군과의 관계 vol.8, pp.12, 2009, https://doi.org/10.13067/jkiecs.2013.8.11.1941
  5. 근로자들의 대사증후군과 건강위험 요인과의 관련성 연구 vol.26, pp.4, 2009, https://doi.org/10.9799/ksfan.2013.26.4.975
  6. Relationship between Physical Activity Level, Amount of Alcohol Consumption and Metabolic Syndrome in Korean Male Drinkers vol.32, pp.2, 2014, https://doi.org/10.5763/kjsm.2014.32.2.97
  7. 건강증진병원에서 실시된 당뇨병 및 심혈관질환 위험군 대상 생활습관개선 프로그램의 질병예방 효과 vol.32, pp.4, 2009, https://doi.org/10.14367/kjhep.2015.32.4.37
  8. 건강행위 이행율에 따른 대사증후군 발생 위험요인 변화 vol.28, pp.3, 2009, https://doi.org/10.7465/jkdi.2017.28.3.559
  9. 중년 여성의 식생활 중심 건강상태 판정 도구의 현장 적용 및 평가 vol.23, pp.4, 2009, https://doi.org/10.5720/kjcn.2018.23.4.277
  10. Infuence of Metabolic Syndrome on Hearing Outcome in Sudden Sensorineural Hearing Loss vol.61, pp.10, 2009, https://doi.org/10.3342/kjorl-hns.2017.00983
  11. Analysis of the association between health-related and work-related factors among workers and metabolic syndrome using data from the Korean National Health and Nutrition Examination Survey (2016) vol.13, pp.5, 2009, https://doi.org/10.4162/nrp.2019.13.5.444
  12. Fruit Intake to Prevent and Control Hypertension and Diabetes vol.42, pp.1, 2009, https://doi.org/10.4082/kjfm.20.0225