The Prevalence of Obesity and Metabolic Abnormalities in Korean Pediatric Population

한국 소아 청소년에서 비만 및 대사 이상의 유병률

  • Nho, Han-Nae (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Kim, Cu-Rie (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Uhm, Ji-Hyun (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Kim, Jeong-Tae (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Jin, Sun-Mi (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Seo, Ji-Young (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Hahn, Hye-Won (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Park, Hwa-Young (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Yoon, Hye-Sun (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Ahn, Young-Min (Department of Pediatrics, College of Medicine, Eulji University) ;
  • Shon, Keun-Chan (Department of Pediatrics, College of Medicine, Eulji University)
  • 노한내 (을지대학교 의과대학 소아청소년과학교실) ;
  • 김규리 (을지대학교 의과대학 소아청소년과학교실) ;
  • 엄지현 (을지대학교 의과대학 소아청소년과학교실) ;
  • 김정태 (을지대학교 의과대학 소아청소년과학교실) ;
  • 진선미 (을지대학교 의과대학 소아청소년과학교실) ;
  • 서지영 (을지대학교 의과대학 소아청소년과학교실) ;
  • 한혜원 (을지대학교 의과대학 소아청소년과학교실) ;
  • 박화영 (을지대학교 의과대학 소아청소년과학교실) ;
  • 윤혜선 (을지대학교 의과대학 소아청소년과학교실) ;
  • 안영민 (을지대학교 의과대학 소아청소년과학교실) ;
  • 손근찬 (을지대학교 의과대학 소아청소년과학교실)
  • Received : 2009.07.29
  • Accepted : 2009.09.03
  • Published : 2009.09.30

Abstract

Purpose: Childhood obesity can be complicated by hypertension, hyperlipidemia, non-alcoholic fatty liver disease, and diabetes mellitus. The aim of this study was to evaluate the prevalence of obesity and metabolic complications of children and adolescents based on the degree of obesity. Methods: We analyzed the records of 8,880 students who received student health examinations between May 2006 and October 2008 at the Eulji General Hospital. The prevalence of obesity was evaluated by the body mass index and obesity index. A total of 1,076 obese students had blood tests. We analyzed aspartate aminotransferase (AST), alanine aminotransferase (ALT), fasting glucose, total cholesterol, and blood pressure according to the degree of obesity. Results: According to the body mass index, the overall prevalence of obesity was 7.2% (7.8% of male and 6.5% of female students). Based on the obesity index, 12.3% of students (mild: 6.3%, moderate: 5.0%, and severe: 1.0%) were obese. The prevalence of hypercholesterolemia, ALT elevation, and hypertension were increased as a function of the degree of obesity (p<0.05), but hyperglycemia showed no significant differences (p=0.298). The overall prevalence of ALT elevation was 17.7% (mild obese group, 10.4%; moderate obese group, 20.5%; and severe obese group, 46.8%). The prevalence of hypercholesterolemia, hypertension, and hyperglycemia were significantly higher in the elevated ALT group (24.7%, 42.6%, and 5.2%, respectively) compared to the normal ALT group (11.1%, 29.8%, and 2.0%, respectively; p<0.05). Conclusion: Hypercholesterolemia, liver function test abnormalities, and hypertension were associated with the degree of obesity. We should focus our attention on managing obese children and adolescents to prevent metabolic complications.

목 적: 식생활의 서구화와 운동량의 감소로 우리 나라에서 소아 비만은 증가하고 있는 추세이며 비만아에서는 고혈압, 이상 지질 혈증, 비알코올성 지방간 및 당뇨 등의 합병증이 발생할 수 있다. 이에 저자들은 비만의 유병률 및 비만아에서 동반되는 대사 이상의 유병률을 알아보고 비만의 정도에 따른 대사 이상의 유병률 변화에 대하여 비교해 보고자 하였다. 방 법: 2006년 5월부터 2008년 10월까지 노원 을지병원에서 학생 건강 검진을 받은 8,880명의 초 중 고등학생의 기록을 분석하였다. 비만의 유병률은 체질량 지수와 비만도로 측정하였으며 비만 및 과체중인 소아 청소년 각각 588명과 488명을 대상으로 AST 수치, ALT 수치, 공복 혈당, 총콜레스테롤을 검사하였다. 각 검사 항목별의 유병률과 비만의 정도에 따른 유병률 변화에 대하여 t-test, ANOVA test, chi-square test를 이용하여 분석하였으며 p-value 0.05 미만을 유의한 것으로 판정하였다. 결 과: 체질량 지수에 의해서 비만의 유병률은 7.2% 이었으며 남아 7.8%, 여아 6.5%가 비만이었고 과체중의 유병률은 25.0%로 남녀 각각 28.8%, 21.0%였다. 비만도에 의해서는 12.3%의 소아 청소년이 비만이었으며 경도 비만 6.3%, 중등도 비만 5.0%, 고도 비만 1.0% 이었고 남아와 여아 각각 15.0%, 9.4%가 비만하였다. 고콜레스테롤혈증, AST 수치 상승, ALT 수치 상승, 고혈압의 유병률은 비만의 정도가 증가함에 따라 높아졌으나(p<0.05) 공복 혈당 상승은 통계적으로 유의하지 않았다. ALT 수치 상승의 유병률은 17.7%로 ALT 정상군보다 ALT 상승군에서 고콜레스테롤혈증(24.7%, 19.1%), 고혈압(11.0%, 9.9%), 공복 혈당 상승(2.0%, 5.2%)의 유병률이 높았다(p<0.05). 결 론: 소아 비만의 상당수에서 대사 이상이 동반되며 이로 인하여 성인에서처럼 제2형 당뇨, 심혈관계 질환이 발생할 위험이 증가하게 된다. 본 연구에서는 비만아에서 비만의 정도가 증가할수록 고콜레스테롤혈증, 간 효소치 상승, 고혈압의 유병률이 증가하였으며 소아 비만이 성인 비만으로 이행할 확률이 높음을 생각하면 소아 청소년 시기에 비만을 조기 발견하여 치료, 관리하는데 역점을 두어야 하겠다.

Keywords

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