Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
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Trend of Prevalence of Low HDL-Cholesterol and Related Factors in Korean Men: Using 3 Korean National Health and Nutrition Examination Survey Data (1998-2005)

한국 남성에서 낮은 HDL-콜레스테롤혈증 유병률 및 그 관련요인 추세: 1998년에서 2005년까지 3개의 국민건강영양조사를 자료를 이용하여

  • Kim, Chang-Hee (Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lim, Su-Min (Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Hye-Soon (Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 김창희 (울산대학교 의과대학 서울아산병원 가정의학교실) ;
  • 임수민 (울산대학교 의과대학 서울아산병원 가정의학교실) ;
  • 박혜순 (울산대학교 의과대학 서울아산병원 가정의학교실)
  • Received : 2009.08.31
  • Accepted : 2010.10.05
  • Published : 2010.10.20
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Abstract

Background: Low high density lipoprotein-cholesterol (HDL-C) is one of the major risk factors for coronary heart disease. Using data from the Korean National Health and Nutrition Examination Survey (KNHANES), we assessed trend of the prevalence of low HDL-C and the factors which are associated with low HDL-C in Korean men. Methods: We analyzed three serial KNHANES data which were conducted in year 1998, 2001, and 2005. Among all survey participants, we included men aged 30-79 years with laboratory data. Low HDL-C was defined by serum HDL-C < 40 mg.dL. We used multiple logistic regression analysis to assess the association between low HDL-C and related factors. We investigated trend of the prevalence of low HDL-C and associated factors among Korean men. Results: The prevalence of low HDL-C in Korean men was increasing from 26.3% (1998) to 38.8% (2001) and 45.9% (2005). Low HDL-C was associated with non-alcohol drinker, current smoking, sedentary physical activity, obesity and hypertriglyceridemia. The prevalence of current smoking decreased linearly. The prevalence of sedentary physical activity and hypertriglyceridemia increased from year 1998 to year 2001, but decreased from year 2001 to year 2005. However, the prevalence of non-alcohol drinker and obesity increased continuously. The patterns of the increasing prevalence of low HDL-C were compatible to the increasing prevalence of obesity according to age in Korean men. Conclusion: From year 1998 to year 2005, the prevalence of low HDL-C in Korean men has increased. Obesity and non-alcohol drinking might be contributing factors of increasing prevalence of low HDL-C in Korean men. Management of obesity is needed to prevent increasing the prevalence of low HDL-C among Korean men.

연구배경: 낮은 high density lipoproteins (HDL)-콜레스테롤혈증은 허혈성심질환을 일으키는 주요한 위험인자 중 하나이다. 본 연구에서는 1998년, 2001년, 2005년의 국민건강영양조사 자료를 이용하여 같은 기준치를 적용했을 때 한국 남성에 서 낮은 HDL-콜레스테롤혈증의 유병률 변화 양상 및 그와 관련된 요인들의 추세도 살펴보아 향후 예방 관리 대책을 모색하는데 기초 자료로 삼고자 하였다. 방법: 1998년, 2001년, 2005년에 시행된 3개의 국민건강영양조사 자료를 분석하였으며 검진자료가 있는 30세에서 79세 나이의 남성이 연구에 포함되었다. 낮은 HDL-콜레스테롤혈증의 기준은 National Cholesterol Education Program Adult Treatment Panel III에서 제시한 40 mg/dL 미만인 경우로 하였으며, 관련 요인은 다변량로지스틱 회귀분석을 이용하였다. 낮은 HDL-콜레스테롤혈증 및 관련 요인에 대해 시계열적으로 유병률 추세를 살펴보았다. 결과: 한국 남성에서 낮은 HDL-콜레스테롤혈증의 유병률은 1998년 26.3%에서 2001년 38.8%, 2005년 45.9%로 지속적으로 증가하고 있었다. 유의한 관련 요인으로 나타난 흡연, 비음주, 신체적 비활동, 비만, 고중성지방혈증의 시계열적 유병률 변화를 볼 때, 흡연 및 신체적 비활동, 고중성지방혈증의 빈도는 2001년도에 비해 2005년도에 감소하고 있는 반면, 비음주와 비만은 지속적으로 증가하고 있었다. 결론: 낮은 HDL-콜레스테롤혈증의 유병률은 점점 증가하여 관리 대책이 필요한 시점이다. 다른 요인들에 비해 비음주와 비만은 지속적으로 증가하고 있어 낮은 HDL-콜레스테롤혈증 유병률 증가에 비음주와 비만의 영향이 크다고 보여지며 이의 예방을 위해서는 비만의 관리가 중요하다고 여겨진다.

Keywords

References

  1. Assmann G, Schulte H. Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM experience). Prospective Cardiovascular Munster study. Am J Cardiol 1992;70:733-7. https://doi.org/10.1016/0002-9149(92)90550-I
  2. Gotto AM Jr. High-density lipoprotein cholesterol and triglycerides as therapeutic targets for preventing and treating coronary artery disease. Am Heart J 2002;144(6 Suppl):S33-42. https://doi.org/10.1067/mhj.2002.130301
  3. Gordon DJ, Probstfield JL, Garrison RJ, Neaton JD, Castelli WP, Knoke JD, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation 1989;79:8-15. https://doi.org/10.1161/01.CIR.79.1.8
  4. Linton JA, Kimm H, Ohrr H, Park IS, Jee SH. High-density lipoprotein-cholesterol and ischemic heart disease risk in Korean men with cardiac risk. Circ J 2009;73:1296-301. https://doi.org/10.1253/circj.CJ-08-0936
  5. Shah PK, Kaul S, Nilsson J, Cercek B. Exploiting the vascular protective effects of high-density lipoprotein and its apolipoproteins: an idea whose time for testing is coming, part I. Circulation 2001;104:2376-83. https://doi.org/10.1161/hc4401.098467
  6. Mackness MI, Arrol S, Abbott C, Durrington PN. Protection of low-density lipoprotein against oxidative modification by high-density lipoprotein associated paraoxonase. Atherosclerosis 1993;104:129-35. https://doi.org/10.1016/0021-9150(93)90183-U
  7. Kuvin JT, Karas RH. The effects of LDL reduction and HDL augmentation on physiologic and inflammatory markers. Curr Opin Cardiol 2003;18:295-300. https://doi.org/10.1097/00001573-200307000-00009
  8. Carroll MD, Lacher DA, Sorlie PD, Cleeman JI, Gordon DJ, Wolz M, et al. Trends in serum lipids and lipoproteins of adults, 1960-2002. JAMA 2005;294:1773-81. https://doi.org/10.1001/jama.294.14.1773
  9. Arai H, Yamamoto A, Matsuzawa Y, Saito Y, Yamada N, Oikawa S, et al. Serum lipid survey and its recent trend inthe general Japanese population in 2000. J Atheroscler Thromb 2005;12:98-106. https://doi.org/10.5551/jat.12.98
  10. Korea Centers for Disease Control and Prevention. The Second Korea National Health and Nutrition Examination Survey (KNHANES II), 2001. Seoul: Korea Centers for Disease Control and Prevention; 2002.
  11. Korea Centers for Disease Control and Prevention. The First Korea National Health and Nutrition Examination Survey (KNHANES I), 1998. Seoul: Korea Centers for Disease Control and Prevention; 1999.
  12. Korea Centers for Disease Control and Prevention. The Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005. Seoul: Korea Centers for Disease Control and Prevention; 2006.
  13. Lim S, Park KS, Lee HK, Cho SI; Korean National Health and Nutrition Examination Surveys. Changes in the characteristics of metabolic syndrome in Korea over the period 1998-2001 as determined by Korean National Health and Nutrition Examination Surveys. Diabetes Care 2005;28:1810-2. https://doi.org/10.2337/diacare.28.7.1810
  14. Suh MS, Lee HG, Yoon YS, Sunwoo S, Park HS. Factors associated low HDL cholesterol in adults. J Korean Acad Fam Med 2001;22:1214-23.
  15. Kim SM, Han JH, Park HS. Prevalence of low HDL-cholesterol levels and associated factors among Koreans. Circ J 2006;70:820-6. https://doi.org/10.1253/circj.70.820
  16. Hu D, Hannah J, Gray RS, Jablonski KA, Henderson JA, Robbins DC, et al. Effects of obesity and body fat distribution on lipids and lipoproteins in nondiabetic American Indians: the Strong Heart Study. Obes Res 2000;8:411-21. https://doi.org/10.1038/oby.2000.51
  17. Despres JP, Tremblay A, Perusse L, Leblanc C, Bouchard C. Abdominal adipose tissue and serum HDL-cholesterol: association independent from obesity and serum triglyceride concentration. Int J Obes 1988;12:1-13.
  18. Vague J. The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr 1956;4:20-34.
  19. Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ 1999;319:1523-8. https://doi.org/10.1136/bmj.319.7224.1523
  20. Hannuksela M, Marcel YL, Kesaniemi YA, Savolainen MJ. Reduction in the concentration and activity of plasma cholesteryl ester transfer protein by alcohol. J Lipid Res 1992;33:737-44.
  21. 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
  22. Jansen DF, Nedeljkovic S, Feskens EJ, Ostojic MC, Grujic MZ, Bloemberg BP, et al. Coffee consumption, alcohol use, and cigarette smoking as determinants of serum total and HDL cholesterol in two Serbian cohorts of the Seven Countries Study. Arterioscler Thromb Vasc Biol 1995;15:1793-7.
  23. Linn S, Fulwood R, Rifkind B, Carroll M, Muesing R, Williams OD, et al. High density lipoprotein cholesterol levels among US adults by selected demographic and socioeconomic variables. The Second National Health and Nutrition Examination Survey 1976-1980. Am J Epidemiol 1989;129:281-94. https://doi.org/10.1093/oxfordjournals.aje.a115133
  24. Nikkila EA, Taskinen MR, Rehunen S, Harkonen M. Lipoprotein lipase activity in adipose tissue and skeletal muscle of runners: relation to serum lipoproteins. Metabolism 1978;27:1661-7. https://doi.org/10.1016/0026-0495(78)90288-3
  25. Patsch W, Gotto AM Jr. High-density lipoprotein cholesterol, plasma triglyceride, and coronary heart disease: pathophysiology and management. Adv Pharmacol 1995;32:375-426. https://doi.org/10.1016/S1054-3589(08)61018-2

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