공복혈당장애군 및 당뇨군의 비만도, 혈압, 혈청 지질 농도 및 영양소 섭취 상태

Anthropometry, Blood Pressure, Serum Lipid Levels and Nutrient Intakes in People with Impaired Fasting Glucose and with Diabetes

  • 발행 : 2002.04.01

초록

1999년 7월 1일부터 1년간 아산재단 강릉병원에서 건강검진을 받은 성인 중에서 공복혈당장애군 (92명), 당뇨군 (119명) 및 이들과 성별 및 연령이 유사한 정상 대조군 (123명)을 대상으로 신체계측을 통하여 비만도를 평가하고, 혈압측정과 혈액분석 그리고 식품 섭취 빈도법을 이용하여 영양소 섭취량을 평가하였다. 1) 남자에서 공복혈당장애군의 BMI(25.7$\pm$2.7kg/$m^2$)와 비만도 지수(119.1$\pm$12.2%)는 당뇨군 및 정상군보다 유의하게 높았으며, WHR (0.92$\pm$0.04)과 혈압 (수축기 139$\pm$19.2mmHg, 이완기 85.1$\pm$12.2mmHg)은 당뇨군과는 차이를 보이지 않는 반면 정상군보다는 유의하게 높았다. 한편 여자의 경우, 공복혈당장애군의 체중, BMI, 비만도 지수 및 WHR는 당뇨군과는 유의한 차이를 보이지 않았으나, 정상군에 비해서는 유의하게 높았다. 2) 비만 이환율을 살펴보면, 남자의 경우 공복혈당장애군 (43.6%)-정상군 (27.4%)-당뇨군 (22.5%)의 순이었으나, 여자는 공복혈당장애군(76.7%)-당뇨군(63.3%)-정상군(54.0%)의 순으로 나타나, 공복혈당장애군에서 비만의 이환율이 더 높았으나 유의한 차이는 아니었다. 3) 남자에서 수축기 및 이완기 고혈압 위험 집단의 비율은 공복혈당장애군에서 각각 40.0%와 52.0%로 가장 높았으나 (p<0.05), 여자에서는 세 군 간에 유의한 차이를 보이지 않았다. 4) 남자에서 공복혈당장애군의 중성지방 농도(177.7$\pm$109.4mg/dl)와 AI(3.16$\pm$0.91)는 정상군 및 당뇨군과 유의한 차이를 보이지 않고 단지 두 군의 중간 정도의 범주에 해당되었다. 그러나, 여자에서는 공복혈당장애군의 AI, relative cholesterol의 수준이 정상군과는 유의하게 다르고, 오히려 당뇨군과는 유의한 차이를 보이지 않았다. 5) 영양소 섭취량은 정상군, 공복혈당장애군 및 당뇨군간에 유의한 차이를 보이지 않았다. 그러나 알코올로부터의 열량 섭취비율을 살펴보면, 남자의 경우 공복혈당장애군이 7.0$\pm$6.9%로서 정상군 (4.5$\pm$5.9%) 및 당뇨군 (5.6$\pm$6.1%) 보다 유의하게 높았다. 30~49세에 해당되는 중년 여성의 에너지, 단백질, 철분 섭취량을 권장량과 비교하여 보면, 각각 74.8$\pm$12.6%, 94.6$\pm$26.4% 및 64.5$\pm$14.1%로 당뇨군 (각각 112.8$\pm$28.5%, 157.8$\pm$68.2%, 92.8$\pm$21.7%)에 비해 유의하게 낮았고 정상군과는 유의한 차이를 보이지 않았다.

The purpose of this study was to compare the anthropometry, blood pressure, blood lipid levels, and nutrient intakes in three groups: a group with an impaired fasting blood glucose (IFG) condition (62 males and 30 females); a group with normal blood glucose (73 males and 50 females); and a group with diabetes mellitus (DM) (79 males and 49 females). In male subjects, body mass index (BMI) and obesity index values were significantly higher in the IFG group than in normal and DM groups, but waist/hip ratio (WHR), systolic blood pressure, and diastolic blood pressure were not significantly different from those of the DM group. In female subjects, there was no difference in body weight, BMI, obesity index and WHR values between the IFG and the DM groups. The prevalence of obesity in the IFG group (males 43.6%, females 76.7%) was the highest among the three groups. The percentage of high SBP (40.0%) and high DBP (52.0%) in male subjects of the IFG group was significantly greater than in the DM group or the normal group. In the male subjects, the serum triglyceride concentration was significantly higher in the DM group than in the normal and IFG groups. There was no difference in various nutrient intakes(energy, carbohydrate, protein, fat, calcium, iron, vitamin A and cholesterol) among the three groups. In male subjects, the percentage of energy intake from alcohol was higher in the IFG group (7.0%) than that of the normal (4.5%) and the DM (5.6%) groups. The fasting blood glucose level had a positive correlation with WHR, TG, the athrogenic index and LDL-cholesterol/HDL-cholesterol. This study suggested that the IFG group had a higher obesity index, BMI, blood pressure and serum lipid levels (TG, cholesterol) than the normal or the DM group; furthermore, the IFG group had higher levels of alcohol intake and habits of taking unbalanced diets. Therefore, guidelines for IFG group should emphasize weight control, diet therapy, physical activities and regular balanced diets, in order to prevent diabetes in this group.

키워드

참고문헌

  1. Lee KY, Shon BH, Kang SK, Bang BK, Park DH, Min BS, Song HY. 한국인 18,201명에서 당뇨병과 관련질환에 관한 역학적 연구. Diabetes 8(1): 5-14,1984
  2. Cho NH. Epidemiologic studies to detennine the risk factors for non-insulin dependent diabetes. Diabetes 20(1): 10-13,1996
  3. 당뇨병 교육 지침서. 대한당뇨병학회,1999
  4. Bennett PH. Epidemiology of diabetes mellitus. In Rifkin H, Porte D (eds): Diabetes mellitus Theory and Practice. 4th Ed. EIsevie, New York-1990
  5. 당뇨병의 진료지침. 대한당뇨병학회, 1990
  6. NIH Consensus development conference on diet and exerdse in NIDDM. Diabetes Care 10(5): 639-644,1987 https://doi.org/10.2337/diacare.10.5.639
  7. Park YS, Lee HK, Kim SY, Koh CS, Min HK, Lee CG, Ahn MY, Kim YI, Shin YS. Risk factors for non-insulin dependent diabetes mellitus. Diabetes 20(1): 14-24,1996
  8. Yudkin JS, Alberti KG, McLarty DG, Swai AB. Impaired glucose tolerance. Br Med J 301: 397-402,1990 https://doi.org/10.1136/bmj.301.6749.397
  9. Oiao Q, Rajala U, Keinanen-Kiukaanniemi S. Hypertension, hypennsulinaemia and obesity in middle-aged Finns with impaired glucose tolerance. J Hypertension 12 (4): 265-269,1998 https://doi.org/10.1038/sj.jhh.1000602
  10. World Health Organizaaon. WHO Study Group on Diabetes Mellitus. Technical Report Series 727. Geneva: WHO, 1985
  11. Lu b, Pan C, Tian H. A study of insulin sensitivity and its related factors in patients with non-insulin dependent diabetes mellitus and impaired glucose tolerance. Chinese J Intern Med 35(10): 678-681,1996
  12. Edelstein SL, Knowler WC, Bam RP, Andies R, Barrett-Connor EL, Dowse GK, Haffner SM. Predictors of progression from impaired glucose tolerance to NIDDM: An analysis of six prospective studies. Diabetes 46(4): 701-710,1997 https://doi.org/10.2337/diabetes.46.4.701
  13. Yang YJ, Kim JY. The nutritional status of middle aged Korean men exhibiting impaired glucose tolerance and their blood lipid profile. Korean J Nutrition 33(1): 59-67, 2000
  14. National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28(12): 1039-1057,1979 https://doi.org/10.2337/diab.28.12.1039
  15. Orchard TJ. From diagnosis and classificayon to complications and therapy: DCCT part II. Diabetes Care 17(4): 326-338,1994 https://doi.org/10.2337/diacare.17.4.326
  16. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 20(Suppl. 1): 1183-1197,1997 https://doi.org/10.2337/diacare.20.7.1183
  17. Gibson RS. Prindples of Nutritional Assessment. Oxford university, New York, 1990
  18. Fridwald WT, Levy RI, Fredrickson DS. Estimadon of the con centration of low density lipoprotein cholesterol in plasma without use of the preparative ultracentnfuge. Clin Chem 18: 499-502,1972
  19. Rho SL, Ko HS. A clinical properties on nutiition intake and serum concentration of diabetic subjects by duration in Ansung Kyunggi-do. Korean J Nutrition 30(10): 1203-1210,1997
  20. Sekikawa A, Tominaga M, Takahashi K, Eguchi H, Igarashi M, Ohnuma H, Sugiyama K, Manaka H, Sasaki H, Fukuyama H, Miyazawa K. Prevalence of diabetes and impaired glucose tolerance in Funagata area, Japan. Diabetes Care 16(4): 570-574, 1993 https://doi.org/10.2337/diacare.16.4.570
  21. Pan CY, Lu )M, Tian H, Kong XT, Lu XP, Yao C, Jiang CE, Deng XX, Wang SY, Zhang XL, Wang ZS, Cui L. Study of the prevalence of diabetes mellitus in adults in the Shousgang cor- poration in Beijing. Diabet Med 13(7): 663-668,1996 https://doi.org/10.1002/(SICI)1096-9136(199607)13:7<663::AID-DIA130>3.0.CO;2-G
  22. Lee MD, Kim YU, Kim HS, Shin YG, Chung CH. Plasma proimsulin levek among the control, impaired glucose tolerance and type 2 diabetes mellitus during oral glucose tolerance test. Diabetes 23(2): 147-154,1999
  23. Kim YI, Chung YE, Kim JY, Kim SW, Lee MS, P ]Y, Hong SK, Lee KU. Leptin concentradon in diabedc and non-diabedc subjects in the community populadon. Diabetes 23(4): 592-600,1999
  24. Kim YI, Chung YE, Kim JY, Kim SW, Lee MS, P JY, Hong SK, Lee KU. Leptin concentradon in diabedc and non-diabedc subjects in the community populadon. Diabetes 23(4): 592-600,1999
  25. Rao G. Insulin resistance syndrome. Am Fam Physicwn 63(6): 1159-1166, 2001
  26. Tuomilehto J, Lindstrom J, Laakso M. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344(18): 1343-1350, 2001 https://doi.org/10.1056/NEJM200105033441801
  27. Reaven PD, Barrett-connor EL, Browner DK. Abnormal glucose tolerance and hyperteinsion. Diabetes Care 13(2): 119-125,1990 https://doi.org/10.2337/diacare.13.2.119
  28. Consensus Conference. Treatment of hypertriglycendemia. JAMA 251(9): 1196-1200,1984 https://doi.org/10.1001/jama.251.9.1196
  29. Kim SY, Yun JS, Cha BK. Relationship among body fat distribution, adiposity, fasting serum insulin and lipids in adult female. Korean J Nutrition 25(3): 221-232, 1992
  30. Yang EJ, Kim WY. The anthropometiic characteristics of non-insulin dependent diabetes mellitus in Koreas. Korean J Nutrition 32(4): 401-406,1999
  31. Kim YS. Hyperlipidemia and Athemsderosis. Hanmedical, 175-185
  32. Recommended Dietaiy Allowance for Koreans, 7th ed., The Korean Nutiition Sodety, Seoul, 2000
  33. Kim KN, Han KA. A study on nutritional intake of the elderly diabetic patients. J Korean Soc Medical Nutritional Sci 1(3): 179-190,1999
  34. Heitmann BL. Body fat in the adult Danish populadon aged 35-65 years: An epidemiologkal study. Int J Obes 15(8): 535-545,1991
  35. Haffner SM, Stem MP, Hazuda HP, Pugh J, Patterson JK. Do upper body and centralized adiposity measure different aspects of regional body fat distribuaon? Diabetes 36(1): 43-51,1987 https://doi.org/10.2337/diabetes.36.1.43
  36. Kolonel NL. Cancer pattems among migrant and native-born Japanese in Hawaii in relation to smoking, drinking, and diet. In: Gelgoin HV, eds., Environmental actors in Expenmental and Human Cancer. Japan Sci Soc Press, Tokyo: 327,1980
  37. Faiquhar JW, Maccoby N, Wood PD. Community educaaon for cardiovascular health. Lancet 1(8023): 1192-1197,1977
  38. Fuller JH, Shipley MJ, Rose G, Jarret RJ, Keen J. Coronary heart disease risk and impaired glucose tolerance, the Whitehall study. Lancet 1(8183): 1373-1376,1980
  39. AIberB KGMM. The clinical implications of impaired ducosetolerance. Diabetic Med 13(11): 927-937,1996 https://doi.org/10.1002/(SICI)1096-9136(199611)13:11<927::AID-DIA279>3.0.CO;2-E
  40. Cho YH, Kim YK, Choi JH, Oh MK. Serum lipid levels and related factors of adults in Yeongdong area. Korean J Dietary Culture 14(4): 405-416,1999
  41. Simpson RW, McDonald J, Wahlqvist ML, Altey L, Outch K. Macronuthents have different metabolic effects in nondiabetics and diabetics. Am J Clin Nutr 42(3): 449-453,1985
  42. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, Hu XZ. Effects of diet and exerdse in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 20(4): 537-544,1997 https://doi.org/10.2337/diacare.20.4.537
  43. Kim DJ, Chung YJ, Oh EY, Hahm JR, Kim BJ, Kim SH, Kim KA, Chung JH, Min YK, Lee MS, Lee MK, Kim KW. The appropriateness of new ADA diagnostic critena for diabetes mellitus in Korean population. Diabetes 23(3): 336-345,1999
  44. Jeong IK, Moon MK, Kim SW, Park YJ, Kim SY, Park DJ, Shin CS, Park KS, Kim SY, Cho BY, Kim NK, Lee HK. Comparison of clinical characteristics of impaired fasting glucose with impaired glucose tolerance in Yonchon county. J Korean Diabetes Asso 24(1): 71-77, 2000