Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Pulse wave velocity and ankle brachial index in obese adolescents

비만 청소년에서 맥파 속도와 발목 상완 동맥압 지수에 대한 연구

  • Kim, Ji Hye (Department of Pediatrics, School of Medicine, Ewha Womans University) ;
  • Koo, Hee Sun (Department of Pediatrics, School of Medicine, Ewha Womans University) ;
  • Hong, Young Mi (Department of Pediatrics, School of Medicine, Ewha Womans University)
  • 김지혜 (이화여자대학교 의과대학 소아과학교실) ;
  • 구희선 (이화여자대학교 의과대학 소아과학교실) ;
  • 홍영미 (이화여자대학교 의과대학 소아과학교실)
  • Received : 2007.09.14
  • Accepted : 2007.10.26
  • Published : 2007.11.15
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Abstract

Purpose : The prevalence of childhood obesity has doubled over the last 30 years. Obesity-associated sequelae in the vasculature begins in the early stages of life. The purpose of this study was to investigate how pulse wave velocity (PWV) and ankle brachial index (ABI) change with height, weight and body mass index (BMI) in obese adolescents. Methods : Seventy-nine obese adolescents (group 1: $85th{\leq}BMI<95th$ percentile, n=40; group 2 ($BMI{\geq}95th$ percentile, n=39) were included. The control group(group 3) included 99 healthy adolescents. Brachial- ankle (ba) PWV and ABI were estimated with blood pressure from four extremities. Heart rate (HR), and pre-ejection period/ejection time (PEP/ET) were also estimated. BMI was calculated from individual height and weight. Linear regression analysis was performed to evaluate the correlations between BMI and PWV. Results : Blood pressure and baPWV were significantly higher in group 2, compared to either group 1 or group 3. However, there was no significant difference in ABI, HR and PEP/ET between the groups. PWV showed linear correlation with both BMI and body weight. Conclusion : Obesity was associated with higher arterial stiffness in adolescents, which was demonstrated by an increase in PWV. There was no significant correlation between obesity and ABI.

목 적 : 맥파 속도는 동맥 경직도를 측정할 수 있는 유용하고 비침습적인 방법이다. 비만은 여러 가지 기전에 의하여 동맥 경직도를 증가시킨다고 알려졌다. 그러나 소아 비만에서 맥파 속도에 대한 연구는 매우 적은 실정이다. 저자들은 비만 청소년에서 비만이 맥파 속도와 발목 상완 지수에 미치는 영향을 알아보고자 본 연구를 실시하였다. 방 법 : 1군은 15-16세 사이의 체질량지수가 85-95 백분위수 사이인 비만 위험군 청소년 40명(남자 22명, 여자 18명)으로 하였고, 2군은 체질량지수가 95백분위수 이상인 비만 청소년 39명(남자 26명, 여자 13명)을 대상으로 하였다. 정상 청소년 99명(남자 54명, 여자 45명)을 대조군으로 하였다. 신장, 체중을 이용하여 체질량지수를 산출하였고, VP-1000 기기(Colin Medical Technology Company, Komaki, Japan)를 이용하여 사지 수축기, 이완기, 평균 혈압, 양측 맥파 속도, 발목-상완 동맥압 지수, 박출 시간, 전구출기를 측정 후 비교 분석하였다. 체질량지수와 좌우 상완-발목 맥파 속도, 발목-상완 동맥압 지수, 혈압을 비교 분석하였고, 각 변수 간의 상관성을 연구하였다. 결 과 : 우상완-발목 맥파 속도는 1군(944.8 cm/sec)이나 3군(941.0 cm/sec)에 비하여 2군(1,012.8 cm/sec)에서 유의하게 높은 값을 보여 주었고, 좌상완-발목 맥파 속도도 2군(1,015.3 cm/ sec)에서 1군(940.1 cm/sec)이나 3군(942.2 cm/sec)에 비해 유의하게 높은 값을 보였다. 발목-상완 동맥압 지수, 심박동수, 전구출기/박동 시간 값은 각 군 간에 유의한 차이가 없었다. 상완-발목 맥파 속도와 혈압은 체질량지수가 증가할수록 증가하는 양의 상관관계를 보였으나 발목-상완 동맥압 지수는 체중, 신장, 체질량지수 어느 것과도 유의한 상관관계가 없었다. 결 론 : 체질량지수가 증가함에 따라 맥파 속도가 증가하는 점을 볼 때, 비만이 동맥 경직도의 증가와 밀접한 연관성이 있음을 알 수 있었다. 맥파 속도를 이용하여 청소년의 비만군 및 위험군을 조기에 발견하여 관리하는 것이 성인기에 심혈관 질환으로 이환되는 것을 예방하는 데 도움이 되리라 생각한다.

Keywords

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