Relationship between Visceral Adipose Tissue and Oriental Obesity Pattern Identification in Obese Korean Women

비만여성에서 내장지방과 한방비만변증의 연관성

  • Kim, Eun-Joo (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, Kyung-Hee University) ;
  • Lee, A-Ra (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, Kyung-Hee University) ;
  • Hwang, Mi-Ja (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, Kyung-Hee University) ;
  • Cho, Jae-Heung (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, Kyung-Hee University) ;
  • Choi, Sun-Mi (Korea Institute of Oriental Medicine) ;
  • Chung, Seok-Hee (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, Kyung-Hee University) ;
  • Song, Mi-Yeon (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, Kyung-Hee University)
  • 김은주 (경희대학교 한의과대학 한방재활의학교실) ;
  • 이아라 (경희대학교 한의과대학 한방재활의학교실) ;
  • 황미자 (경희대학교 한의과대학 한방재활의학교실) ;
  • 조재흥 (경희대학교 한의과대학 한방재활의학교실) ;
  • 최선미 (한국한의학연구원) ;
  • 정석희 (경희대학교 한의과대학 한방재활의학교실) ;
  • 송미연 (경희대학교 한의과대학 한방재활의학교실)
  • Received : 2011.03.14
  • Accepted : 2011.04.02
  • Published : 2011.04.30

Abstract

Objectives : Our purpose of this study was to evaluate the association between abdominal adipose tissue and oriental obesity pattern identification. Methods : This study was performed in 78 healthy obese(BMI(body mass index)${\geq}25kg/m^2$) women in Seoul. Subjects underwent abdominal CT(computed tomography) scanning and were asked to complete the oriental obesity pattern identification questionnaire. Subjects were given written consent and this study was performed under permission of institutional review board of Kyung-hee East-west Neo medical center. Results : 1. VFA(visceral fat area) and VSR(visceral/subcutaneous adipose tissue ratio) were significantly correlated with stagnation of the liver qi(肝鬱, gan-yu)(p<0.05). But, other patterns were not significantly correlated with oriental obesity pattern identification(p>0.05). 2. We evaluated a difference of oriental obesity pattern identification score in visceral obesity group(n=34) versus non-visceral obesity group(n=44). Scores of all patterns except food accumulation(食積, shi-ji) were significantly higher in the visceral obesity group than in the non-visceral obesity group(p<0.05). Especially, there was a further significant difference in stagnation of the liver qi(肝鬱, gan-yu)(p<0.01). Conclusions : Generally, the stagnation of the liver qi(肝鬱, gan-yu) has a close relation with stress and depression. This study suggests that stress and depression might be correlated with visceral fat, and the use of oriental obesity pattern identification would be helpful for planning a treatment schedule of visceral obesity in the clinic.

Keywords

References

  1. Haslam DW, James WP. Obesity. Lancet. 2005;366(9492):1197-209. https://doi.org/10.1016/S0140-6736(05)67483-1
  2. BjoErntorp P. Visceral obesity: a civilization syndrome. Obes Res. 1993;1:206-22. https://doi.org/10.1002/j.1550-8528.1993.tb00614.x
  3. 박혜순, 김표년. 비만 성인에서 컴퓨터 단층촬영에 의한 내장지방 축적과 관련된 생활습관 요인. 대한비만학회지. 2002;11(4):337-48.
  4. 김수경, 김세화, 이유미, 최성희, 조유리 등. 컴퓨터단층촬영으로 측정한 복강내 지방조직 길이와 내장지방 면적, 내장지방/피하지방 면적비 및 내장지방/골격근 면적비와의 비교. 대한내과학회지. 2003;64(1):49-59.
  5. 문진석, 강병갑, 강경원, 심우진, 신미숙, 최선미. 전문가 가중치 부여를 통한 비만변증설문지 적용. 대한한방비만학회지. 2008;8(1):53-61.
  6. Yoshizumi T, Nakamura T, Yamane M, Islam AHMW, Menju M, Yamasaki K, Arai T, Kotani K, Funahashi T, Shizuya Y, Matsuzawa Y. Abdominal fat: standardized technique for measurement at CT. Radiology. 1999;211:283-6. https://doi.org/10.1148/radiology.211.1.r99ap15283
  7. 문진석, 강병갑, 류은경, 최선미. 한의사와 환자의 설문을 통한 비만 변증지표 연구. 대한한방비만학회지. 2007;7(1):55-69.
  8. 강병갑, 문진석, 최선미. 비만변증 설문지에 대한 신뢰도 분석. 한국한의학연구원 논문집. 2007;13(1):109-14.
  9. Examination committee of criteria for 'obesity disease' in Japan-Japan society for the study of obesity. New criteria for 'obesity disease' in Japan. Circ J. 2002;66(11):987-92. https://doi.org/10.1253/circj.66.987
  10. 이병주, 김성훈. 肥滿의 槪念 및 辨證施治에 관한 文獻的 고찰. 대전대학교 한의학연구소 논문집. 1998;7(1):533-41.
  11. 이형철, 최영민, 심우진, 김길수, 최선미, 강병갑, 신승우. 비만환자의 담음변증과 복부내장지방과의 연관성에 관한 연구. 대한한방비만학회지. 2006;6(1):51-9.
  12. 황미자, 정석희, 황덕상, 송미연. 한국 갱년기 여성의 간울과 내장비만의 상관성. 한방재활의학과학회지. 2008;18(2):143-56.
  13. 정원석, 황미자, 김성수, 황덕상, 송미연. 한국 과체중 갱년기 도시 여성의 비만도, 일상생활 스트레스, 자존감, 식이태도, 우울증, 스트레스 반응척도와 갱년기 증상의 연관성. 한방비만학회지. 2008;8(1):71-80.
  14. Ruiz RJ, Stowe RP, Goluszko E, Clark MC, Tan A. The relationship among acculturation, body mass index, depression and interleukin 1-receptor antagonist in Hispanic pregnant women. Ethinicity & Disease. 2007;17(2):338-43.
  15. Rosmond R, BjoEmtorp P. The interactions between hypothalamic-pituitary-adrenal axis activity, testosterone, insulinlike growth factor I and abdominal obesity with metabolism and blood pressure in men. Int J Obes Relat Metab Disord. 1998;22:1189-96.
  16. Kyrou I, Chrousos GP, Tsigos C. Stress, visceral obesity and metabolic complications. Ann NY Acad Sci. 2006;1083:77-110. https://doi.org/10.1196/annals.1367.008
  17. Charmandari E, Tsigos C, Chrousos G. Endocrinology of the stress response. Annu Rev Physiol. 2005;67:259-84. https://doi.org/10.1146/annurev.physiol.67.040403.120816
  18. McEwen BS. Protective and damaging effects of stress mediators. N Eng Journal Med. 1998;338:171-9. https://doi.org/10.1056/NEJM199801153380307
  19. Karen K. Obesity and cortisol: controlling stress hormones to limit fat storage. Available from : URL:http://intelegen.com/nutrients/obesity_and_cortisol_controlling.htm.
  20. BjoEmtorp P. Review: the regulation of adipose tissue distribution in humans. Int Journal Obes Relat Metab Disord. 1996;20:291-302.
  21. Chrousos GP. The role of stress and the hypothalamic-pituitary-adrenal axis in the pathogenesis of the metabolic syndrome: neuro-endocrine and target tissue-related causes. Int J Obes Relat Metab Disord. 2000;24(2):50-5.
  22. Kyrou I, Tsigos C. Stress mechanisms and metabolic complications. Horm Metab Res. 2007;39:430-8. https://doi.org/10.1055/s-2007-981462
  23. Chandola T, Brunner E, Marmot M. Chronic stress at work and the metabolic syndrome: prospective study. BMJ. 2006;332:521-5. https://doi.org/10.1136/bmj.38693.435301.80
  24. Brunner EJ, Chandola T, Marmot MG. Prospective effect of job strain on general and central obesity in the Whitehall II Study. Am J Epidemiol. 2007;165:828-37. https://doi.org/10.1093/aje/kwk058
  25. Kyrou I, Tsigos C. Chronic stress, visceral obesity and gonadal dysfunction. Hormones(Athens). 2008;7(4):287-93.
  26. Pasquali R, Cantobelli S, Casimirri F, Capelli M, Bortoluzzi L, Flamia R et al. The hypothalamo-pituitary-adrenal of body fat distribution. J Clin Endocrinol Metab. 1993;77:341-6. https://doi.org/10.1210/jc.77.2.341
  27. Pasquali R, Anconetani B, Chattat R. Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in women with visceral and subcutaneous obesity: effects of corticotropin-releasing factor/arginine vasopressin test and of stress. Metabolism. 1996;45:351-6. https://doi.org/10.1016/S0026-0495(96)90290-5
  28. BjoEmtorp P, Rosmon R. Neuroendocrine abnormalities in visceral obesity. International Journal of Obesity. 2000;24(2):S80-5.
  29. 이영미, 박혜순, 천병철, 김현수. 복부비만의 지표로서 부위별 허리둘레 측정값의 신뢰도. 대한비만학회지. 2002;11(2):123-30.