Journal of Nutrition and Health

  • 제50권4호
  • /
  • Pages.313-324
  • /
  • 2017
  • /
  • 2288-3886(pISSN)
  • /
  • 2288-3959(eISSN)
한국영양학회 (The Korean Nutrition Society)
권호 표지
DOI QR코드

DOI QR Code

한국 성인의 항산화 비타민 섭취와 대사증후군 위험 간의 관련성

Association between intake of antioxidant vitamins and metabolic syndrome risk among Korean adults

  • 안서은 (서울대학교 보건대학원 보건학과) ;
  • 전신영 (서울대학교 보건대학원 보건학과) ;
  • 강민지 (한국여성과학기술단체총연합회 젠더혁신연구센터) ;
  • 신상아 (서울대학교 의과대학 예방의학교실) ;
  • 위경애 (국립암센터 임상영양실) ;
  • 백현욱 (분당제생병원 임상영양내과) ;
  • 정효지 (서울대학교 보건대학원 보건학과)
  • Ahn, Seoeun (Department of Public Health, Graduate School of Public Health, Seoul National University) ;
  • Jun, Shinyoung (Department of Public Health, Graduate School of Public Health, Seoul National University) ;
  • Kang, Minji (Center for Gendered Innovations in Science and Technology Researches (GISTER), Korea Federation of Women's Science & Technology Associations) ;
  • Shin, Sangah (Department of Preventive Medicine, College of Medicine, Seoul National University) ;
  • Wie, Gyung-Ah (Department of Clinical Nutrition, Research Institute & Hospital, National Cancer Center) ;
  • Baik, Hyun Wook (Department of Internal Medicine, Division of Gastroenterology & Clinical Nutrition, DMC Bundang Jesaeng Hospital) ;
  • Joung, Hyojee (Department of Public Health, Graduate School of Public Health, Seoul National University)
  • 투고 : 2017.05.11
  • 심사 : 2017.07.14
  • 발행 : 2017.08.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 한국 성인의 항산화 비타민 섭취량과 대사증후군의 관련성을 분석하고자 하였다. 이를 위해 한국 성인 614명의 3일치 식사조사 자료를 한국인 상용식품의 항산화 비타민 함량 데이터베이스와 연계하여 항산화 비타민(비타민 A (${\mu}g$ RE, ${\mu}g$ RAE), 레티놀, 카로티노이드, 비타민 C, 비타민 E)의 섭취량을 추정하였다. 항산화 비타민 섭취밀도에 따라 대상자를 3분위로 나누어 대사증후군 및 그 위험요인의 오즈비를 계산한 결과, 남성에서 레티놀, 카로티노이드, 비타민 E의 섭취밀도가 높은 그룹의 대사증후군 유병률이 섭취밀도가 낮은 그룹보다 낮았으며, 여성 대상자에서도 레티놀의 섭취 밀도가 낮은 그룹보다 중간 및 높은 그룹의 대사증후군 유병률이 낮았다. 또한 남성 대상자에서 비타민 A, 카로티노이드, 비타민 E의 섭취밀도가 높은 그룹의 고혈당의 오즈비가 섭취밀도가 낮은 그룹보다 유의하게 낮았고, 여성 대상자에서는 비타민 A (${\mu}g$ RE)의 섭취밀도가 높은 그룹의 복부비만 오즈비가 섭취밀도가 낮은 그룹보다 유의하게 낮았다. 이상의 결과에서 한국 성인에게서 항산화 비타민 섭취량과 대사증후군 사이에 유의한 관련성이 있음을 확인할 수 있었다. 추후 항산화 비타민 섭취량과 대사증후군의 관련성에 대한 대규모 전향적 연구 또는 개입연구가 실시되어 인과관계를 더욱 명확히 파악하게 된다면, 대사증후군 관리 및 예방을 위한 식생활 관련 정책 수립의 과학적 근거를 제공하는데 도움이 될 것이다.

Purpose: The purpose of this study was to examine the association between intake of antioxidant vitamins and prevalence of metabolic syndrome (MetS) among Korean adults. Methods: A total of 614 subjects aged 30~60 years were recruited from those who received a medical checkup at a general hospital in South Korea between 2009 and 2012. Presence of MetS was determined based on criteria issued by the NCEP ATP III. Intakes of antioxidant vitamins (vitamin A, retinol, carotenoids, vitamin C, and vitamin E) were estimated by combining 3-day diet records with an antioxidant vitamin database for common Korean foods. We used multiple logistic regression analysis to assess the association between dietary intakes of antioxidant vitamins and MetS. Results: Men in the highest tertile for retinol (OR = 0.40, 95% CI = 0.23~0.71, P for trend = 0.0009), carotenoids (OR = 0.57, 95% CI = 0.32~1.00, P for trend = 0.0470), and vitamin E (OR = 0.52, 95% CI = 0.30~0.92, P for trend = 0.0190) intakes had a lower likelihood of having Mets than those in the lowest tertile. The OR of high fasting blood glucose among men in the highest tertile for vitamin A (${\mu}g$ RE: OR = 0.55, 95% CI = 0.32~0.97, P for trend = 0.0417, ${\mu}g$ RAE: OR = 0.52, 95% CI = 0.29~0.92, P for trend = 0.0211), carotenoids (OR = 0.41, 95% CI = 0.23~0.73, P for trend = 0.0036), and vitamin E (OR = 0.47, 95% CI = 0.26~0.82, P for trend = 0.0080) intakes was lower than those in the lowest tertile. In women, subjects in the highest tertile of retinol intakes had a lower prevalence of MetS than those in the lowest tertile group (OR = 0.55, 95% CI = 0.30~0.98). The OR for abdominal obesity was lower among women with the highest vitamin A (${\mu}g$ RE) intakes compared to those in the lowest tertile (OR = 0.51, 95% CI = 0.28~0.93, P for trend = 0.0293). Conclusion: These results suggest that dietary intakes of antioxidant vitamins might be associated with reduced risk of having MetS among Korean adults.

키워드

참고문헌

  1. Korean Statistical Information Service. Cause of death statistics [Internet]. Daejeon: Statistics Korea; 2016 [cited 2017 Mar 2]. Available from: http://kosis.kr/statisticsList/statisticsList_01List.jsp?vwcd=MT_ZTITLE&parmTabId=M_01_01.
  2. Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes 1992; 41(6): 715-722. https://doi.org/10.2337/diab.41.6.715
  3. Schulman RC, Mechanick JI. Metabolic and nutrition support in the chronic critical illness syndrome. Respir Care 2012; 57(6): 958-977. https://doi.org/10.4187/respcare.01620
  4. Yang M, Chung SJ, Floegel A, Song WO, Koo SI, Chun OK. Dietary antioxidant capacity is associated with improved serum antioxidant status and decreased serum C-reactive protein and plasma homocysteine concentrations. Eur J Nutr 2013; 52(8): 1901-1911. https://doi.org/10.1007/s00394-012-0491-5
  5. Lim S, Shin H, Song JH, Kwak SH, Kang SM, Won Yoon J, Choi SH, Cho SI, Park KS, Lee HK, Jang HC, Koh KK. Increasing prevalence of metabolic syndrome in Korea: the Korean National Health and Nutrition Examination Survey for 1998-2007. Diabetes Care 2011; 34(6): 1323-1328. https://doi.org/10.2337/dc10-2109
  6. Korea Centers for Disease Control and Prevention. Korean National Health and Nutrition Examination Survey '07-'10 [Internet]. Cheongwon: Korea Centers for Disease Control and Prevention; 2012 [cited 2017 Mar 2]. Available from: https://knhanes.cdc.go.kr/knhanes/index.do.
  7. Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y, Nakayama O, Makishima M, Matsuda M, Shimomura I. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 2004; 114(12): 1752-1761. https://doi.org/10.1172/JCI21625
  8. Apel K, Hirt H. Reactive oxygen species: metabolism, oxidative stress, and signal transduction. Annu Rev Plant Biol 2004; 55(1): 373-399. https://doi.org/10.1146/annurev.arplant.55.031903.141701
  9. Rubin E, Reisner HM. Essentials of Rubin's pathology. 5th ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2009.
  10. Block G. The data support a role for antioxidants in reducing cancer risk. Nutr Rev 1992; 50(7): 207-213. https://doi.org/10.1111/j.1753-4887.1992.tb01329.x
  11. Diaz MN, Frei B, Vita JA, Keaney JF Jr. Antioxidants and atherosclerotic heart disease. N Engl J Med 1997; 337(6): 408-416. https://doi.org/10.1056/NEJM199708073370607
  12. Hirashima O, Kawano H, Motoyama T, Hirai N, Ohgushi M, Kugiyama K, Ogawa H, Yasue H. Improvement of endothelial function and insulin sensitivity with vitamin C in patients with coronary spastic angina: possible role of reactive oxygen species. J Am Coll Cardiol 2000; 35(7): 1860-1866. https://doi.org/10.1016/S0735-1097(00)00616-1
  13. Som S, Basu S, Mukherjee D, Deb S, ChoudhuryPR, Mukherjee S, Chatterjee SN, Chatterjee IB. Ascorbic acid metabolism in diabetes mellitus. Metabolism 1981; 30(6): 572-577. https://doi.org/10.1016/0026-0495(81)90133-5
  14. Rao LG, Rao AV. Oxidative stress and antioxidants in the risk of osteoporosis: role of the antioxidants lycopene and polyphenols. In: Valdes-Flores M, editor. Topics in Osteoporosis. Rijeka: InTech; 2013. p.117-161.
  15. Puchau B, Zulet MA, de Echavarri AG, Hermsdorff HH, Martinez JA. Dietary total antioxidant capacity is negatively associated with some metabolic syndrome features in healthy young adults. Nutrition 2010; 26(5): 534-541. https://doi.org/10.1016/j.nut.2009.06.017
  16. Li Y, Guo H, Wu M, Liu M. Serum and dietary antioxidant status is associated with lower prevalence of the metabolic syndrome in a study in Shanghai, China. Asia Pac J Clin Nutr 2013; 22(1): 60-68.
  17. Sluijs I, Beulens JW, Grobbee DE, van der Schouw YT. Dietary carotenoid intake is associated with lower prevalence of metabolic syndrome in middle-aged and elderly men. J Nutr 2009; 139(5): 987-992. https://doi.org/10.3945/jn.108.101451
  18. Kim SA, Jun S, Joung H. Estimated dietary intake of vitamin A in Korean adults: based on the Korea National Health and Nutrition Examination Survey 2007-2012. J Nutr Health 2016; 49(4): 258-268. https://doi.org/10.4163/jnh.2016.49.4.258
  19. Ashor AW, Siervo M, Lara J, Oggioni C, Afshar S, Mathers JC. Effect of vitamin C and vitamin E supplementation on endothelial function: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr 2015; 113(8): 1182-1194. https://doi.org/10.1017/S0007114515000227
  20. Zhao S, Li R, Li Y, Chen W, Zhang Y, Chen G. Roles of vitamin A status and retinoids in glucose and fatty acid metabolism. Biochem Cell Biol 2012; 90(2): 142-152. https://doi.org/10.1139/o11-079
  21. Ylönen K, Alfthan G, Groop L, Saloranta C, Aro A, Virtanen SM. Dietary intakes and plasma concentrations of carotenoids and tocopherols in relation to glucose metabolism in subjects at high risk of type 2 diabetes: the Botnia Dietary Study. Am J Clin Nutr 2003; 77(6): 1434-1441. https://doi.org/10.1093/ajcn/77.6.1434
  22. Manning PJ, Sutherland WH, Walker RJ, Williams SM, De Jong SA, Ryalls AR, Berry EA. Effect of high-dose vitamin E on insulin resistance and associated parameters in overweight subjects. Diabetes Care 2004; 27(9): 2166-2171. https://doi.org/10.2337/diacare.27.9.2166
  23. Kang NE, Kim WK. Effects of antioxidant vitamins supplementation on antioxidative status and plasma lipid profiles in Korean NIDDM patients. Korean J Nutr 1999; 32(7): 775-780.
  24. Scott KJ, Thurnham DI, Hart DJ, Bingham SA, Day K. The correlation between the intake of lutein, lycopene and a-carotene from vegetables and fruits, and blood plasma concentrations in a group of women aged 50-65 years in the UK. Br J Nutr 1996; 75(3): 409-418. https://doi.org/10.1079/BJN19960143
  25. Lee Y, Lee HS, Jang YA, Lee HJ, Kim BH, Kim CI. Dietary intake pattern of the Korean adult population by weight status: 2001 national health and nutrition survey. Korean J Community Nutr 2006; 11(3): 317-26.
  26. Zulet MA, Puchau B, Hermsdorff HH, Navarro C, Martinez JA. Vitamin A intake is inversely related with adiposity in healthy young adults. J Nutr Sci Vitaminol (Tokyo) 2008; 54(5): 347-352. https://doi.org/10.3177/jnsv.54.347
  27. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2014: Korea National Health and Nutrition Examination Survey (KNHANES VI-2) [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2015 [cited 2017 Mar 2]. Available from: http://knhanes.cdc.go.kr.
  28. Institute of Medicine (US). Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington, D.C.: National Academies Press; 2001.
  29. Ministry of Health and Welfare (KR); The Korean Nutrition Society. Dietary reference intakes for Koreans 2015. Sejong: Ministry of Health and Welfare; 2016.
  30. Park S, Ham JO, Lee BK. Effects of total vitamin A, vitamin C, and fruit intake on risk for metabolic syndrome in Korean women and men. Nutrition 2015; 31(1): 111-118. https://doi.org/10.1016/j.nut.2014.05.011
  31. Bian S, Gao Y, Zhang M, Wang X, Liu W, Zhang D, Huang G. Dietary nutrient intake and metabolic syndrome risk in Chinese adults: a case-control study. Nutr J 2013; 12(1): 106. https://doi.org/10.1186/1475-2891-12-106
  32. Ford ES, Mokdad AH, Giles WH, Brown DW. The metabolic syndrome and antioxidant concentrations: findings from the Third National Health and Nutrition Examination Survey. Diabetes 2003; 52(9): 2346-2352. https://doi.org/10.2337/diabetes.52.9.2346
  33. Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr 2006; 84(6): 1489-1497. https://doi.org/10.1093/ajcn/84.6.1489
  34. Panagiotakos DB, Pitsavos C, Skoumas Y, Stefanadis C. The association between food patterns and the metabolic syndrome using principal components analysis: the ATTICA Study. J Am Diet Assoc 2007; 107(6): 979-987. https://doi.org/10.1016/j.jada.2007.03.006
  35. Hong S, Song Y, Lee KH, Lee HS, Lee M, Jee SH, Joung H. A fruit and dairy dietary pattern is associated with a reduced risk of metabolic syndrome. Metabolism 2012; 61(6): 883-890. https://doi.org/10.1016/j.metabol.2011.10.018
  36. Dugan CE, Barona J, Fernandez ML. Increased dairy consumption differentially improves metabolic syndrome markers in male and female adults. Metab Syndr Relat Disord 2014; 12(1): 62-69. https://doi.org/10.1089/met.2013.0109
  37. Ballard KD, Mah E, Guo Y, Pei R, Volek JS, Bruno RS. Low-fat milk ingestion prevents postprandial hyperglycemia-mediated impairments in vascular endothelial function in obese individuals with metabolic syndrome. J Nutr 2013; 143(10): 1602-1610. https://doi.org/10.3945/jn.113.179465
  38. Lee YJ, Seo JA, Yoon T, Seo I, Lee JH, Im D, Lee JH, Bahn KN, Ham HS, Jeong SA, Kang TS, Ahn JH, Kim DH, Nam GE, Kim NH. Effects of low-fat milk consumption on metabolic and atherogenic biomarkers in Korean adults with the metabolic syndrome: a randomised controlled trial. J Hum Nutr Diet 2016; 29(4): 477-486. https://doi.org/10.1111/jhn.12349
  39. Kim D, Kim J. Dairy consumption is associatedwith a lower incidence of the metabolic syndrome in middle-aged and older Korean adults: the Korean Genome and Epidemiology Study (KoGES). Br J Nutr 2017; 117(1): 148-160. https://doi.org/10.1017/S000711451600444X
  40. Kim MH, Lee HS, Park HJ, Kim WY. Risk factors associated with metabolic syndrome in Korean elderly. Ann Nutr Metab 2007; 51(6): 533-540. https://doi.org/10.1159/000112977
  41. Kim J, Choi YH. Physical activity, dietary vitamin C, and metabolic syndrome in the Korean adults: the Korea NationalHealth and Nutrition Examination Survey 2008 to 2012. Public Health 2016; 135: 30-37. https://doi.org/10.1016/j.puhe.2016.01.002
  42. Westenhoefer J. Age and gender dependent profile of food choice. Forum Nutr 2005; (57): 44-51.
  43. Regitz-Zagrosek V. Sex and gender differences in health. Science & Society Series on Sex and Science. EMBO Rep 2012; 13(7):596-603. https://doi.org/10.1038/embor.2012.87
  44. FerranniniE, Haffner SM, Mitchell BD, Stern MP. Hyperinsulinaemia: the key feature of a cardiovascular and metabolic syndrome. Diabetologia 1991; 34(6): 416-422. https://doi.org/10.1007/BF00403180
  45. Godala MM, Materek-Kusmierkiewicz I, Moczulski D, RutkowskiM, Szatko F, Gaszynska E, Tokarski S, Kowalski J. Lower plasma levels of antioxidant vitamins in patients with metabolic syndrome: a case control study. Adv Clin Exp Med 2016; 25(4): 689-700. https://doi.org/10.17219/acem/41049
  46. Motamed S, Ebrahimi M, Safarian M, Ghayour-Mobarhan M, Mouhebati M, Azarpazhouh M, Esmailie H, Norouzi A, Ferns GA. Micronutrient intake and the presence of the metabolic syndrome. N Am J Med Sci 2013; 5(6): 377-385. https://doi.org/10.4103/1947-2714.114171

피인용 문헌

  1. Associations of Dietary Antioxidants and Risk of Type 2 Diabetes: Data from the 2007–2012 Korea National Health and Nutrition Examination Survey vol.22, pp.10, 2017, https://doi.org/10.3390/molecules22101664
  2. Association between antioxidant vitamin intake and obesity among Korean women: using the Korea National Health and Nutrition Examination Survey 2007 ~ 2016 vol.51, pp.5, 2018, https://doi.org/10.4163/jnh.2018.51.5.400
  3. Intake of fruits and vegetables may modify the risk of cataract in Korean males: data from Korean National Health and Nutrition Examination Survey 2012 vol.51, pp.5, 2018, https://doi.org/10.4163/jnh.2018.51.5.423
  4. Association between Total Diet Quality and Metabolic Syndrome Incidence Risk in a Prospective Cohort of Korean Adults vol.8, pp.1, 2019, https://doi.org/10.7762/cnr.2019.8.1.46
  5. 한국 성인 남녀 대사증후군 집단의 영양소 섭취와 식사의 질 및 hs-CRP와 관련성 - 국민건강영양조사(2015년) 자료를 활용하여 - vol.31, pp.3, 2017, https://doi.org/10.9799/ksfan.2018.31.3.425
  6. 한국 성인의 식생활평가지수에 기반한 전체 식사의 질과 대사증후군 구성요소 및 대사증후군 발생의 연관성 vol.25, pp.1, 2017, https://doi.org/10.5720/kjcn.2020.25.1.61
  7. Vitamin C and Metabolic Syndrome: A Meta-Analysis of Observational Studies vol.8, pp.None, 2017, https://doi.org/10.3389/fnut.2021.728880
  8. Associations of Dietary and Circulating Vitamin E Level With Metabolic Syndrome. A Meta-Analysis of Observational Studies vol.8, pp.None, 2017, https://doi.org/10.3389/fnut.2021.783990
  9. 한국 성인의 식사 패턴과 인슐린 저항성 간의 상관성: 2015년도 국민건강영양조사를 이용하여 vol.54, pp.3, 2017, https://doi.org/10.4163/jnh.2021.54.3.247