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The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Relationship between White Matter Changes and Homocysteine Concentration in Healthy Adults

건강한 성인에서 대뇌 백질 변성과 호모시스테인 농도의 연관성

  • Hur, Wook (Department of Neurology, Chosun University School of Medicine) ;
  • Kang, Hyun Goo (Department of Neurology, Chosun University School of Medicine)
  • 허욱 (조선대학교의과대학 신경과학 교실) ;
  • 강현구 (조선대학교의과대학 신경과학 교실)
  • Received : 2018.05.31
  • Accepted : 2018.08.03
  • Published : 2018.08.31
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Abstract

This study was conducted to analyze the correlation between changes in white matter and homocysteine concentration through brain computed tomography of healthy 50-75 year old subjects without stroke or dementia history. We studied 722 out of 900 patients who underwent health screening at one hospital from 2016 to 2017. Based on the medical records, retrospective studies were conducted and analyzed using SPSS. A chi-square test, T-test and univariate logistic regression analysis were used for analysis. After the subjects were divided into the group with and without white matter changes, the population characteristics were analyzed. The mean age, homocysteine concentration and prevalence of hypertension and diabetes were higher and the duration of education was shorter in the group with white matter changes. In the group with white matter changes, the population increased as homocysteine concentration increased. When the odds ratio was compared based on the lowest group (Q1), age [p<0.001], hypertension [p<0.001] and hyperhomocysteinemia [p=0.021] were risk factors for white matter changes. We also identified modifiable risk factors such as hypertension and hyperhomocysteinemia to prevent complications of white matter changes. However, there has been no report of risk for the each causes of hyperhomocysteinemia and relationship between white matter changes and homocysteine concentration in Koreans. Therefore, large scale prospective studies are needed to better understand this topic.

본 연구는 뇌졸중, 치매 병력이 없는 50-75세 건강한 성인을 대상으로 뇌 CT를 통해 대뇌 백질 변성과 뇌혈관 위험인자들이 상관성이 있는지 분석하고자 하였다. 2016년과 2017년에 일개 병원에서 건강 검진을 받은 900명 중 722명을 대상으로 연구를 진행하였으며 의무기록을 토대로 후향적으로 조사하였고, SPPS를 이용하여 카이제곱검정, 독립표본 t검정, 단변량 로지스틱 회귀분석을 이용하여 분석하였다. 대뇌 백질 변성이 있는 집단과 없는 집단으로 나누어 연구 대상자 특성을 확인하였는데, 대뇌 백질 변성이 있는 군이 없는 군보다 평균 연령과 고혈압, 당뇨 유병률이 높았고, 교육 기간은 짧았으며, 호모시스테인 농도가 높았다. 대뇌 백질 변성이 있는 군에서는 호모시스테인 농도가 증가함에 따라 백질 변성군 내에서 차지하는 비율도 증가했다. 호모시스테인 농도를 4분위하여 가장 낮은 집단(Q1)을 기준으로 상대적 위험도를 비교하였을 때, 나이[p<0.001], 고혈압[p<0.001], 고호모시스테인혈증(Q4)[p=0.021]이 대뇌 백질 변성의 위험인자임을 확인하였다. 이는 건강한 사람에게서 고혈압, 고호모시스테인혈증과 같은 대뇌 백질 변성의 조절 가능한 위험 인자를 확인했다는데 임상적으로 의의가 있다. 하지만 지금까지 고호모시스테인혈증의 일으키는 원인별 위험성에 대한 보고가 없고, 고호모시스테인혈증과 대뇌 백질 변성에 대해 한국인을 대상으로 한 연구가 알려지지 않아 대규모 전향적 연구가 필요할 것으로 사료된다.

Keywords

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