대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)

  • 제54권2호
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  • Pages.95-102
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  • 2022
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  • 1738-3544(pISSN)
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  • 2288-1662(eISSN)
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)
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60세 이상 노인에서 혈중 지단백(a)와 이상지질혈증의 관련성

Relationship between Lipoprotein(a) and Dyslipidemia in the Elderly over 60 Years

  • 서요한 (광주보훈병원 진단검사의학과) ;
  • 신희영 (전남대학교 의과대학 의과학과)
  • Seo, Yo-Han (Department of Laboratory Medicine, Gwangju Veterans Hospital) ;
  • Shin, Hee-Young (Department of Biomedical Science, Chonnam National University Medical School)
  • 투고 : 2022.03.11
  • 심사 : 2022.04.25
  • 발행 : 2022.06.30
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초록

Lp(a)와 이상지질혈증의 관계가 명확하지 않아, 본 연구는 60세 이상 노인 환자를 대상으로 Lp(a)와 이상지질혈증의 관계를 조사하고자 하였다. 2014년 1월 1일부터 2020년 12월 31일까지 7년간 한 종합병원을 내원한 60세 이상 노인 중 나이, 성별, BMI, Lp(a), LDL-C, TG, HDL-C, hs-CRP, HbA1c, 지질강하제 복용 여부, 이상지질혈증 의사진단여부 등의 기록이 있는 2,580명을 최종 분석대상자로 선정하였다. Lp(a)와의 상관성은 hs-CRP (r=0.138), LDL-C (r=0.097), HDL-C (r=-0.089), TG (r=-0.073), 나이(r=0.072) 등이 유의하였으며, BMI, HbA1c는 유의하지 않았다. 변수들을 보정한 Lp(a)와 LDL-C의 편상관관계는 남성그룹에서만 유의하였다(r=0.158, P<0.001). 본 연구에서 이상지질혈증에 대한 Lp(a)의 4사분위의 교차비(교차비=1.376, 95% 신뢰구간=1.038~1.822)가 유의하게 나타남으로써 지질강하제 복용으로도 1차 표적인 LDL-C 수준을 낮추지 못했을 때, 2차적으로 고려해봐야 할 여러 요소 중 Lp(a)도 포함되어야 한다고 판단된다. 성별, 연령, 지질강하제 복용 여부 등에 따른 다양한 지질인자들에 대한 연구들이 필요하다고 사료된다.

The relationship between lipoprotein(a) and dyslipidemia is not clear. This study was therefore undertaken to investigate the relationship between lipoprotein(a) and dyslipidemia in elderly patients over 60 years. From 2014 to 2020, a total of 2,580 adults aged 60 years or older (73.31±7.24 years, 1,954 males) were enrolled in the study. The patients had checked into a general hospital, and data were obtained for lipoprotein(a), LDL-C, TG, HDL-C, hs-CRP, HbA1c, sex, age, BMI, dyslipidemia diagnosis, and use of lipid-lowering agents. BMI and HbA1c showed no correlation with lipoprotein(a), but hs-CRP (r=0.138), LDL-C (r=0.097), HDL-C (r=-0.089), TG (r=-0.073), and age (r=0.072) were significantly correlated to lipoprotein(a). The partial correlation between lipoprotein(a) and LDL-C, which was adjusted for variables, was significant only in the male gender (r=0.158, P<0.001). As the odds ratio of the 4th quartile of lipoprotein(a) (OR=1.376, 95% CI=1.038~1.822) for dyslipidemia was found to be significant in this study when the level of LDL-C, the primary target, could not be reduced even by taking lipid-lowering drugs, we propose that lipoprotein(a) should also be included among the several factors considered as secondary targets. Our results indicate that studies on various lipid factors considering the sex, age, types and use of lipid-lowering agents, are warranted.

키워드

과제정보

This manuscript is a condensed form of the first author's doctoral dissertation from Chonnam National University. This study was supported by a VHS Medical Center Research Grant, Republic of Korea (VHSMC 21027).

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