한국 제2형 당뇨병환자에서 죽상동맥경화증 유무의 예측인자로서 허리둘레 기준치 분석

Abstract

Background: Macrovascular complications are the main causes of death among the diabetic patients and abdominal obesity is well known as the important component of metabolic syndrome. We investigated to decide the proper value of waist circumference which could predict subclinical atherosclerosis in type 2 diabetic patients in Korea.

Methods: We supposed that increased carotid intima-media thickness (IMT) was equivalent to subclinical atherosclerosis and abdominal obesity was judged by four well-known criteria of Korean Society for the Study of Obesity (KSSO), Japan Society for the Study of Obesity (JASSO), International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Mean IMT was measured at both carotid arteries by high resolution B-mode ultrasonography in 771 type 2 diabetic patients. We calculated the relative risk of increased IMT when patients’ waist circumference was over the value of each criterion.

Results: The risk of subclinical atherosclerosis was increased in men with abdominal obesity according to three criteria except JASSO. The relative risk of increased IMT was 1.682 (95% CI = 1.147, 2.466) in whose waist circumference was over 90 cm compared with less than 90 cm. But in women, the risk was not increased at all criteria.

Conclusion: The waist circumference has practical value as marker of subclinical atherosclerosis in type 2 diabetic males in Korea, and the proper cut-off value of waist circumference is 90 cm, which is offered by IDF and KSSO as abdominal obesity