여성대사증후군의 유병률과 관련요인 분석

Abstract

[한글]본 연구는 2005년 국민건강·영양조사 자료를 활용하여 한국 여성의 대사증후군 유병률과 관련된 변인을 파악하고자, WHO의 APC(Asia-pacific criteria)를 기준으로 한 복부비만과 NCEP-ATPⅢ(National Cholesterol Education Program Adult Treatment Panel Ⅲ)를 근거로 한 대사증후군을 참고하였다. 대상은 특정질환이 없는 20세 이상의 기혼 여성 2,137명이며, 자료는 stata program 9.0을 이용하였고, χ²-test, student t-test, multiple logistic regression analysis를 활용하여 다음과 같은 결과를 얻을 수 있었다.

우리나라 20세 이상 기혼 여성의 대사증후군 유병률은 26.72%로 연령이 증가할수록 높게 나타났고 특히 60세 이후 현저히 높게 나타났다. 대사증후군을 구성하는 심혈관 위험인자별 유병률은 높은 혈압, 높은 공복혈당, 높은 중성지방, 낮은 HDL 콜레스테롤, 복부비만이 각각 29.80%, 8.94%, 20.40%, 64.95%, 44.22%이었다. 출산력 관련 특성(첫 출산연령, 임신횟수, 초경연령, 폐경여부, 호르몬복용여부)이 대사증후군에 미치는 위험비를 연령을 보정하여 분석한 결과와 출산 요소들(첫 출산연령, 임신횟수, 평균 수유기간, 초경연령, 폐경 여부)이 대사증후군에 미치는 위험비를 연령과 출산요소들을 동시에 보정하여 분석한 결과에서는 첫 출산연령이 25~29세인 경우에 감소하였고, 초경연령이 16세 이상인 경우와 폐경 후 여성인 경우에 증가하였다. 또한 일반적 특성(연령, 교육수준, 흡연, 음주, 규칙적 운동실천, 체질량지수)을 보정하여 분석한 결과와 일반적 특성(연령, 교육수준, 흡연, 음주, 규칙적 운동실천, 체질량지수)과 출산요소들을 동시에 보정하여 분석한 결과에서는 초경연령이 16세 이상인 경우와 폐경 후 여성인 경우에 증가하였다. 폐경 전, 후에 따른 출산요소들(첫 출산연령, 임신횟수, 평균 수유기간, 초경연령)이 대사증후군에 미치는 위험비를 연령을 보정하여 분석한 결과에서는 폐경 전 여성에서 초경연령이 16세 미만에 비하여 이상인 경우에 증가하였고, 폐경 후 여성에서 첫 출산연령이 25~29세인 군에서 감소하였다.

이상의 연구결과를 종합하여 보면 여성대사증후군의 관련요인은 첫 출산연령, 초경연령, 폐경 여부로 나타났다. 다만 초경의 경우 후속연구를 통하여 여성 대사증후군의 예측인자인지 여부를 명확히 확인할 필요가 있다.

[영문]This study was performed to determine related factors of prevalence of metabolic syndrome among Korean females by using data from 2005 National Health and Nutritional Survey and to investigate metabolic syndrome based on WHO Asia-pacific criteria(APC) of abdominal obesity and National Cholesterol Education Program Adult Treatment Panel Ⅲ(NCEP-ATPⅢ). As subjects 2,137 married females aged 20 years or above without a specific disease were recruited and χ²-test, student t-test and multiple logistic regression analysis were conducted with stata program 9.0 for statistical analysis. The results could be summarized as follows.

Prevalence rate of metabolic syndrome of married females aged 20 years or above was 26.72% in Korea and the prevalence was increased with growing age. In particular, that of the females aged 60 years or above was recorded to be considerably high. Prevalence rates of metabolic syndrome by cardiovascular risk factors were 29.80%, 8.94%, 20.40%, 64.95% and 44.22% in high blood pressure, fasting blood sugar, high neutral fats, low HDL cholesterol and abdominal obesity groups. According to results of analysis on risk of metabolic syndrome of parity related characteristics(age giving birth to a first baby, frequency of pregnancy, age of menarche and menopause and hormone therapy) revising age, and on the risk of reproductive factors(age giving birth to a first baby, frequency of pregnancy, average period of breast feeding, age of menarche and menopause) revising with age and reproductive factors, the prevalence was decreased when age giving birth to firs baby was 25~29 years and it was increased when subjects experienced menarche at 16 or more years old or they were in menopause. In addition, the results revising general characteristics(age, education level, smoking, drinking, regular exercise and BMI) and revising both of general characteristics and reproductive factors showed that the prevalence grew when females experienced menarche at 16 or more years old or they were in menopause. Analysis on the risk of reproductive factors(age giving birth to a first baby, frequency of pregnancy, average period of breast feeding and age of menarche) before and after menopause by revising age, reported that the risk of females experiencing menarche at 16 or more years old was higher compared to that of females doing at less than 16 old years old in subjects before menopause and it was declined when females gave birth to a first baby at 25~29 years old in females after menopause.

In conclusion, related factors of metabolic syndrome among females were found to be age giving birth to a first baby, age of menarche and menopause. However, more researches are necessary to determine whether age of menarche is a predictive factor of metabolic syndrome in females.