한국 성인에서 고립성 저 high-density lipoprotein 콜레스테롤혈증과 인슐린 저항성 간의 독립적인 상관 관계:국민건강영양조사 자료 활용(2008~2011)

Abstract

Background: Low high-density lipoprotein cholesterol (HDL-C) is an independent risk factor for cardiovascular disease and one of the components of metabolic syndrome. In Korea, low HDL-C has the biggest proportion in all kinds ofis the most prevalent type of dyslipidemia and sustains high prevalence with increasing prevalence of metabolic syndromeis becoming more prevalent as rates of metabolic syndrome increase. Recent large-scale population study studies suggests that isolated low HDL-C is also associated with an increased risk of coronary heart disease.

Methods: 24,499 participants aged 19 years and older from who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) during between 2008~2011 were included in this study, excluding lipid-lowering drug users, cardio-cerebrovascular patients and cancer patients. Low HDL-C was defined by serum HDL-C <40mg/dL in men and <50mg/dL in women. Subjects were divided into 3 groups according to lipid levels and analysis of covariance was used to explore the differences of in fasting glucose, HbA1c, fasting insulin and insulin resistance among between groups. Association between lipid levels and insulin resistance was analyzed by multiple logistic regression analysis.

Results: The odds ratio for diabetes mellitus for isolated low HDL-C was 1.31 (95% CI 1.12~1.54). The three HDL-C groups showed statistically significant differences in insulin resistance, fasting insulin, fasting glucose and HbA1c (P<0.01). Isolated low HDL-C was independently associated with increased insulin resistance risk (oOdds ratio 1.38 [95% CI 1.23~1.56]).

Conclusion: Isolated low HDL-C with an independent association with insulin resistance should be screened for and managed to prevent progression to cardiovascular disease or metabolic syndrome.