40대 남성에서 혈청지질 농도, 호르몬 농도 및 체형의 상호 관련성

Abstract

Background: Because Korean men in their 40s show the highest mortality rate in the world, great interest has focused recently on their body fat and muscle distribution, lifestyle pattern, and metabolic variables. The purpose of this study was to determine interrelationship among metabolic and anthropometric variables and lifestyle patterns in healthy Korean men. Methods: Anthropometries, total calorie intake and energy expenditure were determined in 50 normal weight and 74 overweight men aged 40∼49 years. Adipose tissue and muscle areas were calculated from computed tomography scans at 3 body levels, L1, L4 and mid portion of thigh. Serum levels of lipids and hormones and glucose and insulin levels during oral glucose tolerance test (OGTT), were measured. Dyslipidemia was defined as hypertriglyceridemia (≥2200 ㎎/dL), hypercholesterolemia (≥220 ㎎/dL) and high LDL-cholesterol (≥130 ㎎/dL), and/or low HDL-cholesterol (≤40 ㎎/dL). Characteristics of dyslipidemic men (n=17) were compared to normolipidemic men (n=24) with similar age and body mass index. Results: Serum lipid levels highly correlated with anthropometric variables, serum hormone levels and calorie intake and expenditure. In multivariate analysis, waist to hip ratio was the strongest determinant of serum triglyceride and total cholesterol concentrations. Thigh muscle mass and subcutaneous fat at L4 were the strongest determinant of LDL-cholesterol and total/HDL cholesterol ratio, respectively. When stepwise multiple regression analysis was used to evaluate the joint effect of serum hormone levels and calorie intake and expenditure on anthropometric variables, insulin response area during OGTT was the strongest determinant of waist to hip ratio. There was a joint effect of insulin response area during OGTT, total calorie intake and total energy expenditure on subcutaneous fat area at L4. Dyslipidemic men had higher mean values of triglyceride (231 vs 106 ㎎/dL), total cholesterol (242 vs 173 ㎎/dL) and LDL-cholesterol (153 vs 102 ㎎/dL) but lower mean value of HDL-cholesterol (44 vs 51 ㎎/dL). Although there were no significant differences between two groups in age and body mass index, dyslipidemic men showed an increase in waist circumference and total and subcutaneous fat area at L4 level, compared with normolipidemic men. Fasting free fatty acid levels and response areas of insulin and free fatty acid during OGTT were higher in dyslipidemic men than in normolipidemic men. Dyslipidemic men consumed more calorie than their expenditure. Conclusion: In this study, dyslipidemic men showed abdominal fat accumulation and this seems to result in increased serum concentration of free fatty acid and hyperinsulinemia. In addition, serum insulin level, total calorie intake and energy expenditure have a joint effect on central body fat accumulation in healthy men aged 40∼49years