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Clinical Usefulness of Serum Uric Acid and Resting Heart Rate in the Diagnosis of Metabolic Syndrome in Korean Adults
Biomed Sci Letters 2017;23:118-127
Published online June 30, 2017;  https://doi.org/10.15616/BSL.2017.23.2.118
© 2017 The Korean Society For Biomedical Laboratory Sciences.

Kyung-A Shin

Department of Clinical Laboratory Science, Shinsung University, Chungnam 31801, Korea
Correspondence to: Kyung-A Shin. Department of Clinical Laboratory Science, Shinsung University, 1 Daehak-Ro, Dangjin-Si, Chungnam 31801, Korea. Tel: +82-41-350-1408, Fax: +82-41-350-1355, e-mail: mobitz2@shinsung.ac.kr
Received March 12, 2017; Revised March 30, 2017; Accepted May 21, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

Elevated serum uric acid and resting heart rate are risk factors and predictors of metabolic syndrome. However, few studies have examined the optimal cutoff value for serum uric acid and resting heart rate to predict metabolic syndrome in Korean adults. Subjects for this study were 22,302 adults (average age 45 years old), who underwent health screening examination from January 2010 to December 2012 at the Health Promotion Center of one hospital in Gyeonggi-do for general health check-up. The uric acid and resting heart rate cutoff values were calculated by ROC analysis for metabolic syndrome. Elevated serum uric acid and resting heart rate were associated with an increased prevalence of metabolic syndrome in Korean adults. The optimal cutoff value for uric acid level to predict metabolic syndrome in adults was 4.95 mg/dL (male 6.35, female 4.55) and optimal cutoff value for resting heart rate to predict metabolic syndrome was 68 beats per minute (male 66, female 68). However, serum uric acid and resting heart rate were found to have limitations for the diagnosis of metabolic syndrome.

Keywords : Metabolic syndrome, Uric acid, Resting heart rate
꽌濡

슂궛 겕궛떞(xanthine)씠 겕궛떞 궛솕슚냼(xanthine oxidase) 삉뒗 겕궛떞 깉닔냼슚냼(xanthine dehydrogenase)쓽 솢꽦솕뿉 쓽빐 깮꽦릺뒗 벂由곗쓽 理쒖쥌 궗궛臾쇰줈 넻뭾怨 떊옣寃곗꽍쓽 쐞뿕슂씤쑝濡 씤떇릺怨 엳떎(Feig et al., 2013). 洹몃윭굹 뿭븰뿰援щ 넻빐 삁泥 슂궛 궗利앺썑援, 留뚯꽦 떊옣吏덊솚, 떖옣-뇤삁愿吏덊솚怨 愿젴씠 엳떎怨 蹂닿퀬맂떎(Ioachimescu et al., 2008; Tamariz et al., 2011). 듅엳 理쒓렐 뿰援щ뱾 슂궛씠 궗利앺썑援 쐞뿕씤옄씪 肉먮쭔 븘땲씪 떦눊蹂, 怨좏삁븬, 떖삁愿吏덊솚怨 愿젴씠 엳떎怨 젣떆븯怨 엳뼱슂궛쓽 뿭븷뿉 愿떖씠 吏묒쨷릺怨 엳떎(Tamariz et al., 2011; Feig et al., 2013).

삁以 슂궛씠 떖삁愿怨꾩뿉 옉슜븯뒗 湲곗쟾 벂由 궗怨쇱젙뿉꽌 슂궛怨 븿猿 깮꽦릺뒗 궛솕슚냼(superoxidase)뿉 쓽빐 솢꽦궛냼(reactive oxygen species, ROS)쓽 깮꽦 利앷븯怨, 궛솕吏덉냼(nitric oxide, NO)쓽 깮꽦 뼲젣븯뿬 삁愿빆꽦쓣 利앷떆耳 寃곌뎅뿉뒗 삁愿궡뵾꽭룷 湲곕뒫옣븷瑜 珥덈옒븳떎(Kanellis and Kang, 2005). 슂궛뿉 쓽븳 삁愿궡뵾꽭룷 湲곕뒫옣븷뒗 궗利앺썑援 諛쒖깮뿉 빑떖쟻씤 뿭븷쓣 븯뒗 씤뒓由곗빆꽦쓣 쑀諛쒗븯뒗 湲곗쟾쑝濡 깮媛곷맂떎(Tomiyama et al., 2011). 怨좎슂궛삁利앹 怨좎씤뒓由고삁利 諛쒕퀝뿉 꽑뻾븯뿬 굹굹硫, 怨좎씤뒓由고삁利앹 洹쇱쐞꽭눊愿뿉꽌 슂궛쓣 옱씉닔븯뿬 怨좎슂궛삁利앹쓣 씪쑝궓떎(Feig et al., 2013; Li et al., 2013). 삉븳 삁泥 슂궛 삁냼뙋 쓳吏 諛 遺李⑹쓣 쑀룄븯뿬 삁쟾깮꽦怨 諛룄 吏떒諛(low density lipoprotein, LDL) 肄쒕젅뒪뀒濡ㅼ쓽 궛솕瑜 珥됱쭊븿쑝濡쒖뜥 떖삁愿吏덊솚 諛쒖깮뿉 쁺뼢쓣 誘몄튇떎(Kanellis and Kang, 2005). Yoo 벑(2004) 삁泥 슂궛移섍 젙긽踰붿쐞뿉 냽븯뜑씪룄 삁泥 슂궛 냽룄媛 利앷븷닔濡 궗利앺썑援 쐞뿕룄媛 鍮꾨쟻쑝濡 利앷븿쓣 蹂닿퀬븯떎.

븞젙떆 떖諛뺤닔(resting heart rate)뒗 1遺 룞븞 떖옣씠 닔異뺥븯뿬 삁븸쓣 삩紐몄쑝濡 諛뺤텧븯뒗 슏닔瑜 쓽誘명븯硫(Diaz et al., 2005), 援댁떖諛⑷껐젅 솢룞뿉 쓽빐 寃곗젙릺怨 援먭컧떊寃쎄낵 誘몄<떊寃쏀솢꽦쓽 긽샇옉슜뿉 쓽빐 쁺뼢쓣 諛쏅뒗떎(Menown et al., 2013). 븞젙떆 떖諛뺤닔 利앷뒗 援먭컧떊寃쎌쓽 怨쇳솢꽦怨 誘몄<떊寃 湲댁옣룄(vagal tone) 媛먯냼瑜 굹궡뒗 吏뺥썑씠硫(Nanchen et al., 2013), 옄쑉떊寃쎄퀎 씠긽쓣 뙆븙븷 닔 엳뒗 以묒슂븳 吏몴씠떎(Palatini and Julius, 2004; Bemelmans et al.,2012; Johansen et al., 2013; Menown et al., 2013). 援먭컧떊寃 솢꽦 利앷뿉 뵲瑜 븞젙떆 떖諛뺤닔 利앷뒗 씤뒓由곗빆꽦怨 鍮꾨쭔뿉 꽑뻾븯뿬 굹궇 닔 엳쑝硫, 援먭컧떊寃 솢꽦솕뒗 씤뒓由곗빆꽦쓽 썝씤씠옄 寃곌낵濡 蹂닿퀬맂떎(Bemelmans et al., 2012; Nanchen et al., 2013). 洹몃윭誘濡 궗利앺썑援곗뿉꽌뒗 삁븬씠 젙긽씤 寃쎌슦씪룄 援먭컧떊寃쎄퀎媛 빆吏꾨릺怨, 옄쑉떊寃쎄퀎 議곗젅뒫젰씠 븯릺뼱 떖諛뺤닔媛 利앷븯뒗 寃쏀뼢쓣 蹂댁씤떎(Lauer et al., 1996).

븳렪, 삁以 슂궛 냽룄 諛 븞젙떆 떖諛뺤닔쓽 媛먯냼媛 떖삁愿怨꾩쭏솚怨 궗利앺썑援 쐞뿕쓣 삁諛⑺븯뒗 寃껋쑝濡 蹂닿퀬릺怨 엳쑝굹(Liu et al., 2016), 궗利앺썑援 吏꾨떒쓣 쐞븳 슂궛怨 븞젙떆 떖諛뺤닔쓽 쟻젙 젅떒媛 꽕젙(cut-off level)뿉 븳 뿰援щ뒗 留ㅼ슦 젣븳쟻씠떎. 씠뿉 蹂 뿰援ъ뿉꽌뒗 ROC curve瑜 씠슜빐 븳援 꽦씤쓽 궗利앺썑援 吏꾨떒쓣 쐞븳 슂궛怨 븞젙떆 떖諛뺤닔쓽 理쒖쟻 젅떒媛믪쓣 꽕젙븯怨, 궗利앺썑援 吏꾨떒쓽 쑀슜꽦뿉 빐 븣븘蹂닿퀬옄 븯떎.

옱猷 諛 諛⑸쾿

떎뿕 긽옄 諛 궗利앺썑援 吏꾨떒

蹂 뿰援 긽옄뒗 2010뀈 1썡遺꽣 2012뀈 12썡源뚯 寃쎄린吏뿭 씪媛 醫낇빀蹂묒썝뿉꽌 嫄닿컯寃吏꾩쓣 떆뻾븳 20꽭 씠긽쓽 꽦씤궓瑜 긽쑝濡 븯떎. 쟾泥 긽옄 珥 23,356紐 以 怨쇨굅젰쑝濡 떦눊蹂묎낵 怨좏삁븬 吏꾨떒쓣 諛쏆 솚옄, 떖諛뺤닔뿉 쁺뼢쓣 誘몄튂뒗 踰좏李⑤떒젣瑜 蹂듭슜븯뒗 솚옄 寃곗륫移섎 룷븿븯뒗 1,054紐낆쓣 젣쇅븳 理쒖쥌 긽옄뒗 궓꽦 13,652紐, 뿬꽦 8,650紐낆쑝濡 珥 22,302紐 씠뿀떎. 怨쇨굅젰 諛 蹂듭슜븯뒗 빟臾쇱뿉 빐꽌뒗 옄湲곌린엯떇 臾몄쭊몴瑜 넻빐 議곗궗븯쑝硫, 蹂 뿰援щ뒗 寃쎄린吏뿭 醫낇빀蹂묒썝 湲곌깮紐낆쑄由ъ쐞썝쉶쓽 듅씤쓣 諛쏆븘 떆뻾븯떎(IRB No: D-1205-008-2461). 궗利앺썑援 吏꾨떒湲곗 AHA/NHLBI (American Heart Association/National Heart, Lung, and Blood Institute, 2005)쓽 湲곗뿉 뵲씪 蹂듬鍮꾨쭔, 삁븬 긽듅, 삁떦 긽듅, 以묒꽦吏諛 긽듅, HDL-肄쒕젅뒪뀒濡 媛먯냼쓽 5媛吏 쐞뿕슂씤 以 3媛吏 씠긽 留뚯”븷 寃쎌슦 궗利앺썑援곗쑝濡 젙쓽븯떎 (Grundy et al., 2005). 洹 以 삁븬 긽듅 닔異뺢린 삁븬씠 130 mmHg 씠긽 삉뒗 씠셿湲 삁븬씠 85 mmHg 씠긽씤 寃쎌슦, 삁떦 긽듅 怨듬났삁떦씠 100 mg/dL 씠긽씤 寃쎌슦濡 븯떎. 以묒꽦吏諛 긽듅 삁以 以묒꽦吏諛⑹씠 150 mg/dL 씠긽, HDL (high density lipoprotein)-肄쒕젅뒪뀒濡 媛먯냼뒗 삁以 HDL-肄쒕젅뒪뀒濡ㅼ씠 궓꽦 40 mg/dL 誘몃쭔, 뿬꽦 50 mg/dL 誘몃쭔쑝濡 븯떎. 蹂듬鍮꾨쭔 AHA/NHLBI 湲곗쑝濡 궓꽦 102 cm 씠긽, 뿬꽦 88 cm 씠긽쑝濡 젙쓽븯怨 엳쑝굹, 蹂 뿰援ъ뿉꽌뒗 룞뼇씤쓽 蹂듬鍮꾨쭔 湲곗뿉 쟻빀븳 꽭怨꾨낫嫄닿린援 꽌깭룊뼇 吏뿭 International Obesity Task Force뿉꽌 젣떆븯뒗 궓꽦 90 cm 씠긽, 뿬꽦 80 cm 씠긽쓣 蹂듬鍮꾨쭔쑝濡 젙쓽븯떎(WHO, 2000).

떊泥닿퀎痢 諛 븞젙떆 떖諛뺤닔 痢≪젙

떊옣怨 泥댁쨷 DS-103M (Jenix, Seoul, Korea) 옄룞 떊泥닿퀎痢↔린瑜 씠슜븯뿬 痢≪젙븯쑝硫, 泥댁쭏웾吏닔(body mass index, BMI)뒗 紐몃Т寃(kg)瑜 궎(m)쓽 젣怨깆쑝濡 굹늿 떇쑝濡 異붿젙븯떎. 뿀由щ몮젅뒗 뼇 諛쒖쓣 25~30 cm 踰뚮━怨 諛붾줈 꽑 옄꽭뿉꽌 媛덈퉬堉 理쒗븯떒遺쐞 怨⑤컲 뿁뜦堉덈뒫꽑 理쒖긽떒遺쐞쓽 以묎컙 吏젏쓣 痢≪젙븯쑝硫, 뿁뜦씠 몮젅뒗 以꾩옄濡 뿁뜦씠쓽 媛옣 룎異쒕쐞瑜 吏굹 닔룊씠 릺룄濡 븯뿬 痢≪젙븯떎. 닔異뺢린 씠셿湲 삁븬 10遺 씠긽 쑕떇쓣 痍⑦븳 썑 븠 옄꽭뿉꽌 닔 삁븬怨꾨줈 痢≪젙븯떎. 븞젙떆 떖諛뺤닔뒗 몴以 12쑀룄 옄룞 떖쟾怨(Cardiocare 2000, Bionet, Korea)濡 븞젙떆 떖쟾룄瑜 湲곕줉븳 썑 떖쟾룄 긽뿉 湲곕줉맂 떖諛뺤닔瑜 븞젙떆 떖諛뺤닔濡 꽕젙븯떎.

삁븸寃궗

삁븸寃궗뒗 8떆媛 씠긽 怨듬났긽깭濡 쐞뙏젙留(antecubital vein)뿉꽌 梨꾪삁븯쑝硫, TBA-200FR NEO (Toshiba, Tokyo, Japan) 깮솕븰 옄룞遺꾩꽍湲곕줈 怨듬났삁떦, 以묒꽦吏諛, 珥앹퐳젅뒪뀒濡, HDL-肄쒕젅뒪뀒濡, LDL-肄쒕젅뒪뀒濡, 슂궛, 怨좉컧룄C-諛섏쓳떒諛깆쭏(high sensitivity C-reactive protein, hs-CRP)쓣 痢≪젙븯떎. 떦솕삁깋냼(hemoglobin A1c, HbA1c)뒗 EDTA 쟾삁 寃泥대줈 Variant II (Bio Rad, CA, USA)瑜 씠슜븯뿬 怨좎꽦뒫븸泥댄겕濡쒕쭏넗洹몃옒뵾踰(high performance liquid chromatography, HPLC)쑝濡 痢≪젙븯떎. 씤뒓由곗 Modular Analytics E170 (Roche, Mannheim, Germany) 옣鍮꾨줈 쟾湲고솕븰諛쒓킅硫댁뿭遺꾩꽍踰(electrochemiluminescence immunoassay, ECLIA)쓽 썝由щ줈 寃궗븯쑝硫, 씤뒓由곗빆꽦 룊媛 吏몴씤 HOMA-IR (homeostasis model assessment-insulin resistance) 怨듬났삁떦怨 씤뒓由 냽룄瑜 씠슜븯뿬 [怨듬났떆 씤뒓由(μIU/mL) × 怨듬났떆 삁떦(mg/dL)] / 405쓽 怨꾩궛떇쑝濡 룊媛븯떎 (Moon et al., 2010).

옄猷뚯쿂由щ갑踰

蹂 뿰援ъ쓽 넻怨꾪븰쟻 遺꾩꽍 SPSS Windows 21.0 (IBM, Armonk, USA) 봽濡쒓렇옩쓣 씠슜븯쑝硫, 긽옄뱾 삁泥 슂궛移섏 븞젙떆 떖諛뺤닔뿉 뵲씪 4벑遺꾪븯뿬 꽕 援곗쑝濡 遺꾨쪟븯떎. 삁泥 슂궛移 궗遺꾩쐞닔 븞젙떆 떖諛뺤닔 궗遺꾩쐞닔뿉 뵲瑜 궗利앺썑援 쐞뿕슂씤쓽 李⑥씠瑜 鍮꾧탳븯湲 쐞븯뿬 씪썝諛곗튂 遺꾩궛遺꾩꽍(one way ANOVA)쓣 떎떆븯쑝硫, 李⑥씠媛 엳뒗 寃쎌슦 궗썑寃利앹 Bonferroni瑜 쟻슜븯떎. 삉븳 삁泥 슂궛移 궗遺꾩쐞닔 븞젙떆 떖諛뺤닔 궗遺꾩쐞닔媛꾩쓽 꽦蹂 諛 삁븬 긽듅, 삁떦 긽듅, 以묒꽦吏諛 긽듅, HDL-肄쒕젅뒪뀒濡 媛먯냼쓽 5媛吏 궗利앺썑援 쐞뿕슂씤쓽 쑀蹂묐쪧쓣 鍮꾧탳븯湲 쐞빐 移댁씠젣怨 寃젙(chi-square test)쓣 떎떆븯떎. 삁泥 슂궛移섏 븞젙떆 떖諛뺤닔 궗遺꾩쐞닔뿉 뵲瑜 궗利앺썑援 援먯감鍮꾨 援ы븯湲 쐞빐 濡쒖뒪떛 쉶洹遺꾩꽍(logistic regression)쓣 떆뻾븯쑝硫, 삤利덈퉬(odds ratio, OR) 95% 떊猶곌뎄媛(confidence interval, CI)쓣 젣떆븯떎. 삉븳 濡쒖뒪떛 쉶洹遺꾩꽍떆 뿰졊怨 꽦蹂꾩씠 슂궛移섏 븞젙떆 떖諛뺤닔뿉 誘몄튂뒗 쁺뼢쓣 諛곗젣븯湲 쐞빐 愿떖룆由쎈닔 븿猿 뿰졊怨 꽦蹂꾩쓣 룞떆뿉 룆由쎈닔濡 怨좊젮븯뿬 넻젣븳 썑 遺꾩꽍븯떎. 슂궛移섏 븞젙떆 떖諛뺤닔媛 궗利앺썑援 吏꾨떒쓣 쐞븳 젙솗븳 吏몴씤吏瑜 븣븘蹂닿린 쐞빐 ROC 怨≪꽑(Receiver Operating Characteristic Curve)쓽 硫댁쟻쓣 鍮꾧탳븯떎. 硫댁쟻 0怨 1궗씠쓽 媛믪쓣 媛吏硫, 0.5뿉 媛源뚯슱닔濡 삁痢〓젰씠 뾾怨 1씠硫 셿踰쏀븯寃 삁痢≫븯뒗 寃껋쑝濡 遺꾨쪟븯떎. 궗利앺썑援곗쓣 吏꾨떒븯湲 쐞븳 삁泥 슂궛移섏 븞젙떆 떖諛뺤닔쓽 理쒖쟻 젅떒媛(optimum cut-off values)쓣 뙋떒븯湲 쐞빐 誘쇨컧룄(sensitivity) 듅씠룄(specificity)쓽 빀씠 理쒕媛 릺뒗 吏젏쓣 삁泥 슂궛移섏 븞젙떆 떖諛뺤닔쓽 쟻젙 젅떒媛믪쑝濡 梨꾪깮븯떎. 蹂 뿰援ъ쓽 넻怨꾪븰쟻쑝濡 쑀쓽븳 뙋젙湲곗 P<0.05濡 꽕젙븯떎.

寃곌낵

슂궛쓽 궗遺꾩쐞닔뿉 뵲瑜 긽옄쓽 쓽븰쟻 듅꽦

삁泥 슂궛移섎 궗遺꾩쐞닔濡 굹늻뼱 씤泥댁륫젙븰 諛 쓽븰쟻 吏몴쓽 李⑥씠瑜 鍮꾧탳븳 寃곌낵뒗 Table 1怨 媛숇떎. 뿰졊 吏묐떒媛 李⑥씠瑜 蹂댁떎(P<0.001). 씤泥댁륫젙븰쟻 蹂씤 以 떊옣, 泥댁쨷, 泥댁쭏웾吏닔, 뿀由щ몮젅, 뿁뜦씠 몮젅뒗 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔媛 넂븯쑝硫, 1궗遺꾩쐞닔 2궗遺꾩쐞닔蹂대떎 3궗遺꾩쐞닔媛 넂븯떎. 삉븳 4궗遺꾩쐞닔뒗 1궗遺꾩쐞닔, 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 넂寃 굹궗떎(媛곴컖 P<0.001). 닔異뺢린 씠셿湲 삁븬 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔媛 넂븯쑝硫, 1궗遺꾩쐞닔 2궗遺꾩쐞닔蹂대떎 3궗遺꾩쐞닔媛 넂븯떎. 삉븳 4궗遺꾩쐞닔뒗 1궗遺꾩쐞닔, 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 넂寃 굹궗떎(媛곴컖 P<0.001). 珥앹퐳젅뒪뀒濡, LDL-肄쒕젅뒪뀒濡, 以묒꽦吏諛, 씤뒓由, 슂궛 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔媛 넂븯쑝硫, 1궗遺꾩쐞닔 2궗遺꾩쐞닔蹂대떎 3궗遺꾩쐞닔媛 넂븯떎. 삉븳 1궗遺꾩쐞닔, 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 4궗遺꾩쐞닔媛 넂寃 굹궗떎(媛곴컖 P<0.001). 븞젙떆 떖諛뺤닔뒗 4궗遺꾩쐞닔뿉꽌 1궗遺꾩쐞닔, 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 넂寃 굹궗떎(P<0.001). hs-CRP HOMA-IR 1궗遺꾩쐞닔蹂대떎 3궗遺꾩쐞닔媛 넂븯쑝硫, 4궗遺꾩쐞닔뒗 1궗遺꾩쐞닔 2궗遺꾩쐞닔蹂대떎 넂븯떎(媛곴컖 P<0.001). 怨듬났삁떦 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔, 3궗遺꾩쐞닔, 4궗遺꾩쐞닔뿉꽌 넂븯떎(P<0.001). HbA1c뒗 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔 3궗遺꾩쐞닔媛 넂븯쑝硫, 2궗遺꾩쐞닔 3궗遺꾩쐞닔蹂대떎 4궗遺꾩쐞닔媛 넂븯떎(P<0.001). 洹몃윭굹 HDL-肄쒕젅뒪뀒濡ㅼ 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔, 3궗遺꾩쐞닔, 4궗遺꾩쐞닔媛 궙븯쑝硫, 3궗遺꾩쐞닔뒗 1궗遺꾩쐞닔 2궗遺꾩쐞닔蹂대떎 궙븯떎. 삉븳 4궗遺꾩쐞닔뒗 1궗遺꾩쐞닔, 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 궙寃 굹궗떎(P<0.001). 궗利앺썑援 쑀蹂묐쪧 諛 궗利앺썑援 쐞뿕슂씤 吏묐떒媛 李⑥씠瑜 蹂댁쑝硫, 삁븬 긽듅, 삁떦 긽듅, 以묒꽦吏諛 긽듅, 蹂듬鍮꾨쭔 諛 궗利앺썑援 쑀蹂묐쪧 슂궛쓽 遺꾩쐞닔媛 넂븘吏덉닔濡 쑀蹂묐쪧 鍮덈룄媛 넂寃 굹궗떎(媛곴컖 P<0.001).

The variables characteristics of the different uric acid quartiles

  VariablesUric acid levels quartiles (n=22,302)P-value

Quartile 1 ≤4.19Quartile 2 4.20~5.29Quartile 3 5.30~6.29Quartile 4 ≥6.30
No. of subjects5,2085,8385,3615,895
Male (%)*854 (16.4)2,659 (45.4)4,471 (83.4)5,668 (96.1)<0.001
Age (year)45.43±11.4046.42±11.72*45.62±11.1644.07±10.55*<0.001
Height (cm)160.78±7.30164.06±8.53*169.35±7.93*171.46±6.90*<0.001
Weight (kg)57.63±9.2762.83±10.82*69.81±10.63*74.54±10.70*<0.001
Body mass index (kg/m2)22.29±3.1723.39±6.07*24.41±5.86*25.35±4.08*<0.001
Waist circumference (cm)73.31±8.3877.42±8.91*81.89±8.24*84.93±7.60*<0.001
Hip circumference (cm)90.85±5.4092.40±5.56*94.46±5.63*96.05±5.64*<0.001
Systolic blood pressure (mmHg)104.81±14.30108.01±14.24*111.50±13.37*113.26±12.89*<0.001
Diastolic blood pressure (mmHg)66.87±9.8169.24±10.12*72.20±9.95*73.49±10.09*<0.001
Resting heart rate (bpm)63.29±8.7063.12±9.3463.31±9.3363.98±9.51*<0.001
Total cholesterol (mg/dL)185.28±32.12191.19±33.36*194.26±33.79*200.43±34.77*<0.001
HDL-cholesterol (mg/dL)62.10±13.8858.28±13.96*53.39±12.57*50.75±11.60*<0.001
LDL-cholesterol (mg/dL)109.50±29.13116.40±30.41*121.06±30.41*126.36±31.32*<0.001
Triglyceride (mg/dL)87.89±53.23107.96±68.86*132.77±86.46*162.19±104.93*<0.001
Fasting glucose (mg/dL)89.23±20.9190.28±19.28*91.01±17.66*90.57±15.34*<0.001
hs-CRP (mg/dL)0.13±0.510.15±0.410.16±0.37*0.17±0.36*<0.001
HbA1c (%)5.57±0.835.62±0.75*5.61±0.67*5.56±0.55<0.001
Insulin (μU/mL)4.19±2.524.69±3.05*5.14±3.07*5.75±3.46*<0.001
HOMA-IR0.20±0.530.21±0.580.24±0.60*0.25±0.63*<0.001
Uric acid (mg/dL)3.50±0.504.69±0.32*5.74±0.28*7.23±0.85*<0.001
Metabolic Syndrome (%)§258 (5.0)488 (8.4)578 (10.8)840 (14.2)<0.001
 High blood pressure (%)§466 (8.9)697 (11.9)834 (15.6)1,064 (18.0)<0.001
 Low HDL-cholesterol (%)§721 (13.8)899 (15.4)774 (14.4)968 (16.4)0.001
 High fasting glucose (%)§540 (10.4)831 (14.2)855 (15.9)930 (15.8)<0.001
 High triglyceride (%)§543 (10.4)1,094 (18.7)1,625 (30.3)2,563 (43.5)<0.001
 Abdominal obesity (%)§777 (14.9)1,070 (18.3)1,129 (21.1)1,544 (26.2)<0.001

Calculated by one way ANOVA and Bonferroni test.

Values are presented as mean ± SD.

§Calculated by χ2-test Data are presented as number (%).

Abbreviations: HDL, high density lipoprotein; LDL, low density lipoprotein; hs-CRP, high sensitivity C-reactive protein; HbA1c, hemoglobin A1c; HOMA-IR, homeostasis model assessment-insulin resistance.

*Significantly different from Quartile 1 at P<0.05,

Significantly different from Quartile 2 at P<0.05,

Significantly different from Quartile 3 at P<0.05.


븞젙떆 떖諛뺤닔쓽 궗遺꾩쐞닔뿉 뵲瑜 긽옄쓽 쓽븰쟻 듅꽦

븞젙떆 떖諛뺤닔瑜 궗遺꾩쐞닔濡 굹늻뼱 씤泥댁륫젙븰 諛 쓽븰쟻 吏몴쓽 李⑥씠瑜 鍮꾧탳븳 寃곌낵뒗 Table 2 媛숇떎. 뿰졊 吏묐떒媛 李⑥씠瑜 蹂댁떎(P<0.001). 泥댁쨷 1궗遺꾩쐞닔, 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 4궗遺꾩쐞닔뿉꽌 넂寃 굹궗떎(P<0.001). 泥댁쭏웾 吏닔뒗 1궗遺꾩쐞닔蹂대떎 3궗遺꾩쐞닔, 4궗遺꾩쐞닔媛 넂븯쑝硫, 4궗遺꾩쐞닔뒗 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 넂븯떎(P<0.001). 뿀由щ몮젅 뿁뜦씠 몮젅, 닔異뺢린 삁븬, 珥앹퐳젅뒪뀒濡, 怨듬났삁떦, HbA1c뒗 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔 3궗遺꾩쐞닔, 4궗遺꾩쐞닔媛 넂븯쑝硫, 4궗遺꾩쐞닔뒗 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 넂寃 굹궗떎(媛곴컖 P<0.001). 씠셿湲 삁븬, 븞젙떆 떖諛뺤닔, 以묒꽦吏諛, 씤뒓由곗 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔, 3궗遺꾩쐞닔, 4궗遺꾩쐞닔媛 넂븯쑝硫, 2궗遺꾩쐞닔蹂대떎 3궗遺꾩쐞닔, 4궗遺꾩쐞닔媛 넂븯떎. 삉븳 4궗遺꾩쐞닔뒗 3궗遺꾩쐞닔蹂대떎 넂寃 굹궗떎(媛곴컖 P<0.001). LDL-肄쒕젅뒪뀒濡ㅼ 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔, 3궗遺꾩쐞닔, 4궗遺꾩쐞닔媛 넂븯쑝硫, 4궗遺꾩쐞닔뒗 3궗遺꾩쐞닔蹂대떎 넂븯떎(P<0.001). HDL-肄쒕젅뒪뀒濡ㅼ 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔, 3궗遺꾩쐞닔, 4궗遺꾩쐞닔媛 궙븯쑝硫, 4궗遺꾩쐞닔뒗 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 궙븯떎(P<0.001). hs-CRP뒗 1궗遺꾩쐞닔, 2궗遺꾩쐞닔蹂대떎 3궗遺꾩쐞닔, 4궗遺꾩쐞닔媛 넂븯쑝硫, 4궗遺꾩쐞닔뒗 3궗遺꾩쐞닔蹂대떎 넂븯떎(P<0.001). HOMA-IR 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔, 4궗遺꾩쐞닔媛 넂븯쑝硫, 4궗遺꾩쐞닔뒗 2궗遺꾩쐞닔, 3궗遺꾩쐞닔蹂대떎 넂븯떎(P<0.001). 궗利앺썑援곗쑀蹂묐쪧 諛 궗利앺썑援 쐞뿕슂씤 吏묐떒媛 李⑥씠瑜 蹂댁쑝硫, 삁븬 긽듅, 삁떦 긽듅 諛 궗利앺썑援 쑀蹂묐쪧 븞젙떆 떖諛뺤닔 遺꾩쐞닔媛 넂븘吏덉닔濡 쑀蹂묐쪧 鍮덈룄媛 넂寃 굹궗떎(媛곴컖 P<0.001).

The variables characteristics of the different heart rate quartiles

  VariablesHeart rate levels quartiles (n=22,302)P-value

Quartile 1 ≤56.9Quartile 2 57.0~62.9Quartile 3 63.0~67.9Quartile 4 ≥68.0
No. of subjects4,9966,1466,3044,856
Male (%)*3,220 (64.5)3,726 (60.6)3,685 (58.8)3,021 (62.6)<0.001
Age (year)46.55±11.3245.74±11.16*44.64±0.99*44.66±11.46*<0.001
Height (cm)166.79±8.63166.61±8.83166.24±8.80*166.49±8.770.008
Weight (kg)65.87±11.3566.27±12.1366.16±12.3767.36±13.01*<0.001
Body mass index (kg/m2)23.63±4.3723.83±5.1523.91±5.87*24.23±4.58*<0.001
Waist circumference (cm)78.74±8.8379.30±9.18*79.39±9.47*80.77±9.94*<0.001
Hip circumference (cm)93.04±5.6293.41±5.70*93.39±5.89*94.06±6.37*<0.001
Systolic blood pressure (mmHg)107.49±13.54108.67±13.53*109.31±14.04*112.80±14.77*<0.001
Diastolic blood pressure (mmHg)68.98±9.8769.94±10.00*70.54±10.27*72.83±10.85*<0.001
Resting heart rate (bpm)52.44±3.3059.58±1.68*65.73±1.98*76.64±6.94*<0.001
Total cholesterol (mg/dL)190.75±32.66192.81±33.94*193.24±33.47*195.20±35.90*<0.001
HDL-cholesterol (mg/dL)57.07±14.0356.14±13.72*56.04±13.60*54.70±13.48*<0.001
LDL-cholesterol (mg/dL)116.80±29.83118.61±31.02*118.53±30.69*120.14±32.33*<0.001
Triglyceride (mg/dL)109.81±73.29121.05±80.97*125.55±87.46*138.37±98.82*<0.001
Fasting glucose (mg/dL)87.44±12.9289.22±15.89*89.89±17.30*95.07±25.19*<0.001
hs-CRP (mg/dL)0.12±0.290.13±0.310.15±0.37*0.22±0.63*<0.001
HbA1c (%)5.52±0.515.56±0.61*5.58±0.69*5.72±0.93*<0.001
Insulin (μ/mL)3.98±2.494.59±2.82*5.04±2.96*5.96±3.62*<0.001
HOMA-IR0.16±0.480.26±0.59*0.15±0.520.35±0.72*<0.001
Uric acid (mg/dL)5.32±1.415.29±1.465.31±1.505.44±1.52*<0.001
Metabolic Syndrome (%)§289 (5.8)526 (8.6)582 (9.2)767 (15.8)<0.001
High blood pressure (%)§507 (10.1)734 (11.9)839 (13.3)981 (20.2)<0.001
Low HDL-cholesterol (%)§617 (12.3)949 (15.4)955 (15.1)841 (17.3)<0.001
High fasting glucose (%)§511 (10.2)752 (12.2)803 (12.7)1090 (22.4)<0.001
High triglyceride (%)§988 (19.8)1,538 (25.0)1,712 (27.2)1,587 (32.7)<0.001
Abdominal obesity (%)§780 (15.6)1,187 (19.3)1,297 (20.6)1,256 (25.9)<0.001

Calculated by one way ANOVA and Bonferroni test.

Values are presented as mean ± SD.

§Calculated by χ2-test Data are presented as number (%).

Abbreviations: HDL, high density lipoprotein; LDL, low density lipoprotein; hs-CRP, high sensitivity C-reactive protein; HbA1c, hemoglobin A1c; HOMA-IR, homeostasis model assessment-insulin resistance.

*Significantly different from Quartile 1 at P<0.05,

Significantly different from Quartile 2 at P<0.05,

Significantly different from Quartile 3 at P<0.05.


슂궛怨 븞젙떆 떖諛뺤닔 궗遺꾩쐞닔뿉 뵲瑜 궗利앺썑援곌낵쓽 愿젴꽦

濡쒖뒪떛 쉶洹遺꾩꽍쓣 넻빐 슂궛, 븞젙떆 떖諛뺤닔쓽 궗遺꾩쐞닔뿉 뵲瑜 궗利앺썑援곌낵쓽 愿젴꽦쓣 遺꾩꽍븳 寃곌낵 Table 3怨 媛숇떎. 슂궛 1궗遺꾩쐞닔뿉 鍮꾪빐 2궗遺꾩쐞닔뿉꽌 궗利앺썑援 諛쒖깮씠 1.7諛 넂븯쑝硫(odds ratio, OR: 1.680, 95% confidence interval, 95% CI: 1.428~1.976), 3궗遺꾩쐞닔뒗 2.3諛 넂븯떎(OR: 2.311, 95% CI: 1.943~2.749). 삉븳 4궗遺꾩쐞닔뒗 1궗遺꾩쐞닔蹂대떎 궗利앺썑援 諛쒖깮 쐞뿕룄媛 3.4諛 넂 뼇긽쓣 蹂댁떎(OR: 3.426, 95% CI: 2.875~4.083). 븞젙떆 떖諛뺤닔뒗 1궗遺꾩쐞닔蹂대떎 2궗遺꾩쐞닔뿉꽌 궗利앺썑援 諛쒖깮씠 1.7諛 넂븯쑝硫(OR: 1.636, 95% CI: 1.406~1.904), 3궗遺꾩쐞닔뒗 1.9諛 넂븯떎(OR: 1.877, 95% CI: 1.617~2.180). 삉븳 4遺꾩쐞닔뒗 1궗遺꾩쐞닔蹂대떎 궗利앺썑援 諛쒖깮 쐞뿕룄媛 3.4諛 넂寃 굹궗떎(OR: 3.425, 95% CI: 2.961~3.962).

Independent association between uric acid, resting heart rate and metabolic syndrome

VariablesOdds ratio (95% confidence interval) for metabolic syndromeP
Uric acid (mg/dL)Quartile 11
Quartile 21.680 (1.428~1.976)<0.001
Quartile 32.311 (1.943~2.749)<0.001
Quartile 43.426 (2.875~4.083)<0.001

Resting heart rate (bpm)Quartile 11
Quartile 21.636 (1.406~1.904)<0.001
Quartile 31.877 (1.617~2.180)<0.001
Quartile 43.425 (2.961~3.962)<0.001

Calculated by logistic regression adjusted for gender and age.

Values are presented as odds ratio (95% confidence interval).


궗利앺썑援곗쓣 삁痢≫븯湲 쐞븳 슂궛怨 븞젙떆 떖諛뺤닔쓽 젅떒媛

ROC 遺꾩꽍쓣 씠슜븯뿬 궗利앺썑援곗쓣 吏꾨떒븯湲 쐞븳 슂궛怨 븞젙떆 떖諛뺤닔쓽 쟻젙 젅떒媛믪쓣 痢≪젙븳 寃곌낵뒗 Table 4 媛숈쑝硫, Fig. 1Fig. 2뿉꽌뒗 寃궗 빆紐⑸퀎 ROC 怨≪꽑쓣 굹깉떎. 怨≪꽑쓽 븘옒 硫댁쟻씤 AUC (area under the ROC curve)뒗 遺꾨쪟 젙솗룄瑜 굹궡硫, 쟾泥 긽옄뿉꽌 슂궛쓽 AUC 媛믪 0.620, 궓꽦 0.564, 뿬꽦 0.676쑝濡 굹궗떎. 삉븳 궗利앺썑援 吏꾨떒쓣 쐞븳 쟾泥 긽옄쓽 슂궛 젅떒媛믪 4.95 mg/dL, 誘쇨컧룄뒗 73.0%, 듅씠룄뒗 44.3%濡 굹궗떎. 뿬꽦 긽옄쓽 寃쎌슦 슂궛 젅떒媛믪 4.55 mg/dL, 誘쇨컧룄 57.1%, 듅씠룄 69.2%, 궓꽦 긽옄뒗 슂궛 젅떒媛믪 6.35 mg/dL, 誘쇨컧룄 47.7%, 듅씠룄 62.5%濡 굹궗떎. 쟾泥 긽옄뿉꽌 븞젙떆 떖諛뺤닔쓽 AUC 媛믪 0.609, 궓꽦 0.615, 뿬꽦 0.601濡 굹궗떎. 궗利앺썑援 吏꾨떒쓣 쐞븳 쟾泥 긽옄쓽 븞젙떆 떖諛뺤닔 젅떒媛믪 遺꾨떦 67.50쉶뿉 誘쇨컧룄뒗 42.7%, 듅씠룄뒗 73.0%濡 굹궗떎. 뿬꽦 긽옄쓽 寃쎌슦 븞젙떆 떖諛뺤닔 젅떒媛믪 遺꾨떦 67.50쉶뿉 誘쇨컧룄뒗 42.9%, 듅씠룄뒗 72.6%瑜 굹깉쑝硫, 궓꽦쓽 븞젙떆 떖諛뺤닔 젅떒媛믪 遺꾨떦 65.50쉶뿉 誘쇨컧룄 50.1%, 듅씠룄 66.2%瑜 蹂댁떎.

ROC-curve analysis according to uric acid and resting heart rate

VariablesCutoff valueSensitivitySpecificityAUC (95% confidence interval)
Uric acid (mg/dL)Total4.9573.0%44.3%0.620 (0.607~0.632)
Male6.3547.7%62.5%0.564 (0.548~0.579)
Female4.5557.1%69.2%0.676 (0.652~0.699)

Resting heart rate (bpm)Total67.5042.7%73.0%0.609 (0.597~0.622)
Male65.5050.1%66.2%0.615 (0.600~0.630)
Female67.5042.9%72.6%0.601 (0.577~0.625)

Abbreviations: AUC, area under the curve.


Fig. 1.

ROC curve of uric acid for diagnosis of metabolic syndrome. AUC=0.620, Cutoff value=4.95 mg/dL, Sensitivity= 73.0%, Specificity=44.3%


Fig. 2.

ROC curve of resting heart rate for diagnosis of metabolic syndrome. AUC=0.609, Cutoff value=67.50 bpm, Sensitivity= 42.7%, Specificity=73.0%


怨좎같

蹂 뿰援ш껐怨 븳援 꽦씤뿉꽌 꽦蹂, 뿰졊怨쇰뒗 룆由쎌쟻쑝濡 삁泥 슂궛移섏 븞젙떆 떖諛뺤닔媛 넂쓣닔濡 궗利앺썑援 쐞뿕룄媛 利앷븯뒗 寃껋쓣 솗씤븯떎. 삉븳 슂궛 4.95 mg/dL, 븞젙떆 떖諛뺤닔뒗 遺꾨떦 68쉶 씠긽씪 븣 궗利앺썑援 쐞뿕씠 利앷븯뒗 寃껋쑝濡 굹궗쑝硫, 궗利앺썑援곗쓣 吏꾨떒븯뒗뜲 슂궛怨 븞젙떆 떖諛뺤닔쓽 AUC 媛믪 0.7蹂대떎 궙 젙솗룄瑜 蹂댁뿬 蹂댁“쟻씤 吏몴濡 씠슜븯뒗 寃껋씠 떦븷 寃껋쑝濡 깮媛곷맂떎. 궗利앺썑援곗 궡떦뒫옣븷, 蹂듬鍮꾨쭔, 怨좏삁븬, 以묒꽦吏諛 利앷 HDL-肄쒕젅뒪뀒濡 媛먯냼쓽 5媛吏 吏꾨떒湲곗 以 3媛吏 씠긽씠 븳 媛쒖씤뿉寃 援곗쭛솕릺뼱 굹굹뒗 寃껋쓣 留먰븯硫, 蹂듬鍮꾨쭔怨 씤뒓由곗빆꽦씠 빑떖 뿭븷쓣 븳떎怨 븣젮졇 엳떎(Eckel et al., 2010).

슂궛 삁愿 誘쇰Т뒳洹쇱쑁 利앹떇쓣 옄洹뱁븯怨 삁愿궡뵾꽭룷 湲곕뒫옣븷瑜 씪쑝耳 궛솕吏덉냼쓽 깮泥 씠슜瑜좎쓣 뼲젣븯硫, 寃곌뎅 삁愿 궡 뿼利앸컲쓳怨 삁냼뙋 쓳吏 諛 遺李⑸컲쓳뿉 뵲瑜 삁쟾 깮꽦쓽 利앷 媛숈 룞留κ꼍솕利앹뿉꽌 굹굹뒗 삁愿 蹂솕瑜 蹂댁씤떎(Kanellis and Kang, 2005; Choi and Park, 2015). 슂궛뿉 쓽븳 삁愿 솗옣湲곕뒫怨 삁愿궡뵾꽭룷 湲곕뒫쓽 븯뒗 씤뒓由곗빆꽦쓽 諛쒖깮湲곗쟾쑝濡 씤떇릺硫(Tomiyama et al., 2011), 씤뒓由곗빆꽦 肄⑺뙠뿉꽌쓽 슂궛諛곗꽕 媛먯냼 洹쇱쐞 꽭눊愿뿉꽌쓽 슂궛 옱씉닔뿉 쓽빐 삁以 슂궛移 긽듅쓣 쑀룄븳떎(Feig et al., 2013; Li et al., 2013). Yoo 벑(2004) 삁以 슂궛 냽룄媛 怨좏삁븬, 씤뒓由곗빆꽦 諛 궗利앺썑援곗쐞뿕슂씤怨 긽愿愿怨꾧 엳쑝硫, 젙긽踰붿쐞쓽 삁泥 슂궛 냽룄씪 븷吏씪룄 삁泥 슂궛 냽룄쓽 利앷뿉 鍮꾨븯뿬 궗利앺썑援 쐞뿕룄媛 利앷븳떎怨 蹂닿퀬븯떎. 삉븳 뿬꽦 끂씤쓣 긽쑝濡 怨좎슂궛삁利앹씤 寃쎌슦 궗利앺썑援 諛쒕퀝 쐞뿕씠 1.8諛 利앷븯쑝硫(Zhang et al., 2011), 50꽭 씠긽 궓꽦쓣 긽쑝濡 삁泥 슂궛 냽룄瑜 3遺꾩쐞濡 굹늻뼱 5.7뀈媛 異붿쟻愿李고븳 寃곌낵 슂궛 냽룄媛 媛옣 궙 援곕낫떎 媛옣 넂 援곗쓽 궗利앺썑援 諛쒖깮씠 1.8諛 넂븯떎(Sui et al., 2008).

蹂 뿰援ш껐怨 슂궛쓣 궗遺꾩쐞닔濡 援щ텇븯쓣 븣 궙 遺꾩쐞닔뿉꽌 넂 遺꾩쐞닔濡 吏꾪뻾븷닔濡 궗利앺썑援 諛쒖깮쐞뿕씠 넂븯쑝硫, 1궗遺꾩쐞닔蹂대떎 3궗遺꾩쐞닔뿉꽌뒗 2.3諛, 4궗遺꾩쐞닔뿉꽌 궗利앺썑援 諛쒖깮 쐞뿕룄媛 3.4諛 넂寃 굹궗떎. 삉븳 삁泥 슂궛 냽룄쓽 긽븳移섎뒗 궓꽦 7.0 mg/dL, 뿬꽦 6.0 mg/dL濡 젣떆릺硫(Hong et al., 2008), 蹂 뿰援ъ뿉꽌 궗利앺썑援 쐞뿕씠 利앷븯뒗 쟾泥 긽옄쓽 슂궛 쟻젙 젅떒媛믪 4.95 mg/dL쑝硫, 뿬꽦쓽 寃쎌슦 4.55 mg/dL, 궓꽦 6.35 mg/dL濡 꽦蹂꾧낵 뿰졊뿉 뵲씪 떎뼇븳 젅떒媛믪쓣 쟻슜빐빞 븷 븘슂꽦씠 슂援щ맂떎.

궗利앺썑援곗뿉꽌뒗 援먭컧떊寃쎄퀎쓽 솢꽦솕濡 븞젙떆 떖諛뺤닔媛 利앷븯硫, 궗利앺썑援 쐞뿕슂씤쓽 媛쒖닔媛 利앷븿뿉 뵲씪 븞젙떆 떖諛뺤닔媛 넂寃 굹굹怨 엳뼱 떖諛뺤닔媛 떖삁愿吏덊솚쓽 쐞뿕쓣 삁痢≫븷 닔 엳뒗 궗利앺썑援 쐞뿕슂씤쓽 븯굹濡 媛꾩<맂떎(Shin, 2015). 떎젣濡 8뀈媛 3,527紐낆쓣 긽쑝濡 븞젙떆 떖諛뺤닔媛 遺꾨떦 90쉶 씠긽씤 긽옄 70쉶씠븯씤 긽옄瑜 鍮꾧탳븳 寃곌낵 90쉶 씠긽씤 援곗쓽 떖삁愿怨꾩쭏솚뿉 쓽븳 궗留 쐞뿕씠 2.2諛 넂寃 굹궗쑝硫, 떖諛뺤닔媛 넂쓣닔濡 吏덊솚쓽 諛쒕퀝 媛뒫꽦씠 넂怨 寃쎄낵룄 醫뗭 븡쓬쓣 븣 닔 엳뿀떎(Kristal-Boneh et al., 2000).

蹂 뿰援ш껐怨 븞젙떆 떖諛뺤닔瑜 궗遺꾩쐞닔濡 援щ텇븯쓣 븣 궙 遺꾩쐞닔뿉꽌 넂 遺꾩쐞닔濡 吏꾪뻾븷닔濡 궗利앺썑援 諛쒖깮 쐞뿕씠 넂븯쑝硫, 1궗遺꾩쐞닔蹂대떎 4궗遺꾩쐞닔쓽 궗利앺썑援 諛쒖깮 쐞뿕룄뒗 3.4諛 넂寃 굹궗떎. 援먭컧떊寃쎄낵솢꽦怨 誘몄<떊寃 湲댁옣(vagal tone) 媛먯냼瑜 쓽誘명븯뒗 떖諛뺤닔 利앷뒗 씤뒓由곗빆꽦怨 愿젴씠 엳쑝硫, 씤뒓由곗빆꽦 援먭컧떊寃쎄퀎 젅땶-븞吏삤뀗떊 떆뒪뀥쓣 솢꽦솕떆궡쑝濡쒖뜥 떊꽭눊愿뿉꽌 굹듃瑜 옱씉닔瑜 利앷떆耳 삁븬怨 떖諛뺤닔쓽 利앷瑜 쑀諛쒗븯寃 맂떎(Reaven, 2002; Inoue et al., 2008; Nanchen et al., 2013). 떖諛뺤닔媛 鍮좊쇱닔濡 궗利앺썑援 쐞뿕 넂븘吏뒗뜲, 떖洹쇨꼍깋利 솚옄瑜 긽쑝濡 踰좏李⑤떒젣濡 떖諛뺤닔瑜 媛먯냼떆궓 寃곌낵 궗留앸쪧씠 媛먯냼븯뒗 寃껋쑝濡 굹궗떎(Teo et al., 1993). 븞젙떆 떖諛뺤닔뒗 遺꾨떦 60~100쉶濡 젙쓽븯怨 엳쑝硫(Jose and Collison, 1970), 蹂 뿰援ъ뿉꽌뒗 궗利앺썑援 쐞뿕씠 利앷븯뒗 븞젙떆 떖諛뺤닔쓽 쟻젙 젅떒媛믪 遺꾨떦 68쉶濡 굹궗떎. 븳렪, 꽑뻾뿰援ъ뿉꽌뒗 븞젙떆 떖諛뺤닔媛 遺꾨떦 76쉶 씠긽씪 寃쎌슦 愿긽룞留μ쭏솚뿉 쓽븳 궗留 쐞뿕瑜좎씠 넂떎怨 젣떆븯怨 엳뼱 떖諛뺤닔瑜 궙寃 쑀吏븯뒗 寃껋씠 吏덊솚 諛쒖깮쓣 삁諛⑺븯뒗뜲 諛붾엺吏곹븷 寃껋쑝濡 궗猷뚮맂떎(Hsia et al., 2009). 洹몃윭굹 떖諛뺤닔뒗 뿰졊 利앷 븿猿 궙븘吏뒗 寃껋쑝濡 븣젮졇 엳쑝硫(Park et al., 2015), 뿰졊뿉 뵲씪 쟻슜 媛뒫븳 떖諛뺤닔쓽 젅떒媛믪뿉 븳 썑냽뿰援ш 븘슂븯寃좊떎.

蹂 뿰援щ뒗 떒硫 뿰援щ줈뜥 썝씤怨 寃곌낵쓽 씤怨쇨怨꾨 꽕紐낇븷 닔 뾾쑝硫, 씪媛 醫낇빀蹂묒썝 嫄닿컯寃吏꾩꽱꽣뿉꽌 嫄닿컯寃吏꾩쓣 떎떆븳 꽦씤쓣 긽쑝濡 븯뿬 寃곌낵瑜 씪諛섑솕븯뒗뜲 젣븳씠 엳떎. 삉븳 쓬二쇰굹 씉뿰, 슫룞 諛 떇씠뒿愿 벑쓣怨좊젮븯吏 紐삵븳 젣븳젏씠 엳쑝굹, 슂궛怨 븞젙떆 떖諛뺤닔媛 궗利앺썑援 吏꾨떒뿉 쑀슜븳吏瑜 理쒖쟻 젅떒媛 꽕젙쓣 넻빐 븣븘蹂 洹쒕え 뿰援щ줈꽌 쓽誘멸 엳떎.

寃곕줎쟻쑝濡 蹂 뿰援ш껐怨 븳援 꽦씤뿉꽌 슂궛移섏 븞젙떆 떖諛뺤닔媛 넂쓣닔濡 궗利앺썑援 쐞뿕룄媛 利앷븯뒗 寃껋쑝濡 굹궗떎. 궗利앺썑援 쐞뿕씠 利앷븯뒗 슂궛쓽 理쒖쟻 젅떒媛믪 4.95 mg/dL, 븞젙떆 떖諛뺤닔쓽 理쒖쟻 젅떒媛믪 遺꾨떦 68쉶濡 굹굹, 젙긽踰붿쐞씪 븷吏씪룄 궙 닔移섎 쑀吏븯뒗 寃껋씠 諛붾엺吏곹븯寃좊떎. 삉븳 슂궛怨 븞젙떆 떖諛뺤닔뒗 궗利앺썑援곗쓣 삁痢≫븯뒗뜲 룆由쎌쟻쑝濡 궗슜븯湲곗뿉뒗 븳怨꾧 엳쑝굹 蹂댁“쟻씤 吏몴濡쒕뒗 궗슜 媛뒫븷 寃껋쑝濡 깮媛곷맂떎.

CONFLICT OF INTEREST

The authors have no conflicts of interest to disclose.

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