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Prevalence of Irritable Bowel Syndrome and its Association with Psychological Distress among Female College Students in Korea
Biomed Sci Letters 2020;26:351-359
Published online December 31, 2020;  https://doi.org/10.15616/BSL.2020.26.4.351
© 2020 The Korean Society For Biomedical Laboratory Sciences.

Aelee Jang,*

Department of Nursing, University of Ulsan, Ulsan 44610, Korea
Correspondence to: Aelee Jang. Department of Nursing, University of Ulsan, Daehak-ro 93, Nam-gu, Ulsan 44610, Korea.
Tel: +82-52-259-1252, Fax: +82-52-259-1236, e-mail: aeleejang@ulsan.ac.kr
*Professor.
Received November 23, 2020; Revised December 15, 2020; Accepted December 15, 2020.
 Abstract
It is well known that irritable bowel syndrome (IBS) is related to psychological distress. However, only a few studies have investigated the relationship between IBS and various dimensions of psychological distress. This study aimed to evaluate the prevalence of IBS and its relationship with anxiety, depression, and stress in young female college students. A cross-sectional study was conducted using a self-report structured questionnaire with 673 female college students. IBS was diagnosed based on the Rome III criteria. For the evaluation of psychological distress on the IBS, we investigated Hospital Anxiety and Depression Scale (HADS) and Global Assessment of Recent Stress (GARS). The prevalence of IBS was 27.9%. In the univariate analysis, the anxiety, depression, and stress scores were significantly associated with IBS (P<0.001, P=0.001, and P<0.001, respectively). Multivariate analysis showed that anxiety (OR=1.07, 95% CI=1.01~ 1.15, P=0.032) and stress scores (OR=1.23, 95% CI=1.19~1.27, P<0.001) were independently correlated with the IBS. Among the subtypes of IBS, IBS with predominant constipation was the most common, and the anxiety, depression, and stress scores did not significantly differ between the subtypes. Our results suggest that anxiety and stress are closely related to IBS. Managing psychological distress should be considered in the treatment of IBS in young female college students.
Keywords : Irritable bowel syndrome, Female, Student, Psychological distress, Anxiety, Depression, Stress
꽌 濡

怨쇰쇱꽦 옣利앺썑援(irritable bowel syndrome, IBS) 蹂듯넻, 蹂듬 遺덊렪媛 諛 蹂뒿愿쓽 蹂솕瑜 듅吏뺤쑝濡 븯뒗 留뚯꽦 吏덊솚씠떎(Mearin et al., 2016; Ford et al., 2017). 쟾 꽭怨꾩쟻쑝濡 빟 4~22%쓽 쑀蹂묐쪧쓣 蹂댁씠뒗 留ㅼ슦 쓷븳 吏덊솚씠떎(Hungin et al., 2003; Choung and Locke, 2011; Makharia et al., 2011). 遺遺 35꽭 씠쟾뿉 利앹긽씠 諛쒖깮븯怨, 25꽭 씠븯뿉꽌 利앹긽씠 媛옣 留롮씠 굹굹硫(Thomson and Dancey, 1996; Han et al., 2006; Naeem et al., 2012), 젇 뿬꽦뿉꽌 궓꽦蹂대떎 3諛 젙룄 뜑 留롮씠 諛쒖깮븯뒗 寃껋쑝濡 蹂닿퀬릺怨 엳떎(Lee et al., 2001; Chang and Heitkemper, 2002). 듅엳, 븰깮쓣 긽쑝濡 떎떆맂 뿰援ъ뿉꽌 怨쇰쇱꽦 옣利앺썑援곗쓽 쑀蹂묐쪧씠 10.7~24.0%濡 愿李곕릺怨, 뿬옄븰깮뿉꽌뒗 15.7~35.0%濡 궓옄븰깮蹂대떎 넂 鍮덈룄濡 蹂닿퀬릺怨 엳떎(Jafri et al., 2005; Shiotani et al., 2006; Naeem et al., 2012; Ibrahim et al., 2013; Costanian et al., 2015; Alsuwailm et al., 2017). 븯쐞 쑀삎 利앹긽뿉 뵲씪 蹂鍮꾪삎(IBS with predominant constipation), 꽕궗삎(IBS with predominant diarrhea), 샎빀삎(IBS with mixed bowel habits), 誘몃텇瑜섑삎(unsubtyped IBS)쑝濡 遺꾨쪟븯뒗뜲, 궓꽦 꽕궗삎, 젇 뿬꽦뿉꽌뒗 蹂鍮꾪삎씠 슦꽭븳 寃껋쑝濡 븣젮졇 엳떎(Chial and Camilleri, 2002; Adeyemo et al., 2010; Kim and Kim, 2018).

怨쇰쇱꽦 옣利앺썑援곗쓽 젙솗븳 蹂묓깭깮由щ뒗 븘吏 븣젮졇 엳吏 븡吏留, 궡옣쓽 媛먭컖怨쇰 諛 옄쑉떊寃쎄퀎쓽 遺쟻젅븳 蹂솕濡 씤븯뿬 蹂듯넻씠굹 蹂듬 遺덊렪媛먯씠 굹굹硫(Mazurak et al., 2012), 遺덉븞, 슦슱, 뒪듃젅뒪 媛숈 젙떊쟻 슂씤씠 怨쇰쇱꽦 옣利앺썑援곗쓣 쑀諛쒗븯뒗뜲 以묒슂븳 뿭븷쓣 븷 寃껋쑝濡 깮媛곷맂떎(Azpiroz et al., 2000; Whitehead et al., 2002; Chey et al., 2015). 깮泥댁떖由ъ궗쉶쟻 紐⑤뜽(biopsychosocial model)뿉꽌뒗 뇤 옣 궗씠뿉 긽샇옉슜(brain-gut axis)쑝濡 떖由ъ쟻 怨좏넻씠 깮由ъ쟻 湲곕뒫뿉 쁺뼢쓣 誘몄퀜 떊泥댄솕 利앹긽씠 굹궃떎怨 꽕紐낇븯怨 엳떎(Drossman, 1998; Jones et al., 2011; Tanaka et al., 2011). 뵲씪꽌, 怨쇰쇱꽦 옣利앺썑援곗 以묒텛떊寃쎄퀎 떎뼇븳 떖由ъ쟻 怨좏넻쓽 긽샇옉슜씠 옣쓽 뿰룞슫룞怨 넻利앹뿉 븳 誘쇨컧룄뿉 쁺뼢쓣 誘몄퀜 씪뼱궃떎뒗 媛뒫꽦뿉 빐 꽕紐낅맂떎(Porcelli, 2004).

怨쇰쇱꽦 옣利앺썑援곗 깮紐낆쓣 쐞삊븷 닔 엳뒗 以묓븳 吏덊솚 븘땲吏留 諛섎났릺뒗 利앹긽뱾濡 씤빐 궣쓽 吏덉씠 겕寃 븯맂떎(Lu et al., 2005; Chey et al., 2015). 留롮 솚옄뱾 怨쇰쇱꽦 옣利앺썑援곗쓽 利앹긽 븙솕濡 씪긽쟻씤 깮솢뿉 遺덊렪쓣 뒓겮怨, 궗쉶깮솢쓣 젣濡 븯吏 紐삵븯뿬 븰援먮 寃곗꽍븯嫄곕굹 吏곸옣쓣 寃곌렐븯寃 맂떎. 삉븳, 遺덊렪媛먯쑝濡 빟臾쇱쓣 蹂듭슜븯嫄곕굹 븘슂 뾾뒗 寃궗瑜 諛쏄쾶 릺뼱 쓽猷뚮퉬쓽 吏異쒖씠 쁽엳 利앷븯뒗 벑쓽 臾몄젣媛 諛쒖깮븷 닔 엳떎(Azpiroz et al., 2000; Whitehead et al., 2002; Spiegel, 2009). 洹몃윭誘濡 돺寃 媛꾧낵릺怨 엳뒗 怨쇰쇱꽦 옣利앺썑援곗뿉 븳 젙솗븳 吏꾨떒씠 諛쒖깮솗瑜좎씠 넂 젇 뿬꽦뱾뿉寃 븘슂븯떎.

怨쇰쇱꽦 옣利앺썑援 솚옄뿉꽌 젙떊쟻 臾몄젣瑜 룞諛섑븳 寃쎌슦媛 엳뒗 寃껋쑝濡 븣젮졇 엳쑝硫(Esler and Coulston, 1973; Rose et al., 1986; Savas et al., 2009), 吏湲덇퉴吏 紐뉖챺 뿰援ъ뿉꽌 遺덉븞, 슦슱, 뒪듃젅뒪 벑怨 愿젴맂 떖由ъ쟻 怨좏넻쓽 쑀蹂묐쪧쓣 怨쇰쇱꽦 옣利앺썑援 솚옄 젙긽 꽦씤쓣 鍮꾧탳뿰援ы븯떎. 떖由ъ쟻 怨좏넻씠 젙긽 꽦씤뿉 鍮꾪븯뿬 怨쇰쇱꽦 옣利앺썑援 솚옄뿉寃 뜑 떖븯떎怨 蹂닿퀬븳 꽑뻾뿰援щ룄 엳쑝굹(Savas et al., 2009; Sugaya et al., 2012), 李⑥씠媛 뾾떎怨 蹂닿퀬븳 뿰援щ뱾룄 엳뿀떎(Alander et al., 2008; Berman et al., 2012) 삉븳, 떖由ъ쟻 怨좏넻쓣 룞諛섑븳 怨쇰쇱꽦 옣利앺썑援 솚옄뒗 蹂鍮꾪삎쓣 뜑 留롮씠 굹궦떎뒗 蹂닿퀬룄 븘吏 끉쓽 뿬吏媛 엳떎(Muscatello et al., 2010).

뵲씪꽌 蹂 뿰援ъ뿉꽌뒗 젇 뿬옄븰깮쓣 긽쑝濡 怨쇰쇱꽦 옣利앺썑援곗쓽 쑀蹂묐쪧怨 븯쐞 쑀삎쓽 遺꾪룷瑜 議곗궗븯怨 怨쇰쇱꽦 옣利앺썑援곌낵 遺덉븞, 슦슱 諛 뒪듃젅뒪 媛숈 떖由ъ쟻 怨좏넻怨쇱쓽 뿰愿꽦쓣 蹂닿퀬옄 븯떎.

뿰援 諛⑸쾿

뿰援ъ꽕怨

蹂 뿰援щ뒗 援궡 뿬옄븰깮쓣 긽쑝濡 怨쇰쇱꽦 옣利앺썑援 쑀蹂묐쪧怨 遺덉븞, 슦슱 諛 뒪듃젅뒪 媛숈 떖由ъ쟻 怨좏넻怨쇱쓽 뿰愿꽦쓣 뙆븙븯湲 쐞븳 꽌닠쟻 議곗궗뿰援ъ씠떎.

뿰援щ긽

뿰援щ긽옄뒗 B떆 냼옱 4媛쒖쓽 4뀈젣 븰援먯뿉 옱븰 以묒씤 留 18꽭 씠긽 뿬옄븰깮 以 뿰援щぉ쟻쓣 씠빐븯怨 뿰援ъ갭뿬뿉 옄諛쒖쟻쑝濡 룞쓽븳 780紐낆쓣 엫쓽 몴異쒗븯떎. 긽옄 젣쇅湲곗쑝濡쒕뒗 냼솕湲곌퀎넻 닔닠쓣 諛쏆븯嫄곕굹 蹂듯넻쑝濡 엯썝븳 怨쇨굅젰씠 엳뒗 옄, 룞諛섎릺뒗 湲곗쭏쟻 냼솕湲 吏덊솚씠 엳뒗 옄(뿼利앹꽦 옣 吏덊솚, 쑀떦씉닔 옣븷, 蹂듦컯 吏덊솚, 룓뇙꽦 옣 吏덊솚 벑), 以묒쬆 蹂듯빀 硫댁뿭 寃고븤利앹씠굹 媛묒긽꽑 吏덊솚씠 엳뒗 옄, 쁽옱 젙떊 吏덊솚쓣 븪怨 엳嫄곕굹 젙떊怨 빟臾쇱쓣 蹂듭슜븯뒗 옄, 옣 슫룞뿉 쁺뼢쓣 以 닔 엳뒗 빟臾쇱쓣 젙湲곗쟻쑝濡 蹂듭슜븯뒗 옄씠떎. 紐⑥쭛맂 긽옄 780紐 以 긽옄 젣쇅湲곗뿉 빐떦븯뒗 107紐(李몄뿬 嫄곗젅 90紐, 옣 닔닠쓽 怨쇨굅젰 10紐, 湲곗쭏쟻씤 냼솕湲 吏덊솚 룞諛 4紐, 떖媛곹븳 媛묒긽꽑 吏덊솚 3紐)쓣 젣쇅븯怨 뿬옄븰깮 673紐낆쓽 옄猷뚭 理쒖쥌遺꾩꽍뿉 궗슜릺뿀떎(Fig. 1).

Fig. 1. Flow chart of the study process. IBS: Irritable bowel syn-rome.

뿰援щ룄援

怨쇰쇱꽦 옣利앺썑援: 怨쇰쇱꽦 옣利앺썑援 吏꾨떒 Drossman (2006)뿉 쓽븯뿬 媛쒕컻릺怨 Rome III뿉 洹쇨굅븳 Rome III Adult Questionnaire쓣 븳냼솕湲 湲곕뒫꽦 吏덊솚 슫룞븰쉶뿉꽌 븳援뼱濡 踰덉뿭븳 룄援щ줈 뿀媛瑜 諛쏆 썑 궗슜븯떎(Song et al., 2013). 珥 10臾명빆쑝濡 援ъ꽦릺뼱 엳뒗 怨쇰쇱꽦 옣利앺썑援곗쓽 援ъ껜쟻씤 吏꾨떒湲곗쑝濡 1~3踰 臾명빆쓽 蹂듬 넻利앹씠굹 遺덊렪媛먯쓣 寃쏀뿕븳 湲곌컙쓣 痢≪젙 벑쓽 怨쇰쇱꽦 옣利앺썑援 吏꾨떒 議곌굔쓣 留뚯”떆궎뒗 寃쎌슦, A) 4踰 臾명빆 諛곕 썑 利앹긽 셿솕 愿젴, B) 5~6踰 臾명빆 蹂듬 넻利앹씠굹 遺덊렪媛먯쓽 떆옉씠 諛곕 슏닔 愿젴, C) 7~8踰 臾명빆 蹂듬 넻利앹씠굹 遺덊렪媛먯쓽 떆옉씠 諛곕삎깭 愿젴븯뿬 솗씤븳떎. 洹몃━怨 9~10踰 臾명빆 怨쇰쇱꽦 옣利앺썑援곗쓣 蹂鍮꾪삎, 꽕궗삎, 샎빀삎, 誘몃텇瑜섑삎쑝濡 遺꾨쪟븯뒗 臾명빆쑝濡 援ъ꽦릺뼱 엳떎.

怨쇰쇱꽦 옣利앺썑援 吏꾨떒 6媛쒖썡 쟾遺꽣 蹂듬 넻利앹씠굹 蹂듬 뙺留뚭컧 벑 蹂듬 遺덊렪媛 벑쓽 利앹긽씠 떆옉릺뿀怨 吏꾨떒 떆젏뿉꽌 3媛쒖썡 씠궡 1媛쒖썡뿉 2~3씪 씠긽쓽 鍮덈룄瑜 蹂댁씠뒗 蹂듬 넻利앹씠굹 遺덊렪媛먯씠 굹굹怨, 뿬꽦 蹂듬 넻利앹씠굹 遺덊렪媛먯씠 깮由ш린媛꾧낵 愿젴 뾾뼱빞 븯硫, A, B, C 臾명빆 以 몢 媛 臾명빆 씠긽씠 怨쇰쇱꽦 옣利앺썑援곗쓽 吏꾨떒뿉 留뚯”떆耳쒖빞 怨쇰쇱꽦 옣利앺썑援곗쑝濡 吏꾨떒궡由곕떎. 9踰 臾명빆뿉 빐떦릺뒗 寃쎌슦瑜 蹂鍮꾪삎 怨쇰쇱꽦 옣利앺썑援, 10踰 臾명빆뿉 빐떦릺뒗 寃쎌슦瑜 꽕궗삎 怨쇰쇱꽦 옣利앺썑援곕줈 遺꾨쪟븷 닔 엳떎. 9踰덇낵 10踰 臾명빆씠 紐⑤몢 빐떦릺硫 샎빀삎 怨쇰쇱꽦 옣利앺썑援곗쑝濡 紐⑤몢 빐떦씠 븞 릺硫 誘몃텇瑜섑삎 怨쇰쇱꽦 옣利앺썑援곗쑝濡 遺꾨쪟븷 닔 엳떎.

씤援ъ궗쉶븰쟻 듅꽦怨 嫄닿컯愿젴 듅꽦: 꽕臾몄뒗 옄媛蹂닿퀬삎쑝濡 긽옄쓽 씤援ъ궗쉶븰쟻, 嫄닿컯愿젴 듅꽦씠 룷븿릺뼱 엳떎.

遺덉븞怨 슦슱: 遺덉븞怨 슦슱뿉 븳 꽕臾몄 Zigmond Snaith (1983)뿉 쓽빐 媛쒕컻릺怨 Oh 벑 (1999)씠 븳湲濡 踰덉뿭븳 蹂묒썝 遺덉븞 諛 슦슱 룄援(Hospital Anxiety and Depression Scale, HADS)瑜 궗슜븯뒗뜲 룄援 媛쒕컻옄 븳湲 踰덉뿭옄쓽 뿀媛瑜 諛쏆 썑뿉 痢≪젙븯떎. 씠 룄援щ뒗 珥 14臾명빆쑝濡 遺덉븞뿉 愿븳 泥숇룄 7臾명빆怨 슦슱 泥숇룄씤 7臾명빆쑝濡 援ъ꽦릺뼱 엳떎. 媛곴컖쓽 臾명빆 0~3젏쑝濡 珥 0~21젏쓽 4젏 Likert 泥숇룄濡 젏닔媛 넂쓣닔濡 遺덉븞怨 슦슱씠 넂쓬쓣 쓽誘명븳떎. 遺덉븞怨 슦슱 媛곴컖 珥앹젏 0~7젏 遺덉븞 삉뒗 슦슱씠 뾾뒗 긽깭, 8~10젏 寃쎄퀎꽦 遺덉븞 삉뒗 슦슱, 11젏 씠긽 遺덉븞 삉뒗 슦슱 긽깭濡 젙쓽븳떎. 븳援뙋 蹂묒썝 遺덉븞 諛 슦슱 룄援ъ쓽 臾명빆쓽 궡쟻 씪愿꽦뿉 븳 떊猶곕룄 Cronbach's 慣뒗 遺덉븞 .89, 슦슱 .89씠뿀쑝硫(Oh et al., 1999), 蹂 뿰援ъ뿉꽌뒗 遺덉븞 .85, 슦슱 .84떎.

뒪듃젅뒪 吏媛 젙룄: 뒪듃젅뒪뒗 Linn (1985)뿉 쓽빐 媛쒕컻릺怨 Koh (1988)씠 븳湲濡 踰덉뿭븳 뒪듃젅뒪 吏媛 젙룄 룄援(Global Assessment of Recent Stress, GARS)瑜 씠슜븯뿬 理쒓렐 씪二쇱씪 룞븞쓽 씪, 吏곸뾽 諛 븰援먯 愿젴맂 븬諛뺢컧, 씤愿怨꾩쓽 븬諛뺢컧, 씤愿怨꾩쓽 蹂솕濡 씤븳 븬諛뺢컧, 蹂묒씠굹 긽빐뿉 쓽븳 븬諛뺢컧, 湲덉쟾쟻씤 臾몄젣濡 씤븳 븬諛뺢컧, 씪긽쟻씤 寃껋씠 븘땶 궗嫄대뱾뿉 븳 븬諛뺢컧, 씪긽깮솢쓽 蹂솕쑀臾댁 愿젴맂 븬諛뺢컧 諛 씪二쇱씪 媛꾩쓽 쟾諛섏쟻씤 븬諛뺢컧 벑 8臾명빆뿉 븯뿬 議곗궗븯떎. 뒪듃젅뒪媛 쟾 뾾뒗 寃쎌슦瑜 0젏쑝濡 븯怨 洹밸룄濡 떖븳 寃쎌슦瑜 9젏쑝濡 몴떆븯怨, 媛곴컖쓽 臾명빆 0~9젏쑝濡 珥 0~72젏쓽 10젏 Likert 泥숇룄濡 젏닔媛 넂쓣닔濡 뒪듃젅뒪瑜 吏媛곹븯뒗 젙룄媛 넂쓬쓣 굹궦떎. 룄援ш컻諛 떦떆쓽 寃궗-옱寃궗 떊猶곕룄뒗 r=.69뿉꽌遺꽣 r=.92씠뿀쑝硫(Linn, 1985), 蹂 뿰援ъ뿉꽌 Cronbach's 慣뒗 .90씠뿀떎.

옄猷뚯닔吏

蹂 뿰援ъ뿉 븵꽌 P 븰援먮퀝썝뿉꽌 湲곌뿰援ъ쑄由ъ떖쓽쐞썝쉶(IRB)쓽 뿰援ъ듅씤(D-1204-128-002)쓣 嫄곗낀怨, 옄猷뚯닔吏묎린媛꾩 2012뀈 6썡遺꽣 2012뀈 7썡源뚯떎. 옄猷뚯닔吏묒 蹂 뿰援ъ옄 1씤怨 뿰援ъ쑄由ш탳쑁 諛 꽕臾몄“궗 썕젴쓣 諛쏆 뿰援щ낫議곗썝 3씤씠 빐떦 븰쓽 삊議곕 뼸뼱 媛뺤쓽떆媛 씠쇅쓽 떆媛꾩뿉 뿰援щ긽옄뿉寃 뿰援ъ쓽 紐⑹쟻, 븘슂꽦, 諛⑸쾿 벑뿉 븯뿬 꽕紐낆쓣 븯怨 뿰援ъ갭뿬뿉 옄諛쒖쟻쑝濡 룞쓽븳 븰깮뱾뿉寃 꽕臾몄瑜 諛곕븯떎. 뿰援ъ갭뿬옄쓽 沅뚮━瑜 蹂댄샇븯湲 쐞빐 닔吏묐맂 옄猷뚮뒗 씡紐낆쑝濡 泥섎━븯뿬 뿰援ш 吏꾪뻾릺뒗 룞븞 뿰援ъ쓽 李몄뿬쓽궗瑜 뼵젣뱺吏 泥좏쉶븷 닔 엳쓬怨 뿰援ъ쿋쉶濡 씤븳 뼱뼡 遺덉씠씡룄 諛쏆 븡쓣 寃껋씠硫 닔吏묐맂 옄猷뚮뒗 뿰援ъ쓽 紐⑹쟻쑝濡쒕쭔 궗슜븷 寃껋엫쓣 꽕紐낇븯떎. 꽕臾몄 옉꽦 냼슂떆媛꾩 15~20遺 젙룄쑝硫, 꽕臾몄뿉 李몄뿬븳 긽옄뿉寃 냼젙쓽 떟濡뭹쓣 젣怨듯븯떎.

옄猷뚮텇꽍

닔吏묐맂 옄猷뚮뒗 IBM SPSS Statistics 23.0 program쑝濡 遺꾩꽍븯떎. 뿬옄븰깮쓽 怨쇰쇱꽦 옣利앺썑援 쑀蹂묒쑉, 씤援ъ궗쉶븰쟻 諛 嫄닿컯愿젴 듅꽦 떎닔 諛깅텇쑉, 룊洹좉낵 몴以렪李⑤줈 遺꾩꽍븯떎. 뿬옄븰깮쓽 怨쇰쇱꽦 옣利앺썑援 諛쒖깮뿬遺뿉 뵲씪 씤援ъ궗쉶븰쟻 諛 嫄닿컯愿젴 듅꽦, 遺덉븞, 슦슱, 뒪듃젅뒪 吏媛 젙룄쓽 李⑥씠뒗 2-test, independent t-test 삉뒗 Fisher's exact test瑜 씠슜븯뿬 遺꾩꽍븯떎. 怨쇰쇱꽦 옣利앺썑援 利앹긽쓽 븯쐞 쑀삎뿉 뵲瑜 遺덉븞, 슦슱, 뒪듃젅뒪 吏媛 젙룄쓽 李⑥씠뒗 씪썝諛곗튂 遺꾩궛遺꾩꽍(One-way ANOVA)쓣 씠슜븯떎. 遺덉븞, 슦슱, 뒪듃젅뒪 吏媛 젙룄 怨쇰쇱꽦 옣利앺썑援 궗씠쓽 뿰愿꽦 떎蹂웾 濡쒖뒪떛 쉶洹遺꾩꽍쓣 떎떆븳 뮘, 援먯감鍮(Odds Ratio, OR)瑜 궛異쒗븯뿬 룊媛븯떎. 쑀쓽룄(慣)뒗 0.05(뼇痢↔젙)濡 뙋젙븯떎.

寃 怨

긽옄쓽 씤援ъ궗쉶븰쟻 諛 嫄닿컯愿젴 듅꽦 諛 怨쇰쇱꽦 옣利앺썑援 쑀蹂묐쪧

673紐낆쓽 뿰援щ긽옄뱾 以 Rome III 吏꾨떒湲곗뿉 뵲瑜 怨쇰쇱꽦 옣利앺썑援곗쑝濡 吏꾨떒諛쏆 솚옄援곗 188紐(27.9%)怨, 怨쇰쇱꽦 옣利앺썑援곗씠 뾾뒗 嫄닿컯 議곌뎔 485紐 (72.1%)떎(Fig. 1). 씤援ъ궗쉶븰쟻 듅꽦怨 嫄닿컯愿젴 듅꽦 Table 1怨 媛숇떎. 紐⑤몢 뿬옄씠硫, 뿰졊쓽 踰붿쐞뒗 留 18꽭뿉꽌 28꽭濡 룊洹 뿰졊(몴以렪李) 21.0 (짹1.9)꽭쑝硫, 룊洹 泥댁쭏웾吏닔(몴以렪李)뒗 20.4 (짹2.5)kg/m2씠뿀떎. 李몄뿬 븰깮쓽 븰뀈遺꾪룷뒗 4븰뀈 21.5%, 3븰뀈 29.1%, 2븰뀈 31.6%, 1븰뀈 17.7%씠뿀떎. 二쇨굅삎깭뒗 옄湲 吏 嫄곗<媛 57.2%濡 媛옣 留롮븯怨, 쓬二쇳븯뒗 궗엺 81.1%씠硫 씉뿰븯뒗 궗엺 1.5%떎. 怨쇰쇱꽦 옣利앺썑援 솚옄援곌낵 嫄닿컯 議곌뎔 궗씠뿉 씤援ъ궗쉶븰쟻씤 듅꽦뿉꽌 쑀쓽븳 李⑥씠媛 뾾뿀떎. 떎留, 理쒓렐 3媛쒖썡 룞븞 蹂듯넻씠굹 蹂듬 遺덊렪媛먯쑝濡 쓽猷뚭린愿쓣 諛⑸Ц븳 寃쎌슦뒗 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 19.1%濡 嫄닿컯 議곌뎔쓽 12.2%뿉 鍮꾪븯뿬 넻怨꾪븰쟻쑝濡 쓽誘몄엳寃 넂븯떎(P=0.020). 삉븳, 理쒓렐 3媛쒖썡 룞븞 蹂듯넻씠굹 蹂듬 遺덊렪媛먯쑝濡 빟臾쇱쓣 蹂듭슜븳 寃쎌슦뒗 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 43.1%, 嫄닿컯 議곌뎔뿉꽌 23.5%濡 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 썡벑엳 넂븯떎(P<0.001).

General characteristics of participants (N=673)

Variables Categories Total (N=673) IBS patients (n=188) Healthy controls (n=485) χ2/t (P)

n (%) or M ± SD n (%) or M ± SD n (%) or M ± SD
Age (years) 21.0±1.9 21.1±1.9 20.9±1.9 0.98 (0.330)

BMI (kg/m2) 20.4±2.5 20.2±2.6 20.5±2.5 -1.31 (0.301)

Year in school Freshman 119 (17.7) 36 (19.1) 83 (17.2) 6.25 (0.100)
Sophomore 213 (31.6) 46 (24.6) 167 (34.4)
Junior 196 (29.1) 61 (32.4) 135 (27.8)
Senior 145 (21.5) 45 (23.9) 100 (20.6)

Residential status Own house 385 (57.2) 116 (61.7) 269 (55.5) 3.80 (0.284)
Dormitory 190 (28.2) 43 (22.9) 147 (30.3)
Self-boarding 90 (13.4) 27 (14.4) 63 (13.0)
Others 8 (1.2) 2 (1.0) 6 (1.2)

Alcohol Yes 546 (81.1) 158 (84.0) 388 (80.0) 1.45 (0.229)
No 127 (18.9) 30 (16.0) 97 (20.0)

Smoking Yes 10 (1.5) 1 (0.5) 9 (1.9) 1.62 (0.203)*
No 663 (98.5) 187 (99.5) 476 (98.1)

Medical facilities visits (for 3 months) Yes 95 (14.1) 36 (19.1) 59 (12.2) 5.45 (0.020)
No 578 (85.9) 152 (80.9) 426 (87.8)

Medication (for 3 months) Yes 195 (29.0) 81 (43.1) 114 (23.5) 25.24 (<0.001)
No 478 (71.0) 107 (56.9) 371 (76.5)

BMI=Body mass index; IBS=Irritable Bowel Syndrome; *Fisher exact test



怨쇰쇱꽦 옣利앺썑援곌낵 遺덉븞, 슦슱, 뒪듃젅뒪 吏媛 젙룄

遺덉븞 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 遺덉븞븯吏 븡 긽깭(8젏 誘몃쭔)媛 53.7%濡 媛옣 留롮븯怨 寃쎄퀎꽦 遺덉븞(8~ 10젏)씠 25.0%, 遺덉븞븳 긽깭(11젏 씠긽)媛 21.3%씠뿀쑝硫, 슦슱 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 슦슱븯吏 븡 긽깭(8젏 誘몃쭔)媛 62.8%濡 媛옣 留롮븯怨 寃쎄퀎꽦 슦슱(8~10젏)씠 26.6%, 슦슱븳 긽깭(11젏 씠긽)媛 10.6%씠뿀떎. 遺덉븞 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 7.75 (짹3.45)젏, 嫄닿컯 議곌뎔뿉꽌 6.22 (짹3.46)젏씠怨, 슦슱 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 6.56 (짹3.03)젏, 嫄닿컯 議곌뎔뿉꽌 5.64 (짹3.31)젏쑝濡 몢 吏몴 紐⑤몢 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 넂븯떎(P<0.001, P=0.001). 뒪듃젅뒪 吏媛 젙룄뒗 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 43.59 (짹13.01)젏, 嫄닿컯 議곌뎔뿉꽌 25.37 (짹10.88)젏쑝濡 怨쇰쇱꽦 옣利앺썑援 솚옄援곗뿉꽌 넂븯떎(P<0.001) 遺덉븞怨 뒪듃젅뒪뒗 떎蹂웾 濡쒖뒪떛 쉶洹遺꾩꽍뿉꽌 援먯감鍮 1.07 (95% CI=1.01~1.15, P=0.032) 諛 1.23 (95% CI=1.19~1.27, P<0.001)쑝濡 怨쇰쇱꽦 옣利앺썑援곗쓽 룆由쎌쟻씤 쐞뿕씤옄濡 굹궗떎(Table 2).

Differences of HADS and GARS between IBS patients and healthy controls (N=673)

Variables Total (N=673) IBS patients (n=188) Healthy controls (n=485) χ2/t (P) Multiple logistic regression


n (%) or M ± SD n (%) or M ± SD n (%) or M ± SD OR (95% CI) P
HADS Anxiety 6.65±3.52 7.75±3.45 6.22±3.46 -5.15 (<0.001) 1.07 (1.01~1.15) 0.032
<8 438 (65.1) 101 (53.7) 337 (69.5) 16.27 (<0.001)
8~10 138 (20.5) 47 (25.0) 91 (18.8)
≥11 97 (14.4) 40 (21.3) 57 (11.7)

Depression 5.90±3.26 6.56±3.03 5.64±3.31 -3.33 (0.001) 1.00 (0.93~1.06) 0.918
<8 481 (71.5) 118 (62.8) 363 (74.8) 11.28 (0.004)
8~10 127 (18.9) 50 (26.6) 77 (15.9)
≥11 65 (9.7) 20 (10.6) 45 (9.3)

GARS 30.46±14.12 43.59±13.01 25.37±10.88 -17.02 (<0.001) 1.23 (1.19~1.27) <0.001

HADS=Hospital Anxiety and Depression; GARS=Global Assessment of Recent Stress; IBS=Irritable Bowel Syndrome



怨쇰쇱꽦 옣利앺썑援 利앹긽쓽 븯쐞 쑀삎怨 遺덉븞, 슦슱, 뒪듃젅뒪 吏媛 젙룄

Rome III 吏꾨떒湲곗뿉 뵲瑜 怨쇰쇱꽦 옣利앺썑援 利앹긽쓽 븯쐞 쑀삎 蹂鍮꾪삎씠 85紐(45.3%)쑝濡 媛옣 留롮븯쑝硫, 떎쓬쑝濡 샎빀삎씠 54紐(28.7%), 꽕궗삎씠 45紐(23.9%), 誘몃텇瑜섑삎씠 4紐(2.1%) 닚씠뿀떎. 怨쇰쇱꽦 옣利앺썑援 利앹긽쓽 븯쐞 쑀삎 뵲瑜 遺덉븞, 슦슱, 뒪듃젅뒪 吏媛 젙룄뒗 蹂鍮꾪삎뿉꽌 紐⑤몢 빟媛 넂븯쑝굹, 떎瑜 븯쐞 쑀삎怨 넻怨꾪븰쟻씤 李⑥씠瑜 蹂댁씠吏 븡븯떎(Table 3).

Differences of HADS and GARS between IBS subtypes (N=188)

Variables IBS subtypes (M ± SD) F (P)

IBS-C (n=85) IBS-D (n=45) IBS-M (n=54) IBS-U (n=4)
HADS Anxiety 7.87±3.80 7.67±3.18 7.65±3.25 7.50±2.52 0.07 (0.978)
Depression 6.73±2.79 6.47±3.81 6.41±2.74 6.25±2.50 0.16 (0.923)

GARS 43.87±12.56 43.27±13.85 43.44±13.58 43.00±7.96 0.03 (0.994)

HADS=Hospital Anxiety and Depression; GARS=Global Assessment of Recent Stress; IBS=Irritable Bowel Syndrome; IBS-C=IBS-Constipation; IBS-D=IBS-Diarrhea; IBS-M=IBS-Mixed type; IBS-U=IBS-Unsubtyped


怨 李

젇 뿬옄븰깮 빟 4遺꾩쓽 1 씠긽뿉꽌 怨쇰쇱꽦 옣利앺썑援곗쓽 利앹긽쑝濡 遺덊렪븿쓣 샇냼븯怨 엳뿀怨, 怨쇰쇱꽦옣利앺썑援곗쓣 媛吏 뿬옄븰깮뱾씠 遺덉븞怨 슦슱쓣 뜑 留롮씠 샇냼븯怨 뒪듃젅뒪뿉 븳 吏媛 젙룄媛 留ㅼ슦 넂寃 굹궗떎. 젇 뿬옄븰깮 떆뿕怨 吏꾨줈뿉 븳 뒪듃젅뒪媛 떖븯怨, 씠濡 씤븳 遺덉븞怨 슦슱쓣 샇냼븯뒗 寃쎌슦媛 留롮븘꽌 떊泥댄솕 利앹긽쓣 留롮씠 굹궡怨 怨쇰쇱꽦 옣利앺썑援곗쓽 쑀蹂묐쪧씠 넂 寃껋쑝濡 깮媛곷맂떎.

蹂 뿰援ъ뿉꽌뒗 뿬옄븰깮(룊洹 뿰졊 21꽭) 673紐낆쓣 긽쑝濡 ROME III 吏꾨떒湲곗뿉 빐떦븯뒗 怨쇰쇱꽦 옣利앺썑援곗쑝濡 꽑蹂꾨맂 긽옄뒗 188紐낆쑝濡 쑀蹂묐쪧 27.9%濡 굹궗떎. 援궡 怨쇰쇱꽦 옣利앺썑援곗쓽 쑀蹂묐쪧 3.0~28.0%濡 異붿젙릺怨 엳뒗 寃껉낵 鍮꾧탳븯쓣 븣 鍮꾧탳쟻 넂 쑀蹂묐쪧씤 寃껋쓣 븣 닔 엳뿀떎(Han et al., 2006; Lee et al., 2009; Park and Lim, 2011). 怨쇰쇱꽦 옣利앺썑援곗 젇 뿬꽦뿉꽌 궓꽦蹂대떎 3諛 젙룄 뜑 留롮 寃껋쑝濡 蹂닿퀬릺怨 엳떎(Lee et al., 2001; Chang and Heitkemper, 2002). 援궡쇅 뿬옄븰깮쓣 긽쑝濡 議곗궗븳 怨쇰쇱꽦 옣利앺썑援곗쓽 쑀蹂묐쪧씠 15.7%뿉꽌 35.0%濡 蹂 뿰援ъ 鍮꾩듂븯떎(Jafri et al., 2005; Shiotani et al., 2006; Naeem et al., 2012; Ibrahim et al., 2013; Costanian et al., 2015; Alsuwailm et al., 2017; Park et al., 2018). 씠윭븳 寃곌낵뒗 씪諛섎븰깮쓣 긽쑝濡 議곗궗븳 怨쇰쇱꽦 옣利앺썑援곗쓽 쑀蹂묐쪧씠 10.7%씤(Shiotani et al., 2006) 寃껉낵 鍮꾧탳븯硫 젇 뿬옄븰깮쓽 쑀蹂묐쪧씠 留ㅼ슦 넂 寃껋쓣 븣 닔 엳떎. 젇 뿬꽦뿉꽌 궓꽦蹂대떎 怨쇰쇱꽦 옣利앺썑援 쑀蹂묐쪧씠 넂 씠쑀뒗 궡옣 怨쇰쇱꽦쓽 뿭移섍 궙怨, 옣 넻怨쇱떆媛꾩씠 湲몃ʼn, 깮由ъ<湲곗뿉 뵲瑜 뿉뒪듃濡쒓쾺씠굹 봽濡쒓쾶뒪뀒濡, 봽濡쒖뒪湲뵖 벑 샇瑜대が 蹂솕 愿젴 엳뒗 寃껋쑝濡 븣젮졇 엳떎(Heitkemper et al., 2003; Kim and Park, 2011).

怨쇰쇱꽦 옣利앺썑援곗쓽 利앹긽 쑀삎 蹂鍮꾪삎씠 45.3%, 꽕궗-蹂鍮 샎빀삎씠 28.7%, 꽕궗삎 23.9%, 誘몃텇瑜섑삎 2.1% 닚씠뿀떎. 援궡쇅쓽 쟾泥 怨쇰쇱꽦 옣利앺썑援 솚옄瑜 긽쑝濡 븳 꽑뻾뿰援ъ뿉꽌뒗 샎빀삎씠 50.0%뿉꽌 55.7%濡 媛옣 留롮 遺꾪룷瑜 李⑥븯怨 엳뿀怨, 젇 뿬꽦쓣 긽쑝濡 븳 뿰援ъ뿉꽌뒗 蹂鍮꾪삎씠 媛옣 留롮 遺꾪룷瑜 李⑥븯怨 엳뿀떎(Kim and Ban, 2005; Tillisch et al., 2005; Shiotani et al., 2006; Okami et al., 2011). 利앹긽쓽 李⑥씠媛 諛쒖깮븯뒗 湲곗쟾뿉 븯뿬 紐낇솗븯寃 꽕紐낇븷 닔뒗 뾾쑝굹 꽕궗삎쓽 寃쎌슦뒗 옣쓽 슫룞꽦씠 怨쇰룄븯硫, 蹂鍮꾪삎쓽 寃쎌슦뿉뒗 옣쓽 슫룞꽦씠 誘몄빟븯寃 諛쒖깮맂떎. 寃곌뎅, 옣쓽 슫룞꽦쓣 議곗젅븯뒗 以묒텛떊寃쎄퀎쓽 빟솕濡 씤븯뿬 씪뼱굹뒗 쁽긽쑝濡, 利앹긽 쑀삎뿉 뵲씪 떇씠, 빟臾 移섎즺 諛 愿由 諛⑸쾿쓣 떎瑜닿쾶 빐빞 븳떎(Porcelli, 2004; Drossman and Dumitrascu, 2006).

蹂 뿰援ъ쓽 긽옄씤 뿬옄븰깮쓽 떖由ъ쟻 怨좏넻쑝濡 슦슱 꽑뻾뿰援(Dong et al., 2010)蹂대떎 빟媛 궙븯怨 遺덉븞 빟媛 넂븯쑝굹, 쟾諛섏쟻쑝濡 鍮꾩듂븳 닔以씠뿀떎. 諛섎㈃, 怨쇰쇱꽦 옣利앺썑援 솚옄援곌낵 嫄닿컯 議곌뎔쑝濡 굹늻뼱 鍮꾧탳븯硫 썡벑엳 怨쇰쇱꽦 옣利앺썑援 솚옄뿉꽌 떖由ъ쟻 怨좏넻씠 넂寃 굹궗떎. 怨쇰쇱꽦 옣利앺썑援곌낵 젙떊 吏덊솚 媛꾩쓽 愿怨꾨 룊媛븳 뿬윭 꽑뻾뿰援ъ뿉꽌 떊寃쎌쬆, 遺덉븞, 슦슱利 諛 씤吏 湲곕뒫 옣븷媛 怨쇰쇱꽦 옣利앺썑援 솚옄뿉꽌 뜑 留롮씠 諛쒖깮븯뒗 寃껋쑝濡 蹂닿퀬릺뿀떎(Budavari and Olden, 2003; Gonsalkorale et al., 2003; Koloski et al., 2003; Levy et al., 2006). 떖븳 怨쇰쇱꽦 옣利앺썑援 솚옄瑜 긽쑝濡 븳 뿰援ъ뿉꽌뒗 긽옄쓽 44%媛 젙떊蹂묒쟻 利앹긽쓣 寃쏀뿕븳 寃껋쑝濡 굹궗怨 슦슱利앷낵 遺덉븞利앹꽭媛 媛옣 쓷븳 吏덊솚씠뿀떎(Guthrie et al., 2003). 蹂 뿰援ъ뿉꽌룄 遺덉븞怨 뒪듃젅뒪媛 怨쇰쇱꽦 옣利앺썑援곌낵 룆由쎌쟻씤 긽愿愿怨꾨 蹂댁怨, 떎瑜 뿰援щ뱾뿉꽌쓽 寃곌낵 씪移섑븯떎. 124紐낆쓽 怨쇰쇱꽦 옣利앺썑援곌낵 91紐낆쓽 嫄닿컯 議곌뎔뿉꽌 젙떊쟻 슂씤쓽 긽愿愿怨꾨 鍮꾧탳븳 꽑뻾뿰援ъ뿉꽌 遺덉븞怨 슦슱 옣 利앹긽쓽 以묐벑룄 媛옣 諛젒븳 愿젴씠 엳뿀떎(Cho et al., 2011). 767紐낆쓽 궓 븰깮쓣 긽쑝濡 븳 씠쟾쓽 뿰援ъ뿉꽌 뒪듃젅뒪媛 怨쇰쇱꽦 옣利앺썑援 솚옄뿉꽌 넂寃 굹궗떎(Liu et al., 2014). 삉븳, 248紐낆쓽 뿬옄 援곗씤쓣 긽쑝濡 怨쇰쇱꽦 옣利앺썑援곌낵 떖由ъ쟻 怨좏넻쓽 愿젴꽦쓣 솗씤븳 뿰援ъ뿉꽌 怨쇰쇱꽦 옣利앺썑援곗씠 엳뒗 援곗뿉꽌 遺덉븞, 슦슱, 뒪듃젅뒪媛 넂 寃껋쑝濡 굹궗떎(Savas et al., 2009). 씠 媛숈 留λ씫쑝濡 蹂듯넻, 꽕궗, 뙺留뚭컧, 蹂鍮, 떇슃 遺吏, 援ы넗 벑 6媛吏 二쇱슂 쐞옣愿 利앹긽怨 젙떊 긽깭쓽 뿰愿꽦뿉 븳 洹쒕え 臾댁옉쐞 뿰援ъ뿉꽌뒗, 二쇱슂 슦슱利(13.4%), 怨듯솴 옣븷(12.5%) 諛 愿묒옣 怨듯룷利(17.8%) 몢 媛吏 씠긽쓽 쐞옣愿 利앹긽씠 엳뒗 솚옄뿉꽌 뜑 쓷븯寃 諛쒓껄릺뿀떎(Yates, 2005).

怨쇰쇱꽦 옣利앺썑援곌낵 젙떊 吏덊솚怨쇱쓽 뿰愿愿怨꾨뒗 뇤-옣 異(brain-gut axis)쓽 湲곕뒫 옣븷媛 以묒슂븳 뿭븷쓣 븳떎怨 븣젮졇 엳떎(Bercik et al., 2012; Kennedy et al., 2012). 긽뼢떇 紐⑤뜽뿉 뵲瑜대㈃ 蹂듬 利앹긽 씠李⑥쟻쑝濡 遺덉븞怨 슦슱利앹뿉 쁺뼢쓣 誘몄튂怨, 븯뼢떇 紐⑤뜽뿉 뵲瑜대㈃ 뒪듃젅뒪, 遺덉븞 諛 슦슱利앷낵 媛숈 젙떊쟻 슂씤 옄泥닿 誘몄< 諛 援먭컧꽦 떊寃쎌쓣 넻븯뿬 옣쓽 슫룞 湲곕뒫, 媛먭컖 뿭移 諛 뒪듃젅뒪 諛섏쓳꽦怨 媛숈 깮由ъ쟻 슂씤뿉 쁺뼢쓣 誘몄튇떎. 怨쇰쇱꽦 옣利앺썑援 솚옄뿉꽌 넂 닔以쓽 遺덉븞, 슦슱, 뒪듃젅뒪뿉 븳 蹂 뿰援 寃곌낵뒗 怨쇰쇱꽦 옣利앺썑援곗뿉꽌 젙떊쟻 슂씤쓽 뿭븷쓣 뜑슧 뮮諛쏆묠븳떎. 뵲씪꽌 怨쇰쇱꽦 옣利앺썑援 솚옄쓽 룞諛 떖由ъ쟻 怨좏넻씤 遺덉븞, 슦슱, 뒪듃젅뒪瑜 솗씤븯怨 移섎즺븯뒗 寃껋 怨쇰쇱꽦 옣利앺썑援곗쓣 뜑 옒 씠빐븯뒗 뜲 룄씠 릺怨, 뜑 굹 移섎즺 寃곌낵뿉 湲곗뿬븷 寃껋쑝濡 깮媛곷맂떎. 떎젣, 怨쇰쇱꽦 옣利앺썑援 移섎즺瑜 쐞빐 씪諛섏쟻씤 愿由ъ 떖由ъ슂踰뺤쓣 鍮꾧탳븳 19媛 뿰援ъ 쐞빟怨 빆슦슱젣瑜 鍮꾧탳븳 12媛 뿰援щ 鍮꾧탳븳 硫뷀遺꾩꽍뿉꽌, 떖由ъ슂踰 諛 빆슦슱젣媛 怨쇰쇱꽦 옣利앺썑援곗쓽 移섎즺뿉 긽떦븳 씠젏씠 엳쓬쓣 엯利앺뻽떎(Ford et al., 2009).

蹂 뿰援ъ뿉꽌뒗 蹂鍮꾪삎 솚옄뿉꽌 遺덉븞, 슦슱, 뒪듃젅뒪쓽 젏닔媛 빟媛 넂븯쑝굹 떎瑜 븯쐞 쑀삎쓣 媛吏 솚옄뱾怨 鍮꾧탳븯쓣 븣 넻怨꾩쟻쑝濡 쑀쓽븳 李⑥씠瑜 蹂댁씠吏뒗 븡븯떎. Guthrie 벑 (2003)쓽 뿰援ъ뿉 쓽븯硫, 꽕궗삎 솚옄뿉꽌 떎瑜 븯쐞 쑀삎뿉 鍮꾪빐꽌 넂 젙떊蹂묒쟻 룞諛 吏덊솚쑉쓣 蹂닿퀬뻽떎. 諛섎㈃, Eriksson 벑 (2008)쓽 뿰援ъ뿉꽌뒗 蹂鍮꾪삎 솚옄媛 꽕궗삎 솚옄蹂대떎 젙떊쟻 利앹긽씠 뜑 넂븯怨 삁泥 봽濡ㅻ씫떞(prolactin)쓽 닔移섍 뜑 넂븯떎. 洹몃윭굹 꽕궗삎 솚옄뿉꽌 떊泥 湲곕뒫 옣븷뿉 븳 씤떇룄뒗 뜑 넂븯怨, 넂 C-렔떚뱶(C-peptide) 닔移섎 蹂댁떎. 씠뒗 븘留덈룄 옄쑉떊寃쎄퀎 湲곕뒫 옣븷瑜 諛섏쁺븳 寃껋쑝濡 깮媛곷맂떎. 삉븳, 샎빀삎 솚옄뿉꽌뒗 蹂鍮꾪삎怨 꽕궗삎뿉 愿뿬븯뒗 봽濡ㅻ씫떞怨 C-렔씠뱶媛 紐⑤몢 룞떆뿉 議댁옱븯뒗 寃껋쑝濡 蹂댁씤떎. 뵲씪꽌, 怨쇰쇱꽦 옣利앺썑援곗쓽 븯쐞 쑀삎 媛꾩쓽 李⑥씠瑜 利앸챸븯湲 쐞빐 異붽 깮솕븰 뿰援ш 븘슂븷 寃껋쑝濡 깮媛곷맂떎.

蹂 뿰援щ뒗 紐 媛吏 젣븳젏씠 엳떎. 泥レ㎏, 뿰援ъ쓽 몴蹂 겕湲곌 吏湲덇퉴吏쓽 꽑뻾뿰援ъ뿉 鍮꾪빐 鍮꾧탳쟻 겕吏留, 臾댁옉쐞 몴吏묒씠 븘땶 엫쓽 몴吏묒쑝濡 븯湲곗뿉 뿰援 寃곌낵瑜 뿬옄븰깮뿉寃 씪諛섑솕븯湲곗뿉 젣븳쟻씠떎. 몮吏, 怨쇰쇱꽦 옣利앺썑援 Rome III 吏꾨떒湲곗쑝濡 젇 뿬꽦뿉꽌留 寃궗븯뿬 蹂鍮꾪삎씠 媛옣 留롮 鍮덈룄濡 議곗궗릺뿀떎. 洹몃윭굹, 쟾泥 怨쇰쇱꽦 옣利앺썑援 솚옄쓽 븯쐞 쑀삎 以묒뿉 媛옣 留롮 寃껋쑝濡 븣젮吏 샎빀삎씠湲 븣臾몄뿉 蹂 뿰援ш 씪諛섏씤援щ 몴븯吏 븡쓣 닔 엳떎. 씠뿉 뵲씪 蹂 뿰援ъ뿉꽌 遺덉븞, 슦슱, 뒪듃젅뒪쓽 젏닔媛 븯쐞 쑀삎뿉 뵲瑜 겙 李⑥씠瑜 蹂댁씠吏 븡븯쓣 媛뒫꽦씠 엳湲 븣臾몄뿉 젇 꽦씤뿉꽌 꽦蹂꾩뿉 뵲瑜 怨쇰쇱꽦 옣利앺썑援 솚옄쓽 븯쐞 쑀삎쓣 遺꾨쪟븯뿬 떖由ъ쟻 怨좏넻怨쇱쓽 愿젴꽦쓣 議곗궗븯뒗 뿰援ш 븘슂븯떎. 뀑吏, 蹂 뿰援ъ뿉꽌 諛섏쁺릺吏 븡 떎瑜 蹂닔뱾씠 遺덉븞 諛 슦슱怨 媛숈 젙떊 옣븷쓽 쑀蹂묐쪧쓣 利앷떆궗 닔 엳떎. 뵲씪꽌, 궣쓽 吏, 떊泥댄솕 옣븷, 닔硫댁쓽 吏덇낵 媛숈 愿묐쾾쐞븯怨 蹂듭옟븳 쐞뿕 슂냼뿉 븳 뜑 留롮 뿰援ш 븘슂븯硫 떖由 궗쉶쟻 옉뾽 議곌굔 媛꾩쓽 뿰愿꽦뿉 빐꽌룄 異붽쟻씤 議곗궗媛 엳뼱빞 븳떎. 꽬吏, 蹂 뿰援ъ뿉꽌뒗 떎瑜 吏덊솚씠 뾾뒗 젇 뿬옄븰깮쓣 긽쑝濡 怨쇰쇱꽦 옣利앺썑援 吏꾨떒 룄援ъ씤 Rome III瑜 씠슜뻽쑝굹 怨쇰쇱꽦 옣利앺썑援 利앹긽怨 쑀궗븳 利앹긽쓣 媛吏 냼솕湲 吏덊솚쓣 諛곗젣븯吏 紐삵븯쓣 쐞뿕씠 엳떎. 洹몃윭誘濡 異뷀썑 뿰援ъ뿉꽌 怨쇰쇱꽦 옣利앺썑援곗쓣 諛곗젣븯湲 쐞븳 異⑸텇븳 紐⑤땲꽣留곸쓣 룷븿븳 뿰援ш 븘슂븷 寃껋씠떎.

蹂 뿰援щ뒗 젇 뿬옄븰깮뿉꽌 怨쇰쇱꽦 옣利앺썑援곗쓽 쑀蹂묐쪧씠 넂怨, 嫄닿컯 議곌뎔뿉 鍮꾪븯뿬 遺덉븞, 뒪듃젅뒪쓽 젙룄媛 떖븿쓣 蹂댁뿬二쇱뿀떎. 怨쇰쇱꽦 옣利앺썑援곗쓽 븯쐞 쑀삎 以 蹂鍮꾪삎씠 媛옣 留롮씠 諛쒖깮븯쑝굹 遺덉븞, 슦슱 諛 뒪듃젅뒪 벑쓽 떖由ъ쟻 怨좏넻 븯쐞 쑀삎 媛꾩뿉 李⑥씠瑜 蹂댁씠吏뒗 븡븯떎. 젇 뿬옄븰깮뿉꽌뒗 怨쇰쇱꽦 옣利앺썑援곗뿉 븳 씪諛섏쟻씤 移섎즺 븿猿 젙떊쟻 슂씤뿉 븳 議곗궗 愿由ш 룞諛섎릺뼱빞 븷 寃껋씠떎. 뼢썑, 怨쇰쇱꽦 옣利앺썑援 븯쐞 쑀삎怨 떖由ъ쟻 怨좏넻쓽 愿怨꾨 議곗궗븯湲 쐞븳 洹쒕え 뿰援ш 異붽쟻쑝濡 닔뻾븯뿬 븯쐞 쑀삎뿉 뵲瑜 移섎즺 諛⑸쾿쓽 媛쒕퀎솕媛 븘슂븷 寃껋씠떎.

ACKNOWLEDGEMENT

None.

CONFLICT OF INTEREST

The author has declared no conflict of interest.

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