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Journal of the Korean Academy of Family Medicine 2003;24(1):58-63.
Published online January 10, 2003.
The Association between C-reactive Protein and Obesity among Korean Men.
Jeong Sook Hwang, Seung Hun Lee, Hye Soon Park
Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Korea. hyesoon@amc.seoul.kr
한국 성인 남성에서 CRP와 비만과의 연관성
황정숙,이승훈,박혜순
울산대학교 의과대학 서울아산병원 가정의학교실
Abstract
Background
: C-reactive protein (hereinafter CRP) is a substance that is elevated in large quantities when there is an abnormal metabolic reaction or an inflammatory condition. Many researches have identified the substance as a prognostic and an independent risk factor responsible for cardiovascular disease. More recently, many studies have shown that obesity is associated with low-grade systemic inflammation. This study was attempted to illustrate the relationship between obesity and CRP regarding Korean men who were applied by different standards of obesity.

Methods : The subjects included 15,353 men who had visited one health promotion center from May, 2001 to December, 2001, were randomly selected as the total addressable population. We excluded 389 men who were observed to have inflammatory conditions, according to the results of the general chemical and physical diagnosis. Among 15,353 Korean men 14,964 were examined. CRP was quantitatively analyzed by the method of Nephelometry as high sensitivity-CRP. CRP values in relation to age, BMI, clustering of metabolic risk factors were studied, and multiple logistic regression analysis was conducted to identify correlation between obesity and CRP value.

Results : We compared the median values of CRP of each group divided by age, BMI, and clustering of metabolic risk factors. As a matter of the fact, the more age, BMI, and clustering of metabolic risk factors increased, the more the value of CRP significantly increased (P<0.0001). We operationally defined incremented CRP value as CRP of 0.22 mg/dl or more, and conducted multiple logistic regression analysis with the parameters of age, BMI, and obesity related diseases. Consequently, when fasting blood glucose and total cholesterol were high or HDL was low, the risk of CRP increasing was significantly high. Also, when the age was more than 60 or BMI was greater than 25 kg/m2, which was categorized as obese, the risk regarding increase in CRP was significantly high.

Conclusion : Obesity is independently related to increase in CRP in Korean men. Which suggests that low-grade systemic inflammation exists in obese people. Furthermore, our study showed that old age, high level of blood glucose, high level of cholesterol, and low level of HDL have correlation with increase in CRP.
Key Words: obesity, CRP, association, men
초록
연구배경 : C-반응성 단백(이하 CRP)은 염증반응과 세포 및 조직대사의 비특이적 반응이 있을 때 증가하는 물질로, 여러 연구에서 심혈관질환의 예후인자 및 독립적 위험인자로 밝혀져 있다. 서구인에서 비만이 low-grade systemic inflammation과 연관이 있다고 알려져 있어, 이에 본 연구는 비만의 정도가 낮은 한국 성인 남성에서 비만과 CRP의 연관성에 대해 알아보고자 하였다.

방법 : 2001년 5월부터 12월까지 한 종합병원 건강증진센터에 내원한 무증상의 성인 남자 15,353명 중 염증성 질환이 확인된 389명의 자료를 제외한 14,964명의 신체검사 결과와 혈액검사 소견을 분석하였다. CRP는 high sensitivity-CRP로서 Nephelometry법으로 정량분석하였다. 연령, 체질량지수, 대사증후군 위험인자의 군집성에 따른 CRP 값을 조사하였고, 비만과 CRP 증가에 대한 연관성을 파악하기 위해 다중로짓회귀분석을 시행하였다.

결과 : 연령, 체질량지수, 대사증후군 위험인자의 군집성에 따라 CRP 중간값을 비교하였을 때, 연령, 체질량지수, 대사증후군 위험인자의 수가 증가할수록 유의하게 CRP 수치가 증가하였다(P<0.0001). CRP 0.22 mg/dl 이상을 증가된 CRP값으로 정의하여, 연령, 체질량지수, 비만관련질환 유무에 따라 다중로짓회귀분석을 한 결과, 체질량지수가 18.5∼22.9 kg/m2인 정상체중군에 비해 체질량지수 25 kg/m2 이상인 비만군에서 CRP 증가에 대한 위험이 교차비 1.4 (95% 신뢰구간 1.2∼1.6)로, 체질량지수 30 kg/m2 이상인 고도비만에서 교차비 2.8 (95% 신뢰구간 2.2∼3.6)로 유의하게 높았다.

결론 : 우리나라 성인 남성에서도 비만이 독립적으로 CRP증가와 관련이 있으며, 비만한 사람에서 low-grade systemic inflammation이 존재한다고 볼 수 있다. 우리나라 비만의 기준치인 체질량지수 25 kg/m2 이상부터 CRP 증가 위험이 높아진다고 볼 수 있으며, 비만의 정도가 심할수록 CRP 증가 양상도 심해짐을 알 수 있었다.
중심 단어: 비만, CRP, 연관성, 남성


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