40세 이상 성인에서 악력, 폐쇄성수면무호흡증(STOP-bang score)과 폐 기능의 연관성: 제8기 국민건강영양조사 자료(2019) = Association between Handgrip Strength, Obstructive Sleep Apnea (STOP-bang score), and Lung Function in Adults Aged over 40 Years: The 8th Korea National Health and Nutrition Examination Survey (2019)

국문 초록 (Abstract)

연구배경: 악력은 호흡근 강도 감소 및 폐 기능 손상에 영향을 미치는 전체 근육량 감소를 반영한다. 폐쇄성수면무호흡증 또한 산화스트레스를 유발하여 근육 이화 및 폐 손상을 유발한다. 본 연구는 악력과 폐 기능 감소 패턴의 연관성을 확인하고, 폐쇄성수면무호흡증 등 악력과 폐 기능 감소 사이에 영향을 미치는 인자를 살펴보고자 하였다.
방법: 제8기 국민건강영양조사 자료를 사용하여 40세 이상 성인 3,207명을 대상으로 하였다. 악력과 폐 기능의 연관성을 Spearman 상관분석으로 분석하였다. 성별과 폐쇄성수면무호흡증 위험도로 층화하여 악력 그룹에 따른 폐 기능(폐쇄성 또는 제한적 패턴)의 연관성을 확인하기 위해 복합표본 로지스틱 회귀분석을 시행하였고 교차비 및 95% 신뢰구간을 비교하였다.
결과: 남성 1,264명, 여성 1,479명이 정상악력이었다. 남성은 낮은악력군이 정상악력군보다 FVC (L), FVC (%, predicted), FEV1 (L), FEV1 (%, predicted), FEV1/FVC가 유의하게 낮았다. 제한적패턴의 위험도는 악력이 낮은 남성에서 더 유의하게 높았다(aOR, 2.773; 95% CI, 1.220–6.300). 낮은악력과 폐 기능 감소 사이 연관성은 남성에서 더 두드러졌다(P-interaction of sex; 0.002 [폐쇄성], 0.008 [제한성]). 그러나 폐쇄성수면무호흡증 위험도에 의한 유의미한 영향은 없었다.
결론: 낮은악력을 가진 남성은 제한적 폐 기능 감소 위험이 더 높다.

다국어 초록 (Multilingual Abstract)

Background: Decreased handgrip strength (HGS) reflects overall muscle mass reduction, which can reduce respiratory muscle strength and impair lung function. Obstructive sleep apnea (OSA) has also been reported to cause muscle catabolism and lung damage. This study aimed to investigate the relationship between HGS and lung function by exploring the effect modifiers, including OSA.
Methods: Data from the 8th Korea National Health and Nutrition Examination Survey was used in this study. A total of 3,207 adults aged >40 years were included. The association between HGS and lung function was determined using correlation analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using complex sample logistic regression analysis to determine the association between lung function (restrictive or obstructive pattern) according to HGS groups stratified by sex and OSA risk.
Results: In total, 1,264 males and 1,479 females had normal HGS. In males, the low HGS group had lower forced vital capacity (FVC, L), FVC (%, predicted), forced exploratory volume in one second (FEV1), FEV1 (%, predicted), and FEV1/FVC, than the normal HGS group. The risk of having restrictive pattern of lung function was higher in males with low HGS (adjusted OR, 2.77; 95% CI, 1.22–6.30). The association between low HGS and decreased lung function was stronger in males (P interaction of sex: 0.022 for obstructive pattern and 0.008 for restrictive pattern). However, there was no significant effect modification by OSA risk.
Conclusion: Males with a low HGS showed a higher risk of restrictive pattern of decreased pulmonary function.

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