젊은 성인의 체중변동성과 사망 위험: 전국 인구 기반 코호트 연구 = Association between Body Weight Variability and Mortality in Young Adults: A Nationwide Cohort Study

국문 초록 (Abstract)

연구배경: 비만은 심혈관 질환 등의 다양한 질환과 사망 위험을 증가시키며, 체중변동은 건강 상태, 생활습관, 만성질환과 연관이 있다. 그러나 젊은 성인의 체중변동성과 사망 위험에 대한 연구는 부족하다. 이 연구는 한국 젊은 성인의 체중변동성이 사망 위험에 미치는 영향을 조사하고자 하였다.
방법: 2009–2010년 국가 건강검진에 참여한 20–39세 젊은 성인 1,771,152명을 2021년까지 추적 관찰하였다(평균 추적기간 10.8년, 표준편차 0.9). 체중변동성의 척도로는 평균 독립 변동성(variability independent of the mean, VIM)을 사용하였으며, 사분위로 나누어 분석하였다. 체중변동성과 사망 사이의 관련성은 콕스 회귀 모델을 적합하여 분석하였다.
결과: 연구 대상자에서 11,708명(0.66%)의 모든 원인에 의한 사망이 발생하였다. 체중변동성의 가장 작은 사분위(Q1)에 속하는 군에 비해 모든 원인에 의한 사망 위험은 Q3군에서 1.07배(95% 신뢰구간, 1.02–1.13), Q4군에서 1.20배(95% 신뢰구간, 1.14–1.26) 증가하였다. 체중변동성이 커짐에 따라 자살 및 소화기 질환, 내분비 질환으로 인한 사망 위험 역시 증가하였다. 성별, 체중 변화, 비만도에 따른 하위그룹 분석에서도 비슷한 경향을 보였다.
결론: 젊은 성인에서 큰 체중변동성은 모든 원인으로 인한 사망 및 자살, 소화기, 내분비 질환으로 인한 사망 위험을 증가시킬 수 있다. 이 연구 결과는 개인적 또는 국가적 차원에서 젊은 성인의 지속적인 체중 관리의 중요성을 시사한다.

다국어 초록 (Multilingual Abstract)

Background: Body weight variability is associated with health status, lifestyle, and chronic diseases. However, there is limited evidence of its association with mortality in young adults. This study aimed to explore the impact of body weight variability on all-cause and cause-specific mortality risks among young adults in South Korea.
Methods: This retrospective cohort study included 1,771,152 young adults aged 20–39 years who underwent health examinations provided by the Korean National Health Insurance Service between 2009 and 2010 and were followed up until 2021. Body weight variability was assessed using the variability independent of mean (VIM). The association between VIM quartiles in terms of body weight and mortality was analyzed using a Cox regression model.
Results: During a mean follow-up period of 10.8 years, 11,708 all-cause deaths occurred. Compared to the lowest VIM quartile (Q1) group, the all-cause mortality risk was 1.07 times higher in the Q3 group (95% confidence interval [CI], 1.02–1.13) and 1.20 times higher in the Q4 group (95% CI, 1.14– 1.26). The all-cause mortality risk increased with higher VIM quartiles. Higher body weight variability has also been associated with mortality from suicide, gastrointestinal diseases, and endocrine diseases. These associations persisted across subgroups categorized by sex, weight change, and body mass index.
Conclusion: This large-scale nationwide cohort study indicates that higher body weight variability in young adults may elevate the risk of all-cause mortality, mortality from suicide, and gastrointestinal and endocrine diseases. These findings underscore the importance of maintaining stable body weight in young adults.

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