비만 성인에서 대사증후군과 갑상선호르몬과의 상관관계 = The Relationship between Thyroid Hormone and Metabolic Syndrome in Obese Euthyroid Adults

국문 초록 (Abstract)

연구배경: 비만은 암, 심혈관 질환과 조기사망의 원인이지만 그 병태생리적 기전에 대해 충분히 이해되지 않은

부분이 많다. 갑상선호르몬은 에너지 대사에 중요하며 비만과의 관련성에 대해 주목 받아왔기에 비만한 환자 군에

서 갑상선호르몬과 대사적 합병증 발생과의 관련성에 대해 살펴보고자 한다.

방법: 2006년도 3월부터 2007년 9월까지 일개 대학병원 건강검진센터에서 5,248명을 대상으로 현재 및 과거병

력에 대한 설문, 신장, 체중, 허리둘레를 포함하는 신체계측, 혈압 측정, 혈청 지질 및 공복 혈당을 포함하는 조기

검진과 갑상선기능검사를 시행하였다, 갑상선 질환 병력이 있거나 갑상선기능검사 이상, 체질량지수가 25 kg/m2 미

만인 군은 제외하였다.

결과: 총 1,072명이 분석 대상이 되었으며 선형 회귀 분석으로 나이를 보정한 후 갑상선자극호르몬과 삼요오드

티로닌은 남자군에서 수축기와 이완기 혈압, 중성지방과 양의 상관관계를 보였고, 여성군에서 허리둘레, 중성지방

과 양의 상관관계를 보였다. 로지스틱 회귀분석으로 연령과 체질량지수를 보정한 후 대사증후군 요소를 한 개 이하

가지는 군에 비해 2개 이상 가지는 군의 위험도를 비교하였을 때 남자에서는 갑상선자극호르몬이 가장 낮은 제 1사

분위군을 기준으로 높은 제 2, 3, 4사분위군으로 갈수록 각각 1.47 (95% CI, 0.97-2.23), 1.58 (95% CI, 1.04-2.23),

1.56 (95% CI, 1.02-2.37), 삼요오드티로닌이 가장 낮은 제 1사분위 군을 기준으로 제 2, 3, 4 사분위 군에서 남자

에서는 1.65 (95% CI, 1.08-2.51), 1.47 (95% CI, 0.97-2.23), 1.70 (95% CI, 1.12-2.59), 여자에서는 1.14 (95%

CI, 0.58-2.25), 1.43 (95% CI, 0.72-2.82), 1.98 (95% CI, 0.96-4.07) (P for trend < 0.01)의 위험도를 보였다.

결론: 갑상선호르몬은 체질량지수, 복부비만을 포함하는 대사증후군 인자와 관련이 있었으며 대사적으로 건강한

비만군에서는 갑상선자극호르몬과 삼요오드티로닌이 상대적으로 낮은 것으로 관찰되었다. 정상 범위 내의 갑상선

자극호르몬과 삼요오드티로닌 증가가 비만군에서의 대사적 합병증 발생을 시사한다.

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