한국 성인에서 복부비만과 혈액학적 지표 간의 관계: 제7기 국민건강영양조사 2016–2018년도 분석 = Association of Abdominal Obesity and Hematological Parameters in Korean Adults: Korea National Health and Nutrition Examination Survey 2016–2018

다국어 초록 (Multilingual Abstract)

Background: The prevalence of obesity in Korea has gradually increased. Obesity is an accumulation of excessive adipose tissue that secretes interleukin-6 contributing to megakaryocytopoiesis. It was well known that platelets in the blood are produced by megakaryocytes through various differentiation processes. This study hypothesized that the hematological parameters would be increased in patients with abdominal obesity.
Methods: The analysis included 15,176 patients (6,639 male, 8,537 female) aged 19 years and older from the 2016–2018 Korea National Health and Nutrition Examination Survey. The relationship between abdominal obesity and hematological parameters was analyzed using multivariable logistic regression after the adjustment for age, smoking, drinking volume, exercise, and history of diabetes.
Results: The present study included 4,417 patients with abdominal obesity and 10,759 without abdominal obesity. The value of hematological parameters increased when both males and females had abdominal obesity. The odds ratios (OR) (95% confidence interval [CI]) for the highest platelet count quartile in patients with abdominal obesity was 1.427 (1.201–1.695) for male and 2.380 (2.020–2.804) for female (P<0.001). Among patients with abdominal obesity, the OR (95% CI) for the highest white blood cell count quartile was 2.280 (1.908–2.725) for male and 3.939 (3.325– 4.668) for female (P<0.001).
Conclusion: These findings suggest that abdominal obesity is positively associated with hematological parameters in Korean adults.

국문 초록 (Abstract)

연구배경: 비만의 국내 유병률이 점차 증가하고 있는 추세이다. 비 만은 과다한 지방 조직의 축적으로 IL-6 등을 분비하여 거대핵세포 형성과정에 기여한다. 거대핵세포에서 여러 분화과정을 거치며 혈 소판이 생성되는 것은 잘 알려져있다. 본 연구에서는 국내 남녀 성 인을 대상으로 복부비만과 혈액학적 지표의 관계를 확인하고자 하 였다.
방법: 2016–2018년 국민건강영양조사에 등록된 만 19세 이상의 15,176명(남성 6,639명, 여성 8,537명)을 대상으로 분석을 시행하였 다. 복부비만과 혈액학적 지표 간의 관계를 연령, 흡연, 음주량, 운 동, 당뇨 유무를 보정 후 다중 로지스틱 회귀분석을 통해 분석하였 다.
결과: 본 연구는 4,417명의 복부비만군과 10,759명의 정상 허리둘레 군을 포함한다. 남녀 모두 복부비만군에서 혈소판, 백혈구, 적혈구, 헤모글로빈 수치가 증가했다. 정상군과 비교했을 때 복부비만 환자 에서 혈소판 수 사분위의 OR (95% CI)은 남성이 1.427 (1.201–1.695) 이고 여성은 2.380 (2.020–2.804)이었다(P<0.001). 복부비만 환자에서 백혈구 수 사분위의 OR (95% CI)은 남성이 2.280 (1.908–2.725)이고 여성은 3.939 (3.325–4.668)였다(P<0.001).
결론: 한국 남녀 성인 복부비만 환자에서 혈소판, 적혈구, 백혈구, 헤모글로빈 수치는 증가한다.

참고문헌 (Reference)

• 1 Williams JL, "Thrombopoietin requires additional megakaryocyte-active cytokines for optimal ex vivo expansion of megakaryocyte precursor cells" 91 : 4118-4126, 1998
• 2 Patel SR, "The biogenesis of platelets from megakaryocyte proplatelets" 115 : 3348-3354, 2005
• 3 Haque SF, "Sex difference in platelet aggregation detected by new aggregometry using light scattering" 48 : 33-41, 2001
• 4 Park JM, "Relationship between platelet count and insulin resistance in Korean adolescents : a nationwide population-based study" 16 : 470-476, 2018
• 5 Vuong J, "Reference intervals of complete blood count constituents are highly correlated to waist circumference : should obese patients have their own"normal values?"" 89 : 671-677, 2014
• 6 Ho KM, "Reactive thrombocytosis and risk of subsequent venous thromboembolism : a cohort study" 10 : 1768-1774, 2012
• 7 Jones RL, "Platelet survival in patients with diabetes mellitus" 30 : 486-489, 1981
• 8 Samocha-Bonet D, "Platelet counts and platelet activation markers in obese subjects" 2008 : 834153-, 2008
• 9 Taniguchi A, "Platelet count is independently associated with insulin resistance in nonobese Japanese type 2 diabetic patients" 52 : 1246-1249, 2003
• 10 Davì G, "Platelet activation in obese women : role of inflammation and oxidant stress" 288 : 2008-2014, 2002
• 11 Kim SH, "Obesity and insulin resistance : an ongoing saga" 59 : 2105-2106, 2010
• 12 Powell-Wiley TM, "Obesity and cardiovascular disease : a scientific statement from the American Heart Association" 143 : e984-, 2021
• 13 남가은 ; 김양현 ; 한경도 ; 정진형 ; 이은정 ; 이원영 ; the Taskforce Team of the Obesity Fact Sheet of the Korean Society for the Study of Obesity, "Obesity Fact Sheet in Korea, 2020: Prevalence of Obesity by Obesity Class from 2009 to 2018" 대한비만학회 30 (30): 141-148, 2021
• 14 Baatout S, "Interleukin-6 and megakaryocytopoiesis : an update" 73 : 157-162, 1996
• 15 Yudkin JS, "Inflammation, obesity, stress and coronary heart disease : is interleukin-6 the link?" 148 : 209-214, 2000
• 16 Shoelson SE, "Inflammation and insulin resistance" 116 : 2308-, 2006
• 17 Dandona P, "Inflammation : the link between insulin resistance, obesity and diabetes" 25 : 4-7, 2004
• 18 Elmugabil A, "High level of hemoglobin, white blood cells and obesity among Sudanese women in early pregnancy: a cross-sectional study" 3 : FSO182-, 2017
• 19 Ranucci M, "Gender-based differences in platelet function and platelet reactivity to P2Y12 inhibitors" 14 : e0225771-, 2019
• 20 Maury E, "Effect of obesity on growth-related oncogene factor-alpha, thrombopoietin, and tissue inhibitor metalloproteinase-1 serum levels" 18 : 1503-1509, 2010
• 21 Butkiewicz AM, "Does menopause affect thrombocytopoiesis and platelet activation?" 63 : 1291-1293, 2006
• 22 나은희 ; 김수영 ; 조선 ; 조한익, "Complete Blood Count Reference Intervals and Patterns of Changes Across Pediatric, Adult, and Geriatric Ages in Korea" 대한진단검사의학회 38 (38): 503-511, 2018
• 23 Pradhan AD, "C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus" 286 : 327-334, 2001
• 24 Yudkin JS, "C-reactive protein in healthy subjects : associations with obesity, insulin resistance, and endothelial dysfunction : a potential role for cytokines originating from adipose tissue?" 19 : 972-978, 1999
• 25 Kordas K, "Being overweight or obese is associated with lower prevalence of anemia among Colombian women of reproductive age" 143 : 175-181, 2013
• 26 Park WJ, "Association of platelet count with sarcopenic obesity in postmenopausal women : a nationwide population-based study" 477 : 113-118, 2018
• 27 김보연 ; 강선미 ; 강지현 ; 강서영 ; 김경곤 ; 김경배 ; 김범택 ; 김승준 ; 김양현 ; 김정환 ; 김재현 ; 김은미 ; 남가은 ; 박지연 ; 손장원 ; 신윤아 ; 신혜정 ; 오태정 ; 이혁 ; 전언주 ; 정소정 ; 홍용희 ; 김종화 ; 대한비만학회 진료지침위원회, "2020 Korean Society for the Study of Obesity Guidelines for the Management of Obesity in Korea" 대한비만학회 30 (30): 81-92, 2021