아포지단백 B와 콜레스테롤 지표 사이의 일치/불일치 = Concordance/Discordance between Apolipoprotein B Levels and the Cholesterol Indexes

다국어 초록 (Multilingual Abstract)

Background and Objectives：Apolipoprotein B (Apo-B) has been reported to be a better predictor of the coronaryartery disease (CAD) than the cholesterol indexes. The aim of this study was to examine the concordance/discordance between the apolipoprotein B levels and the cholesterol indexes, and to assess the factorsaffecting the discordance. Subjects and Methods：A total of 11,816 participants (6,965 men and 4,851 women)were enrolled in this study from all the individuals who participated in medical screening examinations at thehealth promotion center in Kangbuk Samsung Hospital from January to December 2002. All the participantshad no history of coronary artery disease. We assessed the concordance between the biochemical parameters ofthe atherogenic indexes, and we evaluated the factors affecting the discordance. Results：Despite the fact thatthe Apo-B and the various cholesterol indexes were highly correlated, the concordance rate was merely 47-56%.Multinomial logistic regression analysis showed the possibility of an increased risk for the group of discordancein whom Apo-B level was disproportionately higher than LDL cholesterol in the elderly, the smokers, the menand the people having a larger waist circumference, a lower total cholesterol level, a higher triglyceride level and ahigher HDL-C level. Conclusion：The measurement of apo B, along with the measurement of the standardlipid profile, could be a great help in evaluating the CAD risk and for aiding in the treatment of dyslipidemia inthe elderly, the smokers, men and the people having a larger waist circumference, a lower total cholesterol level, ahigher triglyceride level and a higher HDL-C level.

국문 초록 (Abstract)

배경 및 목적：혈중 아포지단백 B는 혈중 총콜레스테롤, 저밀도 지단백 콜레스테롤, 비 고밀도 지단백 콜레스테롤보다 관동맥 질환의 위험을 예측하는데 보다 효과적이라는 연구들이 보고되고 있다. 본 연구는 콜레스테롤 지표들과 아포지단백 사이의 일치도를 알아보고 이에 영향을 주는 인자들에 대해 평가하고자 하였다.방 법：2002년 1월부터 12월까지 강북삼성병원에서 종합건강검진을 받은 관동맥 질환의 기왕력이 없는 수진자 11,816명을 대상으로 하였다. 문진, 진찰 및 생화학적 검사들을 통해 아포지단백과 콜레스테롤 지표들 사이의 일치도와 일치/불일치에 영향을 주는 심혈관질환의 위험요소를 알아보았다.결 과：아포지단백 B와 여러 콜레스테롤 지표사이에 강한 연관성을 보였으나 일치도는 47~56%에서 보였다. 다변량 명목회귀분석 결과, 고령, 흡연군, 남자, 중성지방, 고밀도 지단백 콜레스테롤이 높을수록, 총콜레스테롤이 낮을수록, 허리둘레가 클수록 아포지단백 B가 저밀도 지단백 콜레스테롤보다 높은 불일치가 증가함을 알 수 있었다.결 론：고령, 흡연군, 그리고 남자에서, 또한 총 콜레스테롤이 낮을수록, 중성지방, 고밀도 콜레스테롤이 높을수록, 허리둘레가 클수록 Apo-B가 LDL-C보다 높은 불일치군의 위험이 증가한다. 따라서 표준 지질검사와 함께 Apo-B의 측정을 추가함으로써 심혈관 질환의 위험인자의 평가 및 콜레스테롤의 강화요법의 치료에 도움이 될 수 있을 것으로 사료된다.

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