한국인에 있어서 Insulin Resistance의 계절적 변동성 = Seasonal Variation in Insulin Resistance in Koreans

다국어 초록 (Multilingual Abstract)

Background and Objectives：There is a seasonal variation in the incidence of diabetes mellitus and cardiovasculardisease. Insulin resistance is important in the development of both non-insulin dependent diabetes mellitus(Type II DM) and cardiovascular disease. Hyperinsulinemia, induced by an insulin resistant state, causes thedevelopment of a chronic inflammatory response in vascular structures, which is one of the main causes ofcardiovascular disease. There have been several studies on seasonal variation in insulin resistance. Therefore,seasonal variation in insulin resistance were investigated to discover if any relationship existed. Subjects andMethods：Korean people examined at a health care center were included. The subjects were divided into fourgroups, according to the season, and a homeostasis model assessment index (HOMA) calculated, as an indicatorof insulin resistance, and compared between the groups. Results：Using the homeostasis model assessment, thehighest insulin resistance was observed during winter. Also, the body mass index and waist-hip ratio were highestduring winter. Conclusion：Compensating for other metabolic factors (age, gender, body mass index, waist-hipratio and season), insulin resistance was still found to be higher during winter. Seasonal variation in insulinresistance can be associated with the incidence of DM or cardiovascular disease. Therefore, a prospective studywill be needed.

국문 초록 (Abstract)

배경 및 목적：당뇨병 및 순환기 질환의 유병율은 계절에 따라서 차이가있다고 알려져 있다. 인슐린 저항성은 인슐린 비 의존성 당뇨병 및 순환기 질환의 발생과 깊은 연관성을 갖고 있으며이를 토대로 인슐린 저항성 역시 계절적 차이가 있을 것이라는 연구가 있었다. 따라서 본 연구에서는 인슐린 저항성의 계절에 따른 변동성 유무를 확인하려 하였다.방 법：2002년에 강북 삼성병원에서 건강 검진을 받은 60,912명의 건강한 한국인을 대상으로 하였다. 이들을 봄, 여름, 가을, 겨울 계절별로 4개의 군으로 나누었으며 각각의 군으로부터 인슐린 저항성을 수량화하여 이에 대한 지표로 쓰이는 HOMA(Homeostasis model assessment) 수치 및 여러대사성 지표들을 측정하여 계절에 따른 차이를 비교하였다.결 과：대상군들에 있어서 인슐린 저항성을 나타내는 HOMA 값은 겨울에 가장 높았으며(봄: 1.68±0.78, 여름: 1.62±0.77,가을: 1.79±0.83, 겨울: 1.94±0.93) 성별, 연령, 체질량지수 및 복부 지방률, 중성 지방의 수치 등을 보정하여 비교했을 때에도 여름에 비하여 겨울에 높은 결과를 보였다.결 론：건강한 성인에서 인슐린 저항성은 이에 영향을 미칠 수있는 요소인 나이, 성별, 체질량 지수, 복부 지방률을 보정하여 비교했을 때 겨울에 높았으며 계절적 변동성이 있는 것으로 나타났다. 이러한 계절적 차이는 당뇨병 및 순환기 질환의 유병율과 연관성이 있다고 생각되며 이에 대한 전향적 연구가 필요할 것이다.

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