무증상 성인 한국인에서 관상동맥 석회 수치의 연령 및 성별 분포와 특성: 심혈관 질환의 위험요인 및 대사 증후군과의 관계 = Distribution of Coronary Artery Calcification in an Asymptomatic Korean Population: Association with Risk Factors of Cardiovascular Disease and Metabolic Syndrome

국문 초록 (Abstract)

배경 및 목적관상동맥 석회수치 (CAC)는 동맥경화반의 총량과 비례하며 향후 허혈성 심장질환 발생의 독립적인 위험인자가 된다. 본 연구는 무증상 성인 한국인의 관상동맥 석회수치의 분포를 알아보고 심혈관 질환 위험인자와 관계를 알아보고자 하였다.방 법2003년 10월부터 2007년 6월까지 서울대학교병원 강남센터에서 건강 검진을 목적으로 MDCT CT로 CAC 수치 검사를 시행한 성인 중 관상동맥 질환을 시사하는 전형적인 증상이나 폐쇄성 관상동맥 질환의 병력이 없는 3,961명 (남자 2,558명 64%, 여자 1,408명, 56±10세)을 대상으로 하였다.
결 과
CAC 유병률 (CAC>0)은 남자 36.2%, 여자 17.0%였고, CAC수치의 평균±표준편차는 남녀 각각 60.5±236.1, 15.1±84.0였다. 석회수치는 연령에 따라 증가하였다 (p<0.001 by ANOVA). 연령과 성별을 통제하고 다변량 분석을 했을 때, 당뇨병은 OR 1.542 (95% CI, 1.252~1.899), 고혈압 OR 1.673 (95% CI, 1.430~1.956), 대사증후군은 OR 1.727 (95% CI, 1.461~2.042; p<0.001), 복부 비만을 의미하는 허리 둘레의 증가 (OR, 1.331; 95% CI, 1.084~1.633; p=0.006)는 CAC의 위험인자였다. 대사 증후군 항목 중에 1) 복부 비만, 2) 중성지방의 상승, 3) 혈압 상승, 4) 공복 혈당의 상승은 석회침착 (CAC>0)의 유의한 위험인자가 되었다.
결 론
이 결과로 한국인의 관상동맥 석회수치를 해석할 수 있는 정보를 제공하고 한국인의 동맥경화의 진행과 위험인자에 대한 이해를 도울 수 있을 것으로 기대한다.

다국어 초록 (Multilingual Abstract)

Background and Objectives: Coronary artery calcification (CAC) has been used as surrogate marker for coronary atherosclerosis. We developed a setof age-and gender-stratified CAC distribution and risk factors for CAC in a population of asymptomatic Korean subjects. Subjects and Methods: Between 2003 and 2007, 3,961 asymptomatic subjects without a history of ischemic heart disease (male 64%, mean age 56±10 years) were screened for CAC by the use of multi-detector computed tomography. Results: The total CAC score was assigned to a percentile according to age and gender. The prevalence of CAC and mean CAC score increased with age [p<0.001 by analysis of variance (ANOVA)]. The prevalence of CAC (mean CAC score) was 36.2% (60.5±236.1) in males, and 17.0% (15.1±84.0) in females. The age-and sex-adjusted odds ratio for the presence of CAC for subjects with diabetes was 1.542 [95% confidence interval (CI) 1.252-1.899], for subjects with hypertension was 1.673 (95% CI 1.430-1.956), for subjects with metabolic syndrome was 1.727 (95% CI 1.461-2.042), and for subjects with abdominal obesity (abdominal obesity defined as a waist circumference ≥90 cm in males; ≥80 cm in females) was 1.445 (95% CI 1.222-1.709). Conclusion: This study reports the distribution of CAC score by age and gender. It will serve as a reference standard for the clinical interpretation of CAC results in the asymptomatic Korean population. (Korean Circ J 2008;38:29-35)

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