소아에서 영양평가로서 생화학적 지표의 유용성 = The effectiveness of biochemical indexes for evaluating the nutrition states of children

다국어 초록 (Multilingual Abstract)

Purpose : This study has been conducted to analyze whether the biochemical nutrition indexes might be useful and effective for evaluating the nutrition states of children.
Methods : We evaluated 269 children, aged 3-9 years old, who had visited Gangneung Asan Hospital for elective surgery from January 2006 to December 2007, and examined their anthropometric and preoperative laboratory data with retrospective analysis. The children were classified into underweight, normal weight, overweight, and obese groups according to body mass index (BMI). The biochemical nutrition indexes (total lymphocyte count (TLC), hemoglobin, hematocrit, serum albumin, cholesterol, et al) of each group were then analyzed statistically.
Results : None of the groups showed statistically significant differences in TLC. Serum albumin decreased significantly in the underweight group. Red blood cell (RBC) count, hemoglobin, hematocrit, and serum total cholesterol in the obese group were higher than in the normal weight group. None of the groups showed statistically significant increase in mean corpuscular volume or mean corpuscular hemoglobin, and it seems that the increase of hemoglobin and RBC count in the overweight and obese groups is due to the enhancement of erythropoiesis rather than iron metabolism. However, in females, almost all nutrition indexes except albumin were statistically significantly poor.
Conclusion : Serum albumin, total cholesterol, RBC count, hemoglobin, and hematocrit were useful as nutrition indexes. However, except for albumin, these indexes were significantly poor for females. More control studies are needed to confirm the effectiveness of biochemical indexes for evaluating the nutritional state of children.

국문 초록 (Abstract)

목 적 : 소아를 대상으로 생화학적 영양지표들이 각각의 체질량지수군 간에서 어떤 차이를 보이는 지 분석하고, 영양상태의 평가로 생화학적 영양지표들이 유용한 것인가를 알아보기 위하여 이 연구를 시행하였다.
방 법 : 2006년 1월부터 2007년 12월까지 강릉 아산병원에 선택적 수술을 받기 위해 내원한 3세 이상 10세 미만의 소아 중 신체계측 자료와 수술 전 혈액검사 자료가 모두 있는 269명을 대상으로 하였다. 체질량지수에 따라 저체중군, 정상체중군, 과체중군, 비만군으로 나누고 각 군 간에 TLC, 혈색소, 적혈구용적, 혈청 알부민, 총콜레스테롤 등과 같은 생화학적 영양지표가 의미 있는 차이를 보이는 지를 후향적으로 분석하였다.
결 과 : 모든 체질량지수군 간에서 TLC는 유의한 차이가 없었다. 하지만 혈청 알부민은 저체중군에서 유의하게 감소되어 있었다. 적혈구수, 혈색소, 적혈구용적과 혈청 총콜레스테롤은 과체중군 또는 비만군에서 정상체중군보다 유의한 증가를 보였다. MCH와 MCV는 모든 군에서 유의한 증가가 없어, 과체중군과 비만군의 혈색소 및 적혈구수 등의 증가는 철분대사 보다는 적혈구 조혈기능의 증강 때문으로 생각된다. 남자와 여자에서 유의한 생화학적 영양지표가 서로 다르게 나타났는데 남자에서는 네 체질량군 간에 적혈구수, 혈색소, 적혈구 용적, 혈청 총콜레스테롤이 일부 유의한 차이를 보인 반면 여자에서는 유의한 차이를 보이지 않았고 알부민만 저체중군과 정상체중군 사이에서 유의한 감소를 보였다.
결 론 : 소아를 대상으로 시행한 생화학적 영양지표 중 적혈구수, 혈색소, 적혈구 용적, 혈청 알부민 및 총콜레스테롤은 체질량지수와 연관성이 있었다. 하지만 여자는 저체중군에서 알부민만 유의한 감소를 보였을 뿐 나머지 생화학 영양지표들과의 통계적 유의성은 없었다. 이에 대해 더 많은 연구가 필요할 것으로 생각된다.

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