비만한 폐경 전 여성에서 체중감량이 내피세포기능에 미치는 영향 = Effect of Weight Loss on Endothelial Function in Obese Premenopausal Women

다국어 초록 (Multilingual Abstract)

Background: Endothelial dysfunction, a pathological feature of obesity, can predict the occurrence of cardiovascular disease. The endothelial function was compared in obese, non-obese, and type 2 diabetic women, and the effect of weight loss on endothelial function in obese premenopausal women was also investigated. Methods: Twenty type 2 diabetes patients, 35 obese and 20 non-obese non-diabetic subjects were recruited. Both the endothelium-dependent vasodilation (EDV) and endothelium-independent vasodilation (EIV) were measured. The body composition, serum lipid, serum adiponectin and resistin were also measured. Weight loss in obese women was obtained by 6 months of calorific restriction, aerobic exercise and medication (sibutramine or orlistat). Results: EDV was significantly impaired in the type 2 diabetes and obese groups compared to the control group (6.0 ± 1.3% in diabetes group, 6.7 ± 3.9% in obese group, 12.4 ± 4.1% in control group, P < 0.01, respectively). The mean weight loss after 6 months was 8.5 ± 3.2 kg (P < 0.001) in the obese group. There was a significant increase in EDV after weight loss (from 5.8 ± 3.5% to 12.3 ± 3.9%, P < 0.05). There was no change in EIV after weight loss. In addition, weight loss was associated with significant reductions in the levels of high-sensitivity C-reactive protein (hs-CRP) and serum triglyceride (P < 0.05, respectively). However, there were no significant changes in the serum adiponectin and resistin levels after weight loss. Conclusions: Our data demonstrated that weight loss was associated with improved endothelial function in obese premenopausal women, as assessed by brachial artery EDV and reduced hs-CRP (J Kor Endocrinol Soc 21:506~514, 2006)

국문 초록 (Abstract)

연구배경: 제2형 당뇨병, 이상지질혈증, 고혈압 및 비만환자에서 혈관내피세포 기능이상이 동반되어 있으며, 비만환자에서 혈관내피세포 기능이상의 정확한 병태생리는 아직까지 잘 알려져 있지 않다. 본 연구에서는 비만한 폐경 전 여성에서 체중감량이 내피세포 기능에 미치는 영향과 이와 관련된 여러 인자들을 찾고자 하였다. 방법: 본원 내분비내과와 검진센터를 방문한 폐경전 여성을 대상으로 하였으며, 이들을 비비만군(대조군), 비만군 및 당뇨병군으로 나누어 내피세포 기능 및 혈청학적 검사를 시행하였으며, 비만군을 대상으로 6개월간의 체중감량 프로그램을 시행하여 체중감량 후 혈청학적 검사 및 내피세포 기능을 재평가 하였다. 결과: 연구대상자는 총 75명이었고, 내피세포의존성 및 비의존성 혈관확장반응은 대조군에 비해 비만군과 당뇨군에서 의미있게 감소되어 있었다(P < 0.01). 체중감량에 참여한 비만여성 13명이 체중감량 프로그램을 완료하였으며, 6개월 후 평균체중은 8.5 ± 3.2 kg (10.7 ± 4.1 %), 허리둘레 7.5 ± 2.6 cm, 복부피하지방 면적 77 ± 32 cm2 감소하였다(P < 0.001, respectively). 체중감량 후 내피세포의존성 혈관확장반응은 5.8 ± 3.5%에서 12.3 ± 3.9%로 증가되어 의미있는 호전을 나타냈으나(P < 0.05), 내피세포비의존성 혈관확장반응은 의미있는 변화가 없었다. 또한 체중감량 후 트리글리세리드는 38% (P < 0.05), high sensitivity C-reactive protein (hs-CRP)은 37% (P < 0.05) 감소하여 의미있는 변화를 나타냈다. 그러나 내피세포의존성 혈관확장반응의 증가 정도와 체중, 피하지방면적, 내장지방면적, 중성지방 및 hs-CRP 변화와는 상관관계가 없었다.

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