학술논문
근감소증이 미란성 식도염에 미치는 영향
Impact of Sarcopenia on the Risk of Erosive Esophagitis
Impact of Sarcopenia on the Risk of Erosive Esophagitis
Document Type
Article
Author
허찬미 / Chan Mi Heo; 김태준 / Tae Jun Kim; 이혁 / Hyuk Lee; 표정의 / Jeung Hui Pyo; 민양원 / Yang Won Min; 민병훈 / Byung-hoon Min; 이준행 / Jun Haeng Lee; 손희정 / Hee Jung Son; 백선영 / Sun-young Baek; 김경아 / Kyunga Kim; 류승호 / Seungho Ryu; 이풍렬 / Poong-lyul Rhee; 김재준 / Jae J Kim
Source
대한소화기학회지 / The Korean Journal of Gastroenterology. Mar 31, 2020 75(3):132
Subject
Language
Korean
ISSN
1598-9992
Abstract
목적: 비만은 미란성 식도염(erosive esophagitis) 발생의 위험인자로 알려져 있으나 근감소증(sarcopenia) 및 비만과 미란성 식도염의 연관성은 아직 알려진 바가 없다. 따라서 본 연구에서는 무증상 남녀에서 일반 비만, 근감소증(sarcopenia), 근감소성 비만(sarcopenic obesity)과 미란성 식도염과의 연관성에 대하여 알아보고자 하였다. 대상 및 방법: 본 연구는 단면적 연구(cross-sectional study) 로써, 2006년 8월부터 2011년 12월까지 삼성서울병원에서 건강검진으로 상부위장관 내시경을 시행한 32,762명을 대상으로 하였다. 근감소증의 정의는 사지 근육량(ASM)을 체중으로 나누어 골격근 질량지수(skeletal muscle mass index: ASM [kg]/체중[kg]×100)를 구하고, 이 값을 젊은 성인 참조군(reference group)의 표준값의 2표준편차 이하인 경우로 정의하였다. 결과: 비만과 근육 감소 정도에 따라 정상군, 일반 비만군, 근감소증군, 근감소성 비만군 이렇게 네 군으로 나누어 분석하였다. 다변량 모형(multivariable model)으로 분석하여 보정교차비(adjusted OR)를 구한 결과, 일반 비만군 1.35 (95% CI 1.22-1.49), 근감소증군 2.12 (95% CI 1.40-3.19), 근감소성 비만군 1.54 (95% CI 1.27-1.87)이 정상군에 비하여 미란성 식도염 발생 위험이 높게 나타났다. 근감소증군과 근감소성 비만군의 미란성 식도염 발생 위험을 일반 비만군과 비교하였을 때, 교차비(ORs)는 각각 1.63 (95% CI 1.08-2.47), 1.22 (95% CI 1.01-1.46)로 일반 비만군에 비하여 높았다. 용량-반응분석에서 근육량 감소 정도는 미란성 식도염의 중증정도와 연관되어 근육량 감소가 심할수록 LA-B 이상 및 LA-C 미란성 식도염 소견을 보였다. 결론: 근감소증은 비만 여부와 상관없이 미란성 식도염의 발생 위험을 증가시키는 위험인자라는 것을 확인하였다.
Background/Aims: An association between obesity and erosive esophagitis has been reported, but the effects of sarcopenia and obesity on erosive esophagitis are unknown. This study examined the relationship between obesity, sarcopenia, sarcopenic obesity, and erosive esophagitis in a large population of asymptomatic men and women. Methods: This study analyzed 32,762 subjects who underwent a comprehensive health check-up, which included upper gastrointestinal endoscopy, from August 2006 to December 2011 by a cross-sectional study. Sarcopenia was defined as a decrease in the appendicular skeletal muscle mass (ASM)/body weight value of two SD or more below the normal means for a younger reference group. Results: The study was carried out on four groups according to obesity and sarcopenic status: normal, obesity, sarcopenic, and sarcopenic obese group. In a multivariable model, the risk of erosive esophagitis was higher in the obese (adjusted OR [aOR] 1.35, 95% CI 1.22-1.49), sarcopenic (aOR 2.12, 95% CI 1.40-3.19), and sarcopenic obese groups (aOR 1.54, 95% CI 1.27-1.87) than in the normal group. The risk of erosive esophagitis was higher in the sarcopenic and sarcopenic obese groups than the obese group; the ORs were 1.63 (95% CI 1.08-2.47) and 1.22 (95% CI 1.01-1.46), respectively. In dose-response analysis, increasing sarcopenia severity showed a positive and graded relationship with the overall, Los Angeles (LA)-B or higher grade, and LA-C erosive esophagitis. Conclusions: This study suggests that sarcopenia is strongly and progressively associated with erosive esophagitis.
Background/Aims: An association between obesity and erosive esophagitis has been reported, but the effects of sarcopenia and obesity on erosive esophagitis are unknown. This study examined the relationship between obesity, sarcopenia, sarcopenic obesity, and erosive esophagitis in a large population of asymptomatic men and women. Methods: This study analyzed 32,762 subjects who underwent a comprehensive health check-up, which included upper gastrointestinal endoscopy, from August 2006 to December 2011 by a cross-sectional study. Sarcopenia was defined as a decrease in the appendicular skeletal muscle mass (ASM)/body weight value of two SD or more below the normal means for a younger reference group. Results: The study was carried out on four groups according to obesity and sarcopenic status: normal, obesity, sarcopenic, and sarcopenic obese group. In a multivariable model, the risk of erosive esophagitis was higher in the obese (adjusted OR [aOR] 1.35, 95% CI 1.22-1.49), sarcopenic (aOR 2.12, 95% CI 1.40-3.19), and sarcopenic obese groups (aOR 1.54, 95% CI 1.27-1.87) than in the normal group. The risk of erosive esophagitis was higher in the sarcopenic and sarcopenic obese groups than the obese group; the ORs were 1.63 (95% CI 1.08-2.47) and 1.22 (95% CI 1.01-1.46), respectively. In dose-response analysis, increasing sarcopenia severity showed a positive and graded relationship with the overall, Los Angeles (LA)-B or higher grade, and LA-C erosive esophagitis. Conclusions: This study suggests that sarcopenia is strongly and progressively associated with erosive esophagitis.