[논문]제7기 (2016-2018년) 국민건강영양조사 자료를 이용한 식생활평가지수 준수와 대사증후군 위험요소 및 대사증후군 발생 관계 연구

최선아; 정성석; 노정옥

doi:10.4163/jnh.2022.55.1.120

제7기 (2016-2018년) 국민건강영양조사 자료를 이용한 식생활평가지수 준수와 대사증후군 위험요소 및 대사증후군 발생 관계 연구
Benefits of adherence to the Korea Healthy Eating Index on the risk factors and incidence of the metabolic syndrome: analysis of the 7th (2016-2018) Korea National Health and Nutrition Examination Survey 원문보기

Journal of nutrition and health, v.55 no.1, 2022년, pp.120 - 140

최선아 (전북대학교 식품영양학과) , 정성석 (전북대학교 통계학과) , 노정옥 (전북대학교 식품영양학과)

초록
AI-Helper

본 연구는 제7기 (2016-2018) 국민건강영양조사자료를 이용하여, KHEI 점수와 대사증후군 위험요소 및 대사증후군의 발생 관련성을 연구하고자 하였다. 연구대상자는 제7기 국민건강영양조사 참여자 중 20-59세의 성인으로 연구에 이용한 변수의 결측치가 없는 8,345명을 최종대상으로 분석하였다. KHEI의 총 평균은 100점 만점에 61.06점, 남성의 총 평균은 59.63점, 여성의 총 평균은 62.50점으로 여성이 남성보다 유의적으로 KHEI 총 평균이 높았다. KHEI의 3개 영역 중 '권고하는 식품 및 적정성 평가영역'과 '절제영역'에서 여성이 남성보다 유의적으로 점수가 높았다. KHEI 점수에 따른 일반적 특성을 파악하기 위하여 KHEI 점수를 4분위수로 나누었으며 남녀 모두 연령대와 가구소득이 Q1그룹에서 Q4그룹으로 갈수록 유의적으로 높았으며, 현재 흡연 비율은 유의적으로 낮았다. 남성은 교육수준과 경제활동상태에서 Q1그룹에 비해 Q4그룹이 대학교 졸업이상 비율과 경제활동 참여율이 유의적으로 높았다. 여성은 음주여부, 우울증여부, 외식횟수에서 Q4그룹이 Q1그룹보다 현재 음주, 우울증 유병자비율과 1일 1회이상 외식 비율이 유의적으로 낮았다. 식품안정성에서는 남녀 모두 Q1그룹이 Q3그룹보다 '식품안정군'이 유의적으로 낮았다. 대사증후군과 관련된 영양소 섭취 실태에서 남녀 모두 Q1 그룹의 에너지 필요 추정량 미만 섭취자 비율이 유의적으로 높았으며, 탄수화물, 단백질, 비타민 C, 칼슘, 비타민 B1, 비타민 B2, 니아신은 평균필요량 미만 섭취자 비율이 유의적으로 높았고, 식이섬유소는 충분 섭취량 미만 섭취자 비율이 유의적으로 높았다. 남성의 공복혈당은 Q3그룹이 Q1그룹보다 유의적으로 높았다. 여성의 BMI는 Q4그룹이 Q2그룹보다 유의적으로 낮았으며, 수축기 혈압은 Q3그룹이 Q1그룹보다 유의적으로 높았다. 여성의 총콜레스테롤은 Q4그룹이 Q1그룹보다 유의적으로 높았다. 대사증후군 위험요인에서 남성의 고중성지방혈증 유병률은 Q1그룹이 Q4그룹보다 유의적으로 높았으며, 고혈당 유병률은 Q3그룹이 Q1그룹보다 유의적으로 높았다. 여성의 고혈압 유병률은 Q3그룹이 Q1그룹보다 유의적으로 높았으며 대사증후군은 Q2그룹이 Q1그룹보다 유의적으로 높았다. KHEI 점수에 따른 대사증후군 위험요인과 대사증후군 연관성 연구결과, 남녀 모두 KHEI 총점수가 높을수록, 20-29세가 50-59세에 비해 대사증후군 위험요소 및 대사증후군의 발생위험이 유의적으로 낮았다. 교육수준, 소득수준, 흡연, 음주, 우울증 여부는 성별에 따라 다른 양상을 보였다. 교육수준에서 남성은 저HDL콜레스테롤혈증, 고혈당의 발생위험이 유의적인 차이를 보였으며, 여성은 우울증이 있는 경우가 없는 경우보다 고중성지방혈증은 1.81배, 고혈당은 1.90배, 대사증후군은 2.50배로 발생위험이 유의적으로 높았다. 남녀 모두 소득수준이 '하'일 때 '상'에 비해 고중성지방혈증, 대사증후군의 발생위험이 유의적으로 높았으며 특히, 여성은 복부비만, 고혈당, 고혈압을 남성은 저HDL콜레스테롤혈증 발생위험이 유의적으로 높았다.

Abstract ▼ AI-Helper

Purpose: The purpose of the study was to investigate whether adherence to the Korea Healthy Eating Index (KHEI) was associated with metabolic syndrome and risk markers. Methods: The participants included 8,345 adults, aged 20-59 years, who took part in the 7th Korea National Health and Nutrition Examination Survey (KNHANES). The data were analyzed using a complex-sample t-test, the Rao Scott χ2-test, and logistic regression analysis on the SPSS v. 26.0 software. The participants were divided into four groups by quartiles of KHEI scores. Results: The average KHEI score was 61.06 points out of 100, and the women's score (62.50 points) was significantly higher than that of men (59.63 points). The KHEI quartiles status showed significant differences by age (p < 0.001), household income (p < 0.001), smoking status (p < 0.001), and food security. Specifically, the KHEI quartiles in the men showed significant differences in education (p < 0.001) and economic activity (p < 0.001) whereas those of women showed significant differences in alcohol-consumption (p < 0.001), depression (p < 0.01) and eating-out (p < 0.001). As the KHEI scores increased, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower, and significantly better levels of intake were observed for carbohydrate, protein, vitamin C, calcium, vitamin B1, vitamin B2, and niacin. The incidence of the metabolic syndrome risk factors, hypertriglyceridemia and hyperglycemia for men and hypertension, and hyperglycemia for women showed significant differences. The KHEI scores were inversely associated with abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, hypertension, and metabolic syndrome. Conclusion: Based on these results, we conclude that higher adherence to the KHEI was associated with lower metabolic syndrome risk factors and incidence of the metabolic syndrome.

주제어

표/그림 (7)

그림 Fig. 1. Flow diagram for selecting study. KNHANES, Korea National Health and Nutrition Examination Survey.
표 Table 1. Scores of the Korean Healthy Eating Index by sex
표 Table 2. General characteristics of subjects by quartiles of KHEI scores
표 Table 3. Proportions of subjects for energy and nutrient intake by food quartiles of KHEI scores
표 Table 4. Comparison of biochemical factor by food quartiles of KHEI scores
표 Table 5. Comparison of metabolic syndrome risk factor by quartiles of KHEI scores
표 Table 6. Logistic regression of metabolic syndrome risk factor and metabolic syndrome

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