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Journal of the Korean Academy of Family Medicine 2003;24(3):271-278.
Published online March 10, 2003.
The Association between Obesity Indices and Physical Fitness.
Yun Joo Jung, Jin Hee Shin, Keun Sang Yum, Chan Hee Song, Whan Seok Choi, Kyung Soo Kim, Jin Hee Park
1Department of Family Medicine, St. Mary's Hospital, The Catholic University of Korea, Korea. kskim@catholic.ac.kr
2Sports Medicine-Obesity Clinic, St. Mary's Hospital, The Catholic University of Korea, Korea.
비만지표와 체력요인의 상관성
정윤주,신진희,염근상,송찬희,최환석,김경수,박진희
1
2
Abstract
Background
: Physical fitness is defined as the ability to carry out work necessary for muscle exercise satisfactorily. Generally, obese person have been considered to have low physical performance. In addition, obesity has been known to be a risk factor of cardiovascular disease such as hyperlipidemia, hypertension, and coronary arterial disease. Based on previous epidemiologic studies, abdominal obesity, especially, visceral obesity, is thought to be more important risk factor for cardiovascular disease rather than obesity itself. Therefore, the interest on assessment of abdominal visceral fat has been increasing. The aim of this study was to see the difference in physical fitness and blood pressure according to obesity degree assessed by BMI, and compare the anthropometric obesity indices with abdominal visceral fat accumulation measured by abdominal CT (Computed Tomogram).

Methods : Four hundred thirty-two subjects, who participated in the exercise program for more than one month duration at the 'Clinic for Obesity' in St. Mary's Hospital from November 1998 to June 2000, were included in the analysis. They were categorized into 4 groups [severe obesity group (BMI≥30), obesity group (25≤BMI<30), overweight group (23≤BMI<25), normal group (BMI<23)] according to their BMI. Blood pressure, anthropometric obesity indices and physical fitness (V02 max, back muscle strength, sit up, forward bending, vertical jump, side step, balance) were measured by one skillful exercise trainer. Among them, one hundred thirty-one subjects performed abdominal CT to assess visceral fatness. We compared anthropometric indices (waist to hip ratio, body mass index, abdominal circumference, skin foldness) with abdominal visceral fat accumulation measured by CT.

Results : Blood pressure, cardiovascular endurance, muscular endurance, muscle strength, speed and balance were significantly different among the four groups categorized by BMI in both sexes, but flexibility and agility were not significant. In women, the correlation coefficients between visceral fat area measured by abdominal CT and each of waist to hip ratio, BMI, abdominal circumference, and skin foldness adjusted for age were 0.487, 0.479, 0.464, 0.31, respectively (P<0.01). However in men, there were no significant correlations.

Conclusion : Obesity tended to increase blood pressure, and reduce physical performance. Only in women, obesity related indices reflected the abdominal visceral fat accumulation.
Key Words: abdominal obesity, visceral obesity, CT, physical fitness, blood pressure
초록
연구배경 : 체력은 근육 운동이 요구되는 작업을 만족스럽게 수행하는 데 필요한 능력으로 정의되며 비만한 사람은 이러한 체력이 낮다고 알려져 있다. 또한 비만은 고지혈증, 고혈압, 관상동맥 질환 등의 심혈관계질환의 주요 위험인자로 알려져 있으며, 특히 내장형 복부비만의 경우 상대적 위험도가 더 높은 것으로 생각되고 있어 최근 내장형 복부비만 평가에 대한 관심이 증가되고 있다. 이에 본 연구에서는 비만도에 따라 체력요인을 분석하고 컴퓨터 단층 촬영에 의한 내장지방량과 일반 복부비만 지표들과의 상관관계를 알아보고자 한다.

방법 : 1998년 11월부터 2000년 6월까지 성모병원 가정의학과 비만클리닉에서 1개월 이상 운동처방을 받았던 성인 432명에 대하여 고도비만군(BMI≥30), 비만군(25≤BMI<30), 과체중군(23≤BMI<25) 및 정상군(BMI<23)으로 나누어 혈압 및 체력요인(최대산소섭취량, 배근력, 윗몸일으키기, 윗몸앞으로굽히기, 수직점프, 사이드 스텝, 눈감고 외발서기)의 차이를 알아보고, 복부비만 평가를 위해 컴퓨터 단층 촬영을 실시했던 131명을 대상으로 복부 컴퓨터 단층 촬영에 의한 내장지방면적과 일반 복부비만 평가지표들(체질량지수, 허리둔부둘레비, 허리둘레, 피지후 두께, 임피던스 측정방식에 의한 체지방률)을 비교 분석하였다.

결과 : 남녀 모두에서 체질량지수에 따른 비만도에 따라 수축기 혈압, 이완기 혈압, 심폐지구력, 근지구력, 근력, 민첩성, 평형성에서 유의한 차이를 보였고(ANCOVA, P<0.05) 유연성과 순발력에서는 유의한 차이를 보이지 않았다. 컴퓨터 단층촬영에 의한 내장지방면적과 허리둔부둘레비, 체질량지수, 허리둘레, 임피던스 측정방식에 의한 체지방률, 피지 후 두께와의 연령을 보정한 상관계수는 여자에서 각각 0.487, 0.479, 0.464, 0.401, 0.31순으로 유의하게 높은 상관성을 보였으나(P<0.01), 남자에서는 유의하지 않았다.

결론 : 비만은 남녀 모두에서 혈압을 증가시키고 체력을 저하시키며, 여자에서만 비만관련지표들이 내장지방량을 반영하였다.
중심 단어: 복부 비만, 내장형 비만, 컴퓨터단층촬영, 체력요인, 혈압


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