폐경이행기 여성의 대사증후군과 건강행태요인

Abstract

본 연구의 목적은 폐경이행기 여성의 대사증후군과 건강행태 요인 및 관련요인을 파악하여 대사증후군 예방 및 간호중재 개발의 기초자료를 제공하고자 하는 것이다. 본 연구의 자료수집은 2014년도 보건복지부 질병관리본부에서 시행한 국민건강영양조사에서 건강검진조사를 수행한 대상자 만 45세 이상 부터 만 55세 이하 폐경이행기 여성 683명 중 대사증후군 진단기준 요인에서 결측치가 있는 경우를 제외한 550명을 최종 대상으로 하였다. 대사증후군 진단기준은 Modified NCEP-ATP Ⅲ (National Cholesterol Education Program in Adult Treatment Panel Ⅲ) 기준을 기본으로 허리둘레는 대한비만학회(Korean Society for the Study of Obesity)의 진단기준에 근거하여 시행하였다. 수집된 자료는 SPSS 19.0 통계프로그램을 이용하여 복합표본(complex samples) 분석을 사용하였으며 가중치를 적용하였다. Frequency & percentage, mean & standard error, chi-square test, t-test, logistic regression, multiple logistic regression으로 분석하였다. 본 연구 결과는 다음과 같다. 1. 대상자의 평균연령은 50.5세로 대사증후군 유병율은 21.6%였다. 대사증후군 유무에 따른 대상자의 연령, 교육수준, 소득수준, 폐경이 통계적으로 유의하였다. 2. 대사증후군 유무에 따른 대사증후군 진단기준 요인의 차이를 분석한 결과 허리둘레, 중성지방, 수축기혈압, 이완기혈압, 공복혈당, HDL-colesterol에서 차이가 있는 것으로 나타났다. 3. 대사증후군 유무에 따른 건강행태 요인으로 흡연여부(=21.641, p<.001), 현재 흡연량(t=16.374, p<.001), 음주량(t=2.015, p=.046), 운동(=9.974, p=.027), 스트레스(=20.672, p=.001)는 통계적으로 유의한 차이가 있는 것으로 나타났다. 4. 대사증후군 위험비는 보정하여 분석한 결과에서 연령이 증가할 때 1.094배(95% CI, 1.012-1.183), 소득수준 하 군일 때 2.907배(95% CI, 1.057-7.995), 초등학교 졸업 군일 때 4.235배(95% CI, 1.501-11.951), 현재 흡연군일 때 6.240배(95% CI, 2.356- 16.525), 흡연량이 증가할 때 2.418배(95% CI, 2.124-2.751), 음주량이 증가할 때 1.219배(95% CI, 1.002-1.484), 운동을 하지 않는 군일 때 1.516배(95% CI, 1.286-1.932), 스트레스를 매우 높게 느끼는 군일 때 4.240배(95% CI, 1.194-15.054) 증가하였다. 본 연구에서 대사증후군이 있는 폐경이행기 여성은 중성지방과 low HDL- cholesterol이 가장 높게 나왔으므로 이를 관리하는데 중점을 두어야 할 것이다. 또한 금주, 금연, 운동, 스트레스 관리를 위한 건강행태 개선프로그램을 소득수준과 교육수준이 낮은 군에게 우선적으로 시행할 필요가 있다. 폐경이행기 여성을 대상으로 대사증후군의 예방 및 관리를 위한 간호중재 프로그램 개발과 효과를 확인하는 연구를 제언한다.;The purpose of this study was to figure out health behaviors and related factors according to the metabolic syndrome of the women who are in the menopausal transition period and then provide baseline data for prevention of metabolic syndrome and development of nursing intervention. This study collected data from the 6th Korea National Health and Nutrition Examination Survey conducted in 2014 by the Korea Center for Disease Control and Prevention. Among 683 Korean women who are 45 to 55 year-old in the menopausal transition period, 550 Korean women were selected as respondents except for those with missing values in the risk factors of metabolic syndrome. Metabolic syndrome diagnoses were based on modified NCEP-ATP Ⅲ (National Cholesterol Education Program Adult Treatment Panel Ⅲ) criteria and waist circumference criterion was based on diagnoses of the Korean Society for the Study of Obesity. The statistical analysis was performed using complex samples analysis with applying weights in the SPSS 19.0 program. The data was analyzed by the following methods : frequency and percentages ; mean and standard error ; and the t-test and -test (used for comparing two groups) ; and then logistic regressions and multiple logistic regression analysis(executed to identify independent factors related to the metabolic syndrome). The major findings of this study were described as follows: 1. The mean age of the respondents was 50.5. The prevalence rate of metabolic syndrome was 21.6%. It showed that there were statistically significant in age, education level, house income status and menopause status between the metabolic syndrome group and the normal group according to the general characteristics of metabolic syndrome. 2. The results of analysing the difference of risk factors of metabolic syndrome between the metabolic syndrome group and the normal group showed that there were statistically significant differences in systolic blood pressure, diastolic blood pressure, waist circumference, fasting blood glucose, triglycerides and HDL-cholesterol. 3. There were statistically significant differences in smoking status (=21.641, p<.001), current smoking amount (t=16.374, p<.001), drinking amount (t=2.015, p=.046), exercise (=9.974, p=.027) and level of stress (=20.672, p=.001) as health behavior factors between the metabolic syndrome group and the normal group. However, there were no statistically significant differences in frequency of drinking. 4. Odds ratio of metabolic syndrome in multiple logistic regression analysis increased in age (OR=1.094, 95% CI, 1.012-1.183), lower in the income level (OR=2.907, 95% CI, 1.057-7.995), elementary school graduates (OR=4.235, 95% CI, 1.501-11.951), current smoker (OR=6.240, 95% CI, 2.356-16.525), smoking amount (OR=2.418, 95% CI, 2.124-2.751), drinking amount (OR=1.219, 95% CI, 1.002-1.484), no exercise group (OR=1.516, 95% CI, 1.286-1.932) and a very high stressful group (OR=4.240, 95% CI, 1.194-15.054). Based on the results, The women who are in the menopausal transition period with metabolic syndrome should prevent and manage triglyceride and low HDL-cholesterol. And this study suggests that health behavior improvement programs such as stop drinking, stop smoking, exercising and managing stress should be implemented for both a low-income level group and a low education group ahead of other groups. This study also suggests that another study to develop a nursing intervention program and prove its effectiveness should be conducted in order to prevent and manage metabolic syndrome for the women who are in the menopausal transition period.