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The Association between Serum Uric Acid and Relative Grip Strength: The 7th Korea National Health and Nutrition Examination Survey (2016-2018)
Korean J Sports Med 2022;40:1-11
Published online March 1, 2022;  https://doi.org/10.5763/kjsm.2022.40.1.1
© 2022 The Korean Society of Sports Medicine.

Yoo Bin Seo, Yeong Sook Yoon

Department of Family Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
Correspondence to: Yeong Sook Yoon
Department of Family Medicine, Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea
Tel: +82-31-910-7115, Fax: +82-31-910-7024, E-mail: ysyoon@paik.ac.kr
Received July 19, 2021; Revised August 29, 2021; Accepted September 28, 2021.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: Uric acid (UA) has both oxidative and antioxidant properties. The relationship between serum UA level and muscle strength is unclear. We aimed to investigate the relationship between serum UA level and relative hand grip strength (HGS) among male and female adults.
Methods: A cross-sectional study was performed evaluating participants in the 7th Korea National Health and Nutrition Examination Survey. A total of 16,495 (7,393 males and 9,102 females) were evaluated. Relative HGS was calculated as maximal absolute handgrip strength from both hands divided by body mass index. Linear regression analyses were performed to estimate the coefficients and 95% confidence intervals (CI) for relative HGS by quartiles of UA levels, adjusted for potential confounders.
Results: With adjustments, UA levels were negatively associated with relative HGS in both males (p-trend, < 0.001) and females (p for trend, < 0.001). In males, coefficients β (95% CI) for the 2nd, 3rd, and 4th quartile were respectively −0.03 (−0.05 to 0.00), −0.05 (−0.08 to −0.03), −0.07 (−0.09 to −0.04). In females, coefficients β (95% CI) for the 3rd and 4th quartile were −0.05 (−0.03 to 0.00) and −0.05 (−0.06 to −0.03), respectively. When the participants were subdivided according to age, disease status, and renal function, the negative correlation between UA and HGS remained in most of the subgroups.
Conclusion: Serum UA is negatively associated with HGS in Korean males and females. Serum UA seems to be a deleterious factor for muscle strength, independent of the sex.
Keywords : Uric acid, Grip strength, Muscle strength, Oxidative stress
꽌 濡

슂궛 벂由 돱겢젅삤떚뱶 궗궛臾쇰줈꽌, 냼닔꽦(hydrophobic) 솚寃쎌뿉꽌 궛솕젣濡 옉슜븯뿬 꽭룷 궡뿉꽌 諛섏쓳꽦 궛냼醫낆쓽 異뺤쟻怨 꽭룷 議곗쭅쓽 湲곕뒫遺쟾쓣 빞湲고븷 닔 엳떎1. 씠윭븳 湲곗쟾쑝濡, 슂궛쓽 利앷뒗 넻뭾 쇅뿉룄 씤뒓由 빆꽦, 궗吏덊솚 諛 떖삁愿吏덊솚怨 뿰愿씠 엳떎뒗 궗떎씠 諛앺졇 솕떎2. 諛섎濡 移쒖닔꽦(hydrophilic) 솚寃쎌뿉꽌뒗 슂궛씠 옄쑀 씪뵒移쇱쓣 젣嫄고븯뒗 媛뺣젰븳 빆궛솕젣씠硫, Maxwell 벑3뿉 뵲瑜대㈃ 슂궛 삁泥 珥 빆궛솕뒫쓽 젅諛 씠긽쓣 떞떦븯怨 엳떎. 씠윭븳 留λ씫뿉꽌 넂 슂궛 냽룄뒗 以묒텛떊寃쎌뿉 븳 蹂댄샇 슚怨쇰 媛뽯뒗떎怨 蹂닿퀬릺湲곕룄 븯떎4.

洹쇰젰 떊泥닿린뒫쓽 쑀吏뿉 븘닔쟻씠硫 굹씠뿉 뵲씪 媛먯냼븳떎5. 洹쇱쑁웾 븯 諛 洹쇰젰쓽 빟솕濡 젙쓽릺뒗 洹쇨컧냼(sarcopenia)뒗 궣쓽 吏 븯 愿젴씠 엳쓣 肉 븘땲씪6, 씤뒓由곗빆꽦 諛 떖삁愿吏덊솚쓽 쐞뿕쓣 넂씠뒗 寃껋쑝濡 븣젮졇 엳떎7. 洹쇨컧냼瑜 씪쑝궎뒗 以묒슂븳 湲곗쟾쑝濡 궛솕 뒪듃젅뒪媛 븣젮졇 엳떎8. 븵꽌 뼵湲됲븯뜕 슂궛쓽 씠以묒쟻 뿭븷뿉 븳 꽑뻾 뿰援щ뱾쓣 諛뷀깢쑝濡 슂궛씠 洹쇱쑁뿉 뼱뼚븳 쁺뼢쓣 誘몄튂뒗吏뿉 븳 愿떖씠 젣湲곕릺뿀쑝硫, 씠뿉 빐 떎뼇븳 뿰援 寃곌낵뱾씠 議댁옱븳떎.

슂궛怨 洹쇰젰뿉 빐 쓬쓽 愿怨꾨 젣떆븯뒗 뿰援щ뱾씠 엳뿀쑝硫9-12, 諛섎濡 뼇쓽 愿怨꾨 蹂댁뿬二쇰뒗 뿰援щ룄 엳뿀떎13-16. 40꽭 씠긽쓽 꽦씤뿉꽌 떎떆맂 븳 떒硫 뿰援ъ뿉꽌 슂궛 利앷뒗 洹쇨컧냼利앹쓽 쐞뿕룄瑜 넂씤떎怨 븯쑝硫9, 65꽭 씠긽쓽 끂씤쓣 긽쑝濡 븳 肄뷀샇듃 뿰援ъ뿉꽌뒗 怨좎슂궛삁利앷낵 떊泥닿린뒫 븯쓽 뿰愿꽦쓣 蹂댁怨10, 삉 떎瑜 肄뷀샇듃 뿰援щ뒗 60꽭 씠긽쓽 끂씤뿉꽌 슂궛 利앷媛 뿀빟(frailty) 쐞뿕룄瑜 넂씤떎怨 븯떎11. 諛섎㈃, 50꽭 씠긽 꽦씤쓣 긽쑝濡 븳 以묎뎅怨 誘멸뎅뿉꽌쓽 떒硫 뿰援щ뒗 슂궛 利앷뿉 뵲씪 洹쇰젰씠 利앷븿쓣 蹂댁뿬二쇱뿀怨13,14, 룊洹 굹씠 93꽭쓽 怨좊졊쓽 끂씤뿉꽌 떎떆맂 뿰援ъ뿉꽌뒗 넂 삁以 슂궛 냽룄媛 꽱 븙젰뿉 븳 룆由쎌쟻 씤옄엫쓣 蹂댁뿬二쇨린룄 븯떎15. 씠泥섎읆 슂궛 냽룄 븙젰쓽 愿怨꾩뿉 븳 떒硫 뿰援 諛 肄뷀샇듃 뿰援ъ쓽 寃곌낵媛 긽씠븯뿬 異붽쟻씤 뿰援ш 븘슂븯떎. 삉븳 遺遺꾩쓽 꽑뻾 뿰援щ뱾 40꽭 誘몃쭔쓽 젇 뿰졊쓣 룷븿븯吏 븡븘, 紐⑤뱺 뿰졊뿉 쟻슜븯湲곗뿉 젣븳씠 엳떎. 洹몃━怨 삁以 슂궛 냽룄 븙젰쓽 遺꾪룷뒗 궓꽦怨 뿬꽦뿉꽌 떎瑜대濡, 슂궛怨 븙젰쓽 뿰愿꽦쓣 媛 꽦蹂꾩뿉꽌 룊媛빐蹂 븘슂媛 엳떎. 씠뿉 빐꽌뒗 냼닔쓽 꽑뻾 뿰援щ쭔씠 議댁옱븯뒗뜲, Kawamoto 벑16쓽 뿰援ъ뿉꽌뒗 뿬꽦뿉꽌留 뼇쓽 愿怨꾨 蹂댁뜕 諛섎㈃, 誘멸뎅뿉꽌 떆뻾맂 National Health and Nutrition Examination Survey (NHANES) 옄猷뚮줈 50꽭 씠긽쓣 遺꾩꽍븳 뿰援ъ뿉꽌뒗 궓 紐⑤몢뿉꽌 뼇쓽 愿怨꾨 굹깉떎14. 뵲씪꽌 슂궛怨 븙젰쓽 뿰愿꽦뿉 빐 젇 씤援щ 룷븿븯뿬 궓 媛곴컖뿉꽌 뵲濡 遺꾩꽍빐 蹂 븘슂媛 엳떎.

씠뿉 蹂 뿰援щ뒗 援誘쇨굔媛뺤쁺뼇議곗궗 젣7湲 옄猷뚯쓽 꽦씤쓣 긽쑝濡 媛 꽦蹂꾩뿉 뵲瑜 슂궛 냽룄 븙젰쓽 愿怨꾨 븣븘蹂닿퀬옄 븳떎. 삉븳 꽑뻾 뿰援ъ뿉 洹쇨굅븯쓣 븣 븙젰쓽 젅媛믩낫떎뒗 긽 븙젰씠 洹쇰젰쓣 뜑슧 옒 諛섏쁺븷 닔 엳뒗 吏몴씠誘濡17, 蹂 뿰援ъ뿉꽌뒗 븙젰쓣 泥댁쭏웾吏닔(body mass index, BMI)濡 굹늿 긽 븙젰쓣 醫낆냽蹂닔濡 븯뿬 뿰援ы븯떎.

뿰援 諛⑸쾿

1. 뿰援 긽

蹂 뿰援ъ쓽 긽옄뒗 젣7湲 1, 2, 3李⑤뀈룄(2016–2018)뿉 李몄뿬븳 留 20꽭 씠긽쓽 꽦씤 19,197紐 以묒슂궛씠 痢≪젙릺吏 븡 寃쎌슦(1,520紐), 븙젰寃궗瑜 떆뻾븯吏 紐삵븳 寃쎌슦(1,143紐)뒗 諛곗젣븯쑝硫, 궗援ъ껜뿬怨쇱쑉(estimated glomerular filtration rate, eGFR) 30 mL/min/1.73 m2 誘몃쭔씤 옄(39紐)瑜 젣븯怨 珥 16,495紐(궓꽦 7,393紐, 뿬꽦 9,102紐)쓣 理쒖쥌 긽옄濡 븯떎. 援誘쇨굔媛뺤쁺뼇議곗궗 젣7湲 以 1李⑤뀈룄 諛 2李⑤뀈룄뒗 援媛媛 吏곸젒 怨듦났蹂듬━瑜 쐞빐 닔뻾븯뒗 뿰援ъ뿉 빐떦븯뿬 뿰援ъ쑄由ъ떖쓽쐞썝쉶 떖쓽瑜 諛쏆 븡怨 닔뻾븯쑝硫, 3李⑤뀈룄뒗 吏덈퀝愿由щ낯遺 뿰援ъ쑄由ъ떖쓽쐞썝쉶 듅씤쓣 諛쏆븘 닔뻾븯떎(No. 2018-01-03-P-A).

2. 슂궛쓽 痢≪젙

삁븸寃궗뒗 8떆媛 씠긽 怨듬났쓣 쑀吏븳 긽깭뿉꽌 梨꾪삁吏移⑥뿉 뵲씪 씠猷⑥뼱議뚯쑝硫 Hitachi Automatic Analyzer 7600-210 (Hitachi, Tokyo, Japan)瑜 씠슜븯뿬 24떆媛 씠궡뿉 遺꾩꽍븯떎. 蹂 뿰援ъ뿉꽌 슂궛 꽦蹂꾩뿉 뵲씪 遺꾪룷蹂꾨줈 4遺꾩쐞濡 굹늻뼱 踰붿<삎 蹂닔濡 젙쓽븯떎. 궓꽦쓽 寃쎌슦 4遺꾩쐞 援ш컙 ≤5.0, 5.1–5.8, 5.9–6.7, ≥6.8 mg/dL쑝硫, 뿬꽦 ≤3.7, 3.8–4.3, 4.4–4.9, ≥5.0 mg/dL떎.

3. 븙젰怨 긽 븙젰

븙젰 뵒吏꽭 븙젰怨(digital grip strength dynamometer, T.K.K 5401; Takei Scientific Instruments, Nigata, Japan)瑜 씠슜븯뿬 痢≪젙븯떎. 뼇넀 媛곴컖 3踰덉뵫 痢≪젙븯쑝硫, 1쉶 痢≪젙 썑 1遺 媛꾧꺽쑝濡 쑕떇떆媛꾩쓣 媛뽯룄濡 븯떎. 蹂 뿰援ъ뿉꽌뒗 뼇넀쓽 븙젰 媛 以 理쒕媛믪쓣 궗슜븯怨, 븙젰쓣 BMI濡 굹늿 媛믪쓣 긽 븙젰쑝濡 젙쓽븯떎.

4. 湲고 蹂닔

嫄닿컯꽕臾몄“궗 諛 寃吏꾩“궗, 쁺뼇議곗궗瑜 넻빐 긽옄쓽 씤援ы븰쟻 슂냼, 떊泥 怨꾩륫, 留뚯꽦吏덊솚, 嫄닿컯 愿젴 뻾룞, 쁺뼇 꽠痍⑥뿉 븳 젙蹂대 닔吏묓븯떎. 씤援ы븰쟻 슂냼濡 굹씠, 냼뱷닔以쓣 룷븿븯쑝硫, 냼뱷 젙룄뒗 媛援 닔엯쓣 媛곴컖 ‘긽’, ‘以묒긽’, ‘以묓븯’, ‘븯’濡 遺꾨쪟븯떎. 떊옣(cm), 泥댁쨷(kg) 紐⑤몢 냼닔 泥 踰덉㎏ 옄由ш퉴吏 痢≪젙븯쑝硫, BMI뒗 泥댁쨷(kg)/떊옣(m2)쑝濡 怨꾩궛븯떎.

씉뿰 쁽옱 씉뿰 뿬遺濡 씉뿰옄 鍮꾪씉뿰옄濡 遺꾨쪟븯쑝硫, 쓬二쇰뒗 理쒓렐 1뀈 룞븞 븳 떖뿉 1쉶 씠긽 닠쓣 留덉떊 쟻씠 엳떎怨 쓳떟븳 寃쎌슦瑜 쓬二쇱옄濡 젙쓽븯떎. 쑀궛냼 떊泥댄솢룞 씪二쇱씪뿉 以묎컯룄 떊泥댄솢룞쓣 2떆媛 30遺 씠긽, 삉뒗 怨좉컯룄 떊泥댄솢룞쓣 1떆媛 15遺 씠긽, 삉뒗 以묎컯룄 怨좉컯룄 떊泥댄솢룞쓣 꽎뼱꽌 媛 솢룞뿉 긽떦븯뒗 떆媛(怨좉컯룄 1遺꾩 以묎컯룄 2遺) 떎泥 뿬遺濡 遺꾨쪟븯쑝硫, 洹쇰젰슫룞 씪닔뒗 1二쇱씪媛 洹쇰젰슫룞쓣 떆뻾븳 씪닔濡 議곗궗븯떎. 븯쐞 洹몃9 遺꾩꽍뿉꽌 쟻젅븳 洹쇰젰슫룞 씪닔쓽 湲곗 2씪 씠긽쑝濡 븯떎.

삁떦怨 珥 肄쒕젅뒪뀒濡, 怨좊룄 肄쒕젅뒪뀒濡, 以묒꽦吏諛, 諛룄 肄쒕젅뒪뀒濡ㅼ 12떆媛 씠긽쓽 怨듬났긽깭뿉꽌 Hitachi Automatic Analyzer 7600-210 옣鍮꾨줈 痢≪젙븯떎. 怨좉컧룄 C-諛섏쓳꽦 떒諛(high sensitivity C-reactive protein, hs-CRP) Cobas (Roche, Basel, Germany) 옣鍮꾨 씠슜븯뿬 痢≪젙븯떎. 삁以 겕젅븘떚땶 냽룄뒗 Hitachi Automatic Analyzer 7600-210 옣鍮꾨줈 痢≪젙븯쑝硫, eGFR 삁以 겕젅븘떚땶 냽룄瑜 씠슜븯뿬 Modification of Diet in Renal Disease 怨듭떇쓣 넻빐 궛異쒗븯떎.

鍮꾨쭔쓽 湲곗 BMI 25 kg/m2 씠긽쑝濡 븯떎. 留뚯꽦吏덊솚 씠솚긽깭 빆紐⑹쑝濡 怨좏삁븬, 떦눊蹂, 怨좎삁利, 븫, 愿젅뿼쓣 룷븿븯떎. 怨좏삁븬 닔異뺢린 삁븬씠 140 mm Hg 씠긽, 삉뒗 씠셿湲 삁븬씠 90 mm Hg 씠긽, 삉뒗 怨좏삁븬 빟臾쇱쓣 蹂듭슜븳 궗엺쑝濡 젙쓽븯떎. 怨듬났 삁떦씠 126 mg/dL 씠긽씠嫄곕굹, 쓽궗吏꾨떒쓣 諛쏆븯嫄곕굹, 삁떦媛뺥븯젣瑜 蹂듭슜븯嫄곕굹, 씤뒓由 二쇱궗瑜 닾뿬 諛쏄퀬 엳뒗 寃쎌슦瑜 떦눊濡 遺꾨쪟븯떎. 怨좎삁利앹 珥 肄쒕젅뒪뀒濡ㅼ씠 240 mg/dL 씠긽씠嫄곕굹 吏吏덇컯븯젣瑜 蹂듭슜븯怨 엳뒗 궗엺쑝濡 젙쓽븯떎. 愿젅뿼 쁽옱 怨④젅뿼 삉뒗 瑜섎쭏떚뒪꽦 愿젅뿼 쑀蹂 뿬遺뿉 ‘삁’濡 쓳떟븳 궗엺쑝濡, 븫 쓽궗 吏꾨떒 뿬遺뿉 ‘삁’濡 쓳떟븳 궗엺쑝濡 議곗궗븯떎.

쁺뼇議곗궗뒗 24떆媛 쉶긽踰뺤쑝濡 議곗궗븯怨 1씪 뿉꼫吏 꽠痍⑤웾(kcal), 1씪 떒諛깆쭏 꽠痍⑤웾(g)쓣 룷븿븯떎. 쟻젙 떒諛 꽠痍 뿬遺뒗 꽭怨꾨낫嫄닿린援ъ쓽 沅뚭퀬 湲곗뿉 뵲씪 떒쐞 泥댁쨷떦 0.8 g 씠긽쓽 떒諛깆쭏 꽠痍 뿬遺濡 遺꾨쪟븯떎18.

5. 넻怨 遺꾩꽍

옄猷 遺꾩꽍쓣 쐞빐 IBM SPSS version 25.0 (IBM Corp., Armonk, NY, USA)쓣 궗슜븯쑝硫, 紐⑤뱺 遺꾩꽍뿉꽌 媛꽕 寃젙쓣 쐞븳 넻怨꾩쟻 쑀쓽꽦 p<0.05瑜 湲곗쑝濡 븯떎. 蹂 뿰援щ뒗 援誘쇨굔媛뺤쁺뼇議곗궗 遺꾩꽍吏移⑥뿉 뵲씪 썝떆옄猷뚯쓽 蹂듯빀몴蹂 꽕怨꾪듅꽦쓣 怨좊젮븯뿬 遺꾩꽍븯떎. 뿰냽삎 蹂닔뒗 룊洹좉낵 몴以렪李, 踰붿<삎 蹂닔뒗 鍮꾩쑉(%)濡 젣떆븯떎. 긽옄뒗 꽦蹂꾩뿉 뵲씪 굹늻뼱 媛 슂궛 援ш컙뿉 뵲瑜 듅꽦쓣 鍮꾧탳븯쑝硫, 踰붿<삎 蹂닔뿉꽌뒗 移댁씠젣怨 寃젙쓣, 뿰냽삎 蹂닔뿉꽌뒗 遺꾩궛遺꾩꽍쓣 궗슜븯떎.

媛 꽦蹂꾩뿉꽌 슂궛怨 븙젰쓽 뿰愿꽦쓣 뙆븙븯湲 쐞빐 슂궛 援ш컙쓣 룆由 蹂닔, 븙젰쓣 醫낆냽蹂닔濡 꽑젙븯뿬 援먮蹂닔뱾쓣 떒怨꾨퀎濡 蹂댁젙븳 떎以 꽑삎쉶洹遺꾩꽍쓣 떆뻾븯떎. Model 1뿉꽌뒗 굹씠 냼뱷쓣 蹂댁젙븯쑝硫 model 2뿉꽌뒗 異붽쟻쑝濡 BMI, 怨좏삁븬, 떦눊, 怨좎삁利, 愿젅뿼, 븫, 씉뿰 諛 쓬二, 쑀궛냼슫룞, 洹쇰젰슫룞 씪닔, 씪씪 뿉꼫吏 꽠痍⑤웾 諛 떒諛깆쭏 꽠痍⑤웾쓣 蹂댁젙븯怨, 理쒖쥌쟻쑝濡 model 3뿉꽌뒗 hs-CRP eGFR쓣 異붽濡 蹂댁젙븯떎. 援먮蹂닔瑜 蹂댁젙븳 긽깭뿉꽌 꽑삎 愿怨꾩뿉 븳 넻怨꾩쟻 쑀쓽꽦쓣 뙆븙븯湲 쐞빐 寃쏀뼢 遺꾩꽍(trend analysis)쓣 넻빐 p for trend瑜 援ы븯떎.

留덉留됱쑝濡, 굹씠, 留뚯꽦吏덊솚, 嫄닿컯뻾깭 듅꽦뿉 뵲씪 슂궛怨 븙젰 뿰愿꽦뿉 李⑥씠媛 엳뒗吏 뙆븙븯湲 쐞븯뿬 굹씠蹂(50꽭 湲곗), 留뚯꽦吏덊솚 쑀臾, 嫄닿컯뻾깭 遺꾨쪟뿉 뵲씪 븯쐞 洹몃9 遺꾩꽍쓣 떆뻾븯떎.

寃 怨

1. 媛 꽦蹂꾩뿉꽌 슂궛 援ш컙뿉 뵲瑜 씪諛섏쟻 듅꽦

뿰援 긽옄 珥 16,495紐(궓꽦 7,393紐, 뿬꽦 9,102紐)씠 遺꾩꽍긽뿉 룷븿릺뿀떎. 留 굹씠뒗 궓꽦 룊洹 46.3±0.29꽭, 뿬꽦 47.95±0.28꽭떎. 슂궛쓽 룊洹 諛 몴以삤李⑤뒗 궓꽦뿉꽌 5.95± 0.02 mg/dL, 뿬꽦뿉꽌 4.40±0.01 mg/dL떎. 븙젰쓽 룊洹 諛 몴以삤李⑤뒗 궓꽦뿉꽌 40.79±0.14 kg, 뿬꽦뿉꽌 23.79±0.09 kg씠뿀떎.

媛 꽦蹂꾩뿉꽌 슂궛 援ш컙뿉 뵲瑜 씤援ы븰쟻 諛 嫄닿컯 愿젴 듅꽦쓣 Table 1뿉 젣떆븯떎. 궓꽦쓽 寃쎌슦 슂궛 援ш컙씠 利앷븿뿉 뵲씪 룊洹 굹씠媛 媛곴컖 52.2꽭, 46.5꽭, 44.2꽭, 42.7꽭濡 젏李 궙븘議뚯쑝硫, 슂궛 援ш컙 Q1, Q2蹂대떎 Q3, Q4뿉꽌 냼뱷 ‘긽’쓽 鍮꾩쑉씠 넂怨 냼뱷 ‘븯’ 鍮꾩쑉씠 궙븯떎. 슂궛씠 利앷븿뿉 뵲씪 BMI, 怨좎삁利 쑀蹂묐쪧 利앷뻽怨, 떦눊 쑀蹂묐쪧, 愿젅뿼, 븫 쑀蹂묐쪧 媛먯냼뻽떎. 슂궛씠 媛옣 궙 Q1援곗뿉꽌 1씪 뿉꼫吏 꽠痍⑤웾怨 떒諛깆쭏 꽠痍⑤웾씠 궙븯怨, eGFR 슂궛씠 利앷븿뿉 뵲씪 궙븘議뚮떎. 씉뿰쑉怨 洹쇰젰슫룞씪닔뒗 슂궛 援ш컙蹂 쑀쓽븳 李⑥씠瑜 蹂댁씠吏 븡븯떎. 뿬꽦뿉꽌, Q4뿉꽌 룊洹좊굹씠媛 49.2꽭濡 媛옣 넂븯쑝硫, BMI뒗 Q1–Q4뿉꽌 닚李⑥쟻쑝濡 넂븘議뚮떎. 怨좏삁븬, 떦눊, 怨좎삁利 쑀蹂묐쪧, 씉뿰옄 鍮꾩쑉怨 쓬二쇱옄 鍮꾩쑉, hsCRP뒗 슂궛씠 利앷븿뿉 뵲씪 넂븘議뚭퀬, eGFR 궙븘議뚮떎. 媛援 냼뱷, 븫 쑀蹂묐쪧, 쑀궛냼 떊泥댄솢룞, 1씪 뿉꼫吏 꽠痍⑤웾, 떒諛깆쭏 꽠痍⑤웾 슂궛 援ш컙蹂 쑀쓽븳 李⑥씠瑜 蹂댁씠吏 븡븯떎.

Table 1 . Characteristics of study participants by quartiles of serum uric acid

CharacteristicMaleFemale


Q1Q2Q3Q4p-valueQ1Q2Q3Q4p-value
Age (yr)52.2±0.546.5±0.544.2±0.542.7±0.5<0.00147.9±0.547.6±0.547.1±0.549.2±0.50.002
Income (%)<0.0010.081
Low16.912.811.911.115.814.815.218.9
Low medium23.723.119.523.122.725.024.424.7
High medium29.029.231.230.129.629.629.227.0
High30.234.937.535.732.030.631.229.4
BMI (kg/m2)23.7±0.124.1±0.124.8±0.125.8±0.1<0.00122.2±0.123.0±0.123.3±0.124.6±0.1<0.001
Hypertension (%)33.628.427.934.2<0.00119.019.522.032.6<0.001
Diabetes (%)20.210.57.17.7<0.0017.97.48.111.7<0.001
Hyperlipidemia (%)19.416.016.421.20.00317.119.921.727.3<0.001
Arthritis (%)5.43.62.72.9<0.00113.511.612.915.40.010
Cancer (%)4.52.72.51.8<0.0015.15.15.16.00.650
Smoking status (%)37.133.035.135.70.2583.95.36.17.8<0.001
Alcohol (%)65.769.676.277.8<0.00141.644.848.747.8<0.001
Physical activity (%)45.952.050.753.40.00442.244.544.945.80.224
Resistance exercise (day/wk)1.041.131.121.140.4280.480.580.550.620.044
Daily intake (kcal/day)2,285±27.12,425±30.72,439±30.22,401±34.5<0.0011,689±18.01,697±19.31,704±20.21,669±19.50.597
Protein intake (g/day)81.4±1.288.8±1.588.4±1.387.9±1.5<0.00160.4±0.860.0±0.860.8±0.960.4±0.90.920
hs-CRP (mg/L)1.25±0.071.15±0.061.12±0.051.42±0.06<0.0010.95±0.050.93±0.041.01±0.041.32±0.04<0.001
eGFR (mL/min/1.73 m2)97.2±0.795.4±0.594.1±0.591.3±0.6<0.001105.9±0.6101.8±0.599.5±0.694.4±0.6<0.001
Handgrip strength (kg)39.5±0.240.7±0.241.2±0.241.6±0.3<0.00123.6±0.124.1±0.123.9±0.123.5±0.10.002
Relative handgrip strength (kg/BMI)1.68±0.011.71±0.011.68±0.011.64±0.01<0.0011.08±0.011.07±0.011.05±0.010.98±0.01<0.001

Values are presented as mean±standard error or percentage.

BMI: body mass index, hs-CRP: high sensitivity C-reactive protein, eGFR: estimated glomerular filtration ratio.

Quartiles of serum uric acid (mg/dL): Q1, the 1st quartile (5.0 in males and 3.7 in females); Q2, the 2nd quartile (5.1−5.8 in males and 3.8−4.3 in females); Q3, the 3rd quartile (5.9−6.7 in males and 4.4−4.9 in females); Q4, the 4th quartile (6.8 in males and 5.0 in females).

Analysis of variance was used for continuous variables and the chi-square analysis was used for categorical variables.



궓꽦쓽 븙젰 슂궛 냽룄쓽 媛 援ш컙뿉 뵲씪 39.5, 40.7, 41.2, 41.6 kg濡 굹궗쑝硫(p<0.001), 븙젰쓣 BMI濡 굹늻뼱 궛異쒗븳 긽 븙젰 媛곴컖 1.68, 1.71, 1.68, 1.64 kg/BMI濡 굹궗떎(p<0.001). 뿬꽦뿉꽌 븙젰 슂궛 냽룄쓽 媛 援ш컙뿉 뵲씪 23.6, 24.1, 23.9, 23.5 kg濡 굹궗쑝硫(p<0.001), 븙젰쓣 BMI濡 굹늻뼱 궛異쒗븳 긽 븙젰 媛곴컖 1.08, 1.07, 1.05, 0.98 kg/BMI濡 굹궗떎(p<0.001).

2. 삁以 슂궛 냽룄 긽 븙젰쓽 愿怨

슂궛 援ш컙쓣 룆由쎈닔濡, 긽 븙젰쓣 醫낆냽蹂닔濡 븯뿬 떒닚 꽑삎쉶洹遺꾩꽍怨, 援먮蹂닔쓽 蹂댁젙쓣 떎떆븳 떎蹂웾 꽑삎쉶洹遺꾩꽍쓣 떎떆븯떎(Table 2). 슂궛 媛 援ш컙(Q1–Q4)뿉꽌쓽 쉶洹 怨꾩닔(β coefficient), 쑀쓽븳 꽑삎 愿怨꾨 쓽誘명븯뒗 ‘p for trend’瑜 븿猿 젣떆븯떎.

Table 2 . Multiple linear regression for relative handgrip strength according to quartiles of serum uric acid

ModelMaleFemale


Q1Q2Q3Q4p for trendQ1Q2Q3Q4p for trend
Crude modelRef0.02 (−0.01 to 0.05)−0.01 (−0.03 to 0.02)−0.52* (−0.08 to −0.02)<0.001Ref−0.01 (−0.03 to 0.00)−0.03* (−0.05 to −0.01)−0.11* (−0.12 to −0.09)<0.001
Model 1Ref−0.02 (−0.05 to0.01)−0.07* (−0.09 to −0.04)−0.12* (−0.15 to −0.01)<0.001Ref−0.02 (−0.03 to 0.00)−0.04* (−0.05 to −0.02)−0.09* (−0.11 to −0.08)<0.001
Model 2Ref−0.01 (−0.04 to 0.01)−0.03* (−0.06 to −0.01)−0.04* (−0.07 to −0.02)<0.001Ref0.01 (−0.01 to 0.02)−0.01 (−0.02 to 0.01)−0.03* (−0.05 to −0.01)<0.001
Model 3Ref−0.03* (−0.05 to 0.00)−0.05* (−0.08 to −0.03)−0.07* (−0.09 to −0.04)<0.001Ref0.00 (−0.02 to 0.01)−0.02* (−0.03 to 0.00)−0.05* (−0.06 to −0.03)<0.001

Values are presented as β coefficients (95% confidence interval) for relative grip strength.

Ref: reference, Quartiles of serum uric acid (mg/dL): Q1, the 1st quartile (5.0 in males and 3.7 in females); Q2, the 2nd quartile (5.1−5.8 in males and 3.8−4.3 in females); Q3, the 3rd quartile (5.9−6.7 in males and 4.4−4.9 in females); Q4, the 4th quartile (6.8 in males and 5.0 in females).

Model 1: adjusted for age, income; model 2: further adjusted for hypertension, diabetes, hyperlipidemia, cancer, arthritis, smoking status, alcohol intake, daily intake (kcal/day), protein intake (g/day), physical activity, and resistance exercise (day/week); model 3: further adjusted for high sensitivity C-reactive protein (mg/L) and estimated glomerular filtration ratio (mL/min/1.73 m2).

*Significant value.



궓꽦쓽 寃쎌슦 떒닚 쉶洹遺꾩꽍뿉꽌 슂궛怨 긽 븙젰 쑀쓽븳 쓬쓽 꽑삎 愿怨꾨 굹깉쑝硫(p for trend, <0.001), Q1怨 鍮꾧탳븯뿬 Q4뿉꽌쓽 긽 븙젰씠 쑀쓽븯寃 媛먯냼븯떎(β coefficient [95% confidence interval], –0.52 [–0.08 to –0.02]). 씤援ы븰쟻 슂씤씤 굹씠 냼뱷쓣 蹂댁젙븳 model 1뿉꽌 Q1怨 鍮꾧탳븯뿬 Q3 (–0.07 [–0.09 to –0.04]), Q4 (–0.12 [–0.15 to –0.01])뿉꽌 긽 븙젰 媛먯냼瑜 蹂댁쑝硫(p for trend, <0.001), 嫄닿컯 愿젴 슂씤쓣 異붽濡 蹂댁젙븳 model 2뿉꽌뒗 Q3 (–0.03 [–0.06 to –0.01]), Q4 (–0.04 [–0.07 to –0.02])뿉꽌 슂궛 利앷뿉 뵲瑜 긽 븙젰쓽 媛먯냼瑜 蹂댁떎(p for trend, <0.001). 理쒖쥌쟻쑝濡 hsCRP eGFR쓣 異붽濡 蹂댁젙븳 model 3뿉꽌, Q2 (–0.03 [–0.05 to 0.00]), Q3 (–0.05 [–0.08 to –0.03]), Q4 (–0.07 [–0.09 to –0.04])濡 슂궛怨 긽 븙젰 쑀쓽븳 쓬쓽 꽑삎 愿怨꾨 굹깉떎(p for trend, <0.001).

뿬꽦쓽 寃쎌슦뿉뒗 蹂댁젙 쟾 遺꾩꽍뿉꽌 Q1뿉 鍮꾪븯뿬 Q3 (–0.03 [–0.05 to –0.01]), Q4 (–0.11 [–0.12 to –0.09])뿉꽌 긽 븙젰쓽 媛먯냼瑜 蹂댁떎. Model 1뿉꽌뒗 Q1쓣 湲곗쑝濡 Q3 (–0.04 [–0.05 to –0.02]), Q4 (–0.09 [–0.11 to –0.08])뿉꽌 긽 븙젰씠 媛먯냼뻽怨(p for trend, <0.001), model 2뿉꽌뒗 Q4 (–0.09 [–0.11 to –0.08])뿉꽌 쑀쓽븳 긽 븙젰 媛먯냼媛 굹궗떎(p for trend, <0.001). 理쒖쥌쟻쑝濡 model 3뿉꽌뒗 Q1쓣 湲곗쑝濡 Q3 (–0.04 [–0.05 to –0.02]), Q4 (–0.09 [–0.11 to –0.08])뿉꽌 슂궛 利앷뿉 뵲瑜 긽 븙젰쓽 媛먯냼瑜 蹂댁떎(p for trend, <0.001).

3. 씤援ы븰쟻 슂씤 諛 嫄닿컯 愿젴 슂씤뿉 뵲瑜 슂궛怨 븙젰쓽 愿怨

異붽쟻쑝濡, 슂궛怨 븙젰쓽 愿怨꾧 굹씠뿉 뵲씪, 洹몃━怨 嫄닿컯 愿젴 슂씤(鍮꾨쭔 諛 궗吏덊솚 쑀臾, 嫄닿컯 愿젴 뻾룞, 떒諛깆쭏 꽠痍, eGFR)뿉 뵲씪 떖씪吏뒗吏 솗씤븯湲 쐞븯뿬 媛 븯쐞 吏묐떒蹂 떎蹂웾 쉶洹遺꾩꽍쓣 떎떆븯떎. 삉븳, 媛 슂씤쓽 援먰샇옉슜쓣 솗씤븯쑝硫 洹 寃곌낵(p for interaction)瑜 Table 3뿉 젣떆븯떎. 궓꽦 諛 뿬꽦뿉꽌 굹씠(50꽭 湲곗), 궗吏덊솚 쑀臾, 쓬二 뿬遺, 슫룞, 떒諛깆쭏 꽠痍⑥뿉 뵲瑜 援먰샇옉슜 뾾뿀쑝硫 슂궛怨 븙젰 遺遺꾩쓽 븯쐞 洹몃9뿉꽌 쓬쓽 꽑삎 愿怨꾨 굹깉떎. 洹몃윭굹 뿬꽦뿉꽌뒗 씉뿰뿉 뵲瑜 援먰샇옉슜씠 솗씤릺뿀떎(p interaction= 0.006).

Table 3 . Multiple linear regression for relative handgrip strength according to serum uric acid, stratified by age, BMI, and health-related factors

VariableMaleFemale


Q1Q2Q3Q4p for trendp for interactionQ1Q2Q3Q4p for trendp for interaction
Age (yr)
<50Ref−0.05* (−0.86 to 0.00)−0.13* (−0.17 to −0.09)−0.19* (−0.23 to −0.15)<0.0010.055Ref−0.03*(−0.06 to −0.01)−0.04*(−0.06 to −0.01)−0.10**(−0.13 to −0.08)<0.0010.264
≥50Ref−0.05* (−0.08 to −0.02)−0.06*(−0.09 to −0.02)−0.07* (−0.10 to −0.03)<0.001Ref−0.01(−0.04 to 0.01)−0.05*(−0.07 to −0.03)−0.08*(−0.11 to −0.06)<0.001
BMI (kg/m2)
≥25Ref−0.02 (−0.06 to 0.02)−0.04*(−0.08 to 0.00)−0.10* (−0.14 to −0.06)<0.0010.085Ref0.02(−0.02 to 0.05)−0.02(−0.05 to 0.01)−0.06*(−0.08 to −0.03)<0.0010.214
<25Ref−0.05* (−0.09 to 0.02)−0.10*(−0.13 to −0.06)−0.10* (−0.13 to −0.06)<0.001Ref−0.02*(−0.04 to −0.01)−0.04*(−0.06 to −0.02)−0.07*(−0.09 to −0.05)<0.001
Hypertension
YesRef−0.04 (−0.08 to 0.01)−0.11*(−0.15 to −0.06)−0.12* (−0.17 to −0.07)<0.0010.081Ref−0.03*(−0.05 to −0.01)−0.04*(−0.06 to −0.02)−0.10*(−0.12 to −0.08)<0.0010.294
NoRef−0.05* (−0.08 to −0.02)−0.10*(−0.13 to −0.07)−0.17* (−0.21 to −0.67)<0.001Ref−0.02(−0.04 to 0.02)−0.06*(−0.10 to −0.03)−0.11* (−0.14 to −0.08)<0.001
Diabetes
YesRef−0.07* (−0.12 to −0.01)−0.13*(−0.20 to −0.06)−0.13* (−0.21 to −0.06)0.0030.728Ref0.00(−0.06 to 0.05)−0.04(−0.10 to 0.01)−0.08*(−0.13 to −0.03)0.0010.744
NoRef−0.04* (−0.08 to −0.01)−0.10*(−0.13 to −0.07)−0.16* (−0.19 to −0.12)<0.001Ref−0.03*(−0.05 to −0.01)−0.05*(−0.07 to −0.03)−0.11*(−0.13 to −0.09)<0.001
Hyperlipidemia
YesNo−0.06 (−0.12 to −0.01)−0.11*(−0.16 to −0.06)−0.13* (−0.19 to −0.08)<0.0010.549Ref0.00(−0.04 to 0.03)−0.02(−0.05 to 0.01)−0.07*(−0.10 to −0.04)<0.0010.258
NoRef−0.04* (−0.07 to −0.01)−0.10*(−0.13 to −0.07)−0.16* (−0.19 to −0.12)<0.001Ref−0.03*(−0.05 to −0.01)−0.06*(−0.08 to −0.04)−0.11*(−0.14 to −0.09)<0.001
Smoking
YesRef−0.02 (−0.06 to 0.03)−0.09*(−0.13 to −0.05)−0.13* (−0.18 to −0.09)0.0330.558Ref0.09(0.00 to 0.19)0.08(−0.01 to 0.16)0.02(−0.07 to 0.10)0.7580.006
NoRef−0.06* (−0.10 to −0.03)−0.11*(−0.14 to −0.08)−0.17* (−0.21 to −0.13)<0.001Ref−0.03*(−0.05 to −0.01)−0.05*(−0.07 to −0.04)−0.11*(−0.13 to −0.09)<0.001
Alcohol
YesRef−0.05* (−0.08 to −0.01)−0.09* (−0.12 to −0.06)−0.15* (−0.19 to −0.12)<0.0010.524Ref−0.03(−0.05 to 0.00)−0.04*(−0.07 to −0.02)−0.10*(−0.12 to −0.07)<0.0010.803
NoRef−0.05* (−0.11 to 0.00)−0.14* (−0.20 to −0.08)−0.16* (−0.23 to −0.10)<0.001Ref−0.03(−0.05 to 0.00)−0.05*(−0.08 to −0.03)−0.11*(−0.13 to −0.09)<0.001
Adequate physical activity
YesRef−0.05* (−0.08 to −0.01)−0.09* (−0.13 to −0.06)−0.14* (−0.18 to 0.10)<0.0010.506Ref−0.03*(−0.06 to 0.00)−0.05*(−0.08 to −0.03)−0.11*(−0.14 to −0.08)<0.0010.890
NoRef−0.05* (−0.08 to −0.01)−0.11* (−0.15 to −0.07)−0.17* (−0.21 to −0.13)<0.001Ref−0.02*(−0.04 to 0.00)−0.04*(−0.06 to −0.02)−0.10*(−0.12 to −0.07)<0.001
Adequate resistance exercise
YesRef−0.03 (−0.07 to 0.02)−0.05* (−0.10 to −0.01)−0.13* (−0.18 to −0.08)<0.0010.938Ref−0.02(−0.06 to 0.02)−0.02(−0.06 to 0.02)−0.07*(−0.12 to −0.03)0.0030.952
NoRef−0.05* (−0.09 to −0.02)−0.12* (−0.15 to −0.09)−0.16* (−0.20 to −0.13)<0.001Ref−0.03*(−0.04 to −0.01)−0.05*(−0.07 to −0.03)−0.11*(−0.13 to −0.09)<0.001
Adequate protein intake
YesRef−0.04* (−0.07 to −0.01)−0.09* (−0.12 to −0.05)−0.15* (−0.18 to −0.11)<0.0010.271Ref−0.02(−0.04 to 0.00)−0.04(−0.06 to −0.02)−0.09*(−0.12 to −0.07)<0.0010.466
NoRef−0.05 (−0.10 to 0.00)−1.13* (−0.19 to −0.08)−0.14* (−0.19 to −0.09)<0.001Ref−0.02(−0.05 to 0.00)−0.05(−0.08 to 0.02)−0.11(−0.14 to −0.08)<0.001
eGFR (mL/min/1.73 m2)
≥60Ref−0.05* (−0.08 to −0.02)−0.10* (−0.13 to −0.07)−0.15* (−0.18 to −0.12)<0.0010.078Ref−0.03*(−0.04 to −0.01)−0.05*(−0.07 to −0.03)−0.10*(−0.12 to −0.08)<0.0010.135
<60Ref0.07 (−0.07 to 0.20)−0.06 (−0.19 to 0.06)0.01 (−0.12 to 0.15)0.696Ref−0.10(−0.27 to 0.07)−0.09(−0.23 to 0.05)−0.18*(−0.29 to −0.08)0.003

Values are presented as β coefficients (95% confidence interval) for relative grip strength.

Ref: reference, BMI: body mass index, eGFR: estimated glomerular filtration ratio.

Adjusted for age, income, hypertension, diabetes, hyperlipidemia, cancer, arthritis, smoking status, alcohol intake, daily intake (kcal/day), protein intake (g/day), physical activity and resistance exercise (day/week), high sensitivity C-reactive protein (mg/L), and eGFR (mL/min/1.73 m2).

Quartiles of serum uric acid (mg/dL): Q1, the 1st quartile (5.0 in males and 3.7 in females); Q2, the 2nd quartile (5.1−5.8 in males and 3.8−4.3 in females); Q3, the 3rd quartile (5.9−6.7 in males and 4.4−4.9 in females); Q4, the 4th quartile (6.8 in males and 5.0 in females).

*Significant value.


怨 李

蹂 뿰援щ뒗 20꽭 씠긽쓽 紐⑤뱺 꽦씤쓣 궓濡 굹늻뼱 슂궛怨 긽 븙젰쓽 愿怨꾨 遺꾩꽍븳 泥 뿰援щ줈꽌, 슦由щ굹씪쓽 몴꽦 엳뒗 옄猷뚯씤 젣7湲 援誘쇨굔媛뺤쁺뼇議곗궗瑜 諛뷀깢쑝濡 븯떎. 洹 寃곌낵 궓꽦怨 뿬꽦 紐⑤몢뿉꽌 援먮蹂닔瑜 紐⑤몢 蹂댁젙븯쓣 븣, 꽦蹂꾩뿉 뵲瑜 슂궛 4遺꾩쐞 援ш컙쓽 利앷뿉 뵲씪 긽 븙젰씠 媛먯냼븯뒗 쓬쓽 꽑삎 愿怨꾧 굹궗떎.

媛 꽦蹂꾩뿉꽌 슂궛 援ш컙뿉 뵲瑜 씪諛섏쟻 듅꽦쓣 궡렣蹂대㈃, 뿬꽦쓽 寃쎌슦 슂궛씠 媛옣 넂 援곗뿉꽌 룊洹 굹씠媛 媛옣 넂븯뜕 諛섎㈃ 궓꽦 슂궛 援ш컙씠 利앷븷닔濡 룊洹 굹씠媛 궙븘議뚮떎. 씠뿉 빐 씠쟾 뿰援ъ 吏곸젒쟻 鍮꾧탳뒗 뼱졄吏留, NHANES瑜 솢슜븳 García-Esquinas 벑19쓽 뿰援ъ뿉꽌룄 굹씠蹂꾨줈 20–40꽭 援ш컙쓽 젇 씤援ъ뿉꽌뒗 긽쟻쑝濡 슂궛씠 넂 洹몃9(3rd tertile)뿉꽌 궓꽦쓽 鍮꾩쑉씠 留롮븯怨, 40–60꽭, 60꽭 씠긽쑝濡 媛덉닔濡 슂궛씠 궙 洹몃9뿉꽌 궓꽦 鍮꾩쑉씠 留롮븯떎19. 궓 紐⑤몢뿉꽌 BMI 諛 怨좎삁利앹쓽 쑀蹂묐쪧, 뿬꽦뿉꽌 怨좏삁븬 쑀蹂묐쪧 슂궛 援ш컙 利앷뿉 뵲씪 利앷븯쑝硫, eGFR 삉븳 슂궛 援ш컙 利앷뿉 뵲씪 利앷븯뒗뜲 씠뒗 꽑뻾 뿰援ъ뿉꽌 諛앺吏 씪諛섏쟻 궗떎怨 씪移섑븳떎2,20. 떎留 궓꽦뿉꽌뒗 떦눊쓽 쑀蹂묐쪧씠 슂궛 援ш컙 利앷뿉 뵲씪 媛먯냼븯떎. 씠뿉 빐 떦눊뒗 떎瑜 궗吏덊솚怨쇰뒗 떖由 삁以 슂궛 냽룄 쓬쓽 愿怨꾨 媛吏꾨떎怨 蹂닿퀬븯뜕 뿰援щ뱾씠 엳쑝硫, 썝씤쑝濡쒕뒗 넂 삁떦씠 떊옣 洹쇱쐞 꽭눊愿뿉꽌 슂궛쓽 옱씉닔瑜 뼲젣븯뿬 슂궛 냽룄瑜 궙異섎떎怨 꽕紐낇븯떎21,22.

삁以 슂궛 냽룄 洹쇰젰 紐⑤몢 꽦蹂꾩뿉 뵲씪 떎瑜 遺꾪룷瑜 蹂댁씠誘濡, 슂궛怨 븙젰쓽 愿怨꾧 媛 꽦蹂꾩뿉 뵲씪 떎瑜닿쾶 굹궇 닔 엳쓣 媛뒫꽦씠 議댁옱븳떎. 씠뿉 뵲씪 蹂 뿰援ъ뿉꽌뒗 슂궛怨 긽 븙젰쓽 愿怨꾨 궓濡 굹늻뼱 遺꾩꽍븯떎. 洹 寃곌낵, 궓꽦뿉꽌 蹂댁젙 쟾怨 썑 紐⑤몢 슂궛怨 긽 븙젰씠 쑀쓽븳 쓬쓽 슜웾 諛섏쓳 愿怨꾨 굹궡뿀떎. 뿬꽦뿉꽌룄 留덉갔媛吏濡 슂궛怨 긽 븙젰 蹂댁젙 쟾怨 썑 紐⑤뜽뿉꽌 쑀쓽븳 쓬쓽 愿怨꾨 蹂댁떎. 씠뒗 꽦蹂꾩뿉 愿怨 뾾씠 슂궛씠 洹쇰젰 媛먯냼뿉 룆由쎌쟻쑝濡 쁺뼢쓣 誘몄튂뒗 씤옄濡 옉슜븷 닔 엳쓬쓣 떆궗븳떎.

紐뉖챺 꽑뻾 뿰援ш 蹂 뿰援ъ 씪移섑븯뒗 寃곌낵瑜 蹂댁뿬以떎. Beaver 벑9쓽 뿰援ъ뿉꽌 7,544紐낆쓽 40꽭 씠긽 꽦씤쓣 긽쑝濡 슂궛 利앷뿉 븳 洹쇨컧냼利앹쓽 濡쒖뒪떛 쉶洹遺꾩꽍쓣 떆뻾븳 寃곌낵 삁以 슂궛씠 1 mg/dL 利앷븷 븣留덈떎 洹쇨컧냼利앹뿉 븳 援먯감鍮꾧 1.12濡 굹궗쑝硫, 삁以 슂궛 냽룄 >8 mg/dL뿉 냽븳 吏묐떒 6 mg/dL 誘몃쭔씤 吏묐떒蹂대떎 洹쇨컧냼利앹뿉 븳 쐞뿕씠 2.0諛곕씪怨 蹂닿퀬븯떎. Veronese 벑10 65꽭 씠긽쓽 씠깉由ъ븘씤 1,904紐낆뿉 빐 4.4뀈媛 異붿쟻 愿李고븳 肄뷀샇듃 뿰援ъ뿉꽌 怨좎슂궛삁利앹씠 떊泥닿린뒫 븯 쑀쓽븳 뿰愿꽦쓣 蹂댁씤떎怨 蹂닿퀬븯떎. 60꽭 씠긽쓽 끂씤쓣 긽쑝濡 떎떆븳 븳 肄뷀샇듃 뿰援ъ뿉꽌뒗 二쇨쟻 뵾濡, 떊泥댄솢룞 젙룄, 蹂댄뻾냽룄, 븙젰쑝濡 援ъ꽦맂 뿀빟(frailty) 젙룄瑜 슂궛뿉 뵲씪 룊媛븯怨, 넂 슂궛 삁以 냽룄 뿀빟 쐞뿕룄 媛꾩쓽 뼇쓽 긽愿愿怨꾨 젣떆뻽떎11. 40–88꽭쓽 꽦씤뿉꽌 洹쇰젰怨 슂궛쓽 愿怨꾨 遺꾩꽍븳 Park 벑12쓽 援궡 떒硫 뿰援ъ뿉꽌뒗, 궓 紐⑤몢뿉꽌 븙젰怨 媛곷젰씠 넂 吏묐떒뿉꽌 怨좎슂궛삁利앹뿉 븳 援먯감鍮꾧 궙븘吏꾨떎怨 蹂닿퀬븯떎.

삁以 슂궛 냽룄 븙젰씠 쓬쓽 愿怨꾨 蹂댁씠뒗 寃껋뿉 빐 紐 媛吏 湲곗쟾뱾씠 젣떆릺뼱 솕떎. 泥レ㎏, 븵꽌 뼵湲됲븯벏 슂궛 떎뼇븳 留뚯꽦吏덊솚怨 뿰愿씠 엳뒗뜲, 떖삁愿吏덊솚, 궗利앺썑援, 떊湲곕뒫 븯 벑 洹쇰젰 븯 愿젴씠 엳떎怨 븣젮졇 엳떎. 洹몃윭굹 蹂 뿰援ъ뿉꽌뒗 떎뼇븳 궗吏덊솚 諛 留뚯꽦吏덊솚 쑀臾, eGFR쓣 蹂댁젙븳 썑뿉룄 슂궛怨 긽 븙젰씠 쓬쓽 꽑삎 愿怨꾨 굹깉쑝硫, 뵲씪꽌 룞諛섎맂 떊泥댁쟻 긽솴 쇅뿉 슂궛 옄泥닿 留ㅺ컻븯뒗 湲곗쟾씠 議댁옱븿쓣 떆궗븳떎. 몮吏, 슂궛 洹쇨컧냼 愿젴씠 엳뒗 CRP, interleukin-6씠굹 tumor necrosis factor alpha 媛숈 듅젙 뿼利앹꽦 궗씠넗移댁씤怨 愿젴씠 엳떎뒗 떎뿕뿰援 諛 뿭븰뿰援ш 엳떎23. 뿼利앹꽦 궗씠넗移댁씤 吏곸젒쟻쑝濡 洹쇱쑁쓽 씠솕옉슜쓣 씪쑝궎湲곕룄 븯吏留, 씤뒓由 빆꽦 利앷, 꽦옣 샇瑜대が 媛먯냼瑜 珥됱쭊븯湲곕룄 븳떎. 뀑吏, 꽭룷 궡 슂궛 궛솕 뒪듃젅뒪瑜 쑀룄븯뿬 洹쇱꽟쑀쓽 뼇쟻씤 媛먯냼 湲곕뒫 븙솕뿉 쁺뼢쓣 以 닔 엳떎24. 꽬吏, 룞臾쇨낵 씤媛꾩쓣 긽쑝濡 븳 뿰援ъ뿉꽌 슂궛 洹쇰젰쓣 議곗젅븯뒗 뜲 以묒슂븳 샇瑜대が쑝濡 諛앺吏 vitamin D쓽 깮궛쓣 빐븯뒗 뿭븷쓣 븳떎뒗 궗떎씠 蹂닿퀬릺뿀떎24.

븵꽑 뿰援ъ 떖由, 紐뉖챺 뿰援ъ뿉꽌뒗 슂궛씠 洹쇨컧냼뿉 빐 蹂댄샇 슚怨쇰 媛뽯뒗떎怨 븯떎. 50꽭 삉뒗 60꽭 씠긽쓽 怨좎뿰졊瑜 긽쑝濡 떆뻾맂 紐뉖챺 꽑뻾 뿰援ъ뿉꽌뒗 슂궛怨 븙젰 媛꾩뿉 뼇쓽 긽愿愿怨꾧 엳떎怨 蹂닿퀬븯떎. 50꽭 씠긽쓽 꽦씤쓣 긽쑝濡 以묎뎅뿉꽌 떆뻾븳 떒硫 뿰援ъ, 媛숈 뿰졊쓽 꽦씤쓣 긽쑝濡 븳 誘멸뎅쓽 뿰援ъ뿉꽌 媛곴컖 슂궛씠 利앷븷닔濡 洹쇰젰씠 利앷븯뒗 寃곌낵瑜 굹깉떎13,14. Molino-Lova 벑15 룊洹 굹씠 93꽭쓽 씠깉由ъ븘 끂씤뿉꽌 슂궛怨 洹쇰젰쓽 뼇쓽 愿怨꾨 蹂닿퀬븯쑝硫, Kawamoto 벑16쓽 뿰援ъ뿉꽌뒗 룊洹 굹씠 72꽭 씪蹂 뿬꽦 끂씤뿉꽌 鍮꾩듂븳 寃곌낵瑜 젣떆븯떎. 씠뿉 븳 湲곗쟾쑝濡, 슂궛씠 삁泥뿉꽌 以묒슂븳 빆궛솕臾쇱쭏濡 湲곕뒫븯뒗 寃껋씠 븣젮졇 엳쑝硫, 二쇰줈 뇤議몄쨷씠굹 뙆궓뒯蹂묎낵 媛숈 떊寃쏀눜뻾꽦 吏덊솚뿉꽌 슂궛쓽 빆궛솕 옉슜 諛 蹂댄샇 슚怨쇨 蹂닿퀬릺뼱솕떎25.

García-Esquinas 벑19쓽 NHANES 뜲씠꽣瑜 씠슜븳 뿰援ъ뿉꽌뒗 굹씠蹂꾨줈 슂궛怨 洹쇰젰뿉 븳 뿰愿꽦씠 떎瑜닿쾶 굹궃떎怨 蹂닿퀬븯뒗뜲, 20–40꽭뿉꽌뒗 쓬쓽 愿怨, 60꽭 씠긽뿉꽌뒗 뼇쓽 愿怨꾨 蹂댁뿬 젇 뿰졊뿉꽌留 蹂 뿰援ъ 씪移섑븯뒗 寃곌낵瑜 蹂댁떎. 蹂 뿰援ъ뿉꽌룄 슂궛怨 븙젰쓽 愿怨꾧 굹씠蹂꾨줈 떖씪吏뒗吏 솗씤븯湲 쐞븯뿬 媛 꽦蹂꾩뿉꽌 50꽭瑜 湲곗쑝濡 굹늻뼱 떎蹂웾 쉶洹遺꾩꽍쓣 떆뻾븯떎. 湲곗쓣 50꽭濡 꽕젙븳 씠쑀뒗 꽑뻾 뿰援ъ뿉 洹쇨굅븯뿬 50꽭遺꽣 쑀쓽븯寃 洹쇰젰쓽 媛먯냼媛 愿李곕릺硫26, 씠뿉 뵲씪 50꽭瑜 湲곗쑝濡 슂궛씠 洹쇰젰뿉 誘몄튂뒗 쁺뼢쓽 蹂솕媛 엳쓣 媛뒫꽦씠 엳湲 븣臾몄씠떎. 遺꾩꽍 寃곌낵 굹씠뿉 뵲瑜 援먰샇옉슜 뾾뿀쑝硫(p interaction, >0.05), 몴뿉뒗 젣떆븯吏 븡븯吏留 60꽭 씠긽쓽 궓뿉꽌 떎蹂웾 쉶洹遺꾩꽍쓣 떎떆뻽쓣 븣뿉룄 슂궛怨 븙젰 쑀쓽븳 쓬쓽 꽑삎 愿怨꾨 蹂댁떎. 洹 쇅 븯쐞 洹몃9 遺꾩꽍뿉꽌 遺遺꾩뿉꽌 씪愿꽦 엳寃 쓬쓽 꽑삎 愿怨꾨 굹깉쑝굹 뿬꽦뿉꽌 씉뿰뿉 뵲瑜 援먰샇옉슜씠 솗씤릺뿀떎. 鍮꾪씉뿰援곌낵 떖由 씉뿰援곗뿉꽌뒗 Q2, Q3뿉꽌쓽 븙젰씠 Q1, Q4蹂대떎 넂 ‘뿭 J삎(inverted J shape)’ 愿怨꾨 蹂댁떎. 떞諛곕뒗 떎뼇븳 諛섏쓳꽦 궛냼醫 諛 옄쑀 씪뵒移쇱쓣 룷븿븯誘濡27, 씠濡 씤븳 씉뿰옄 鍮꾪씉뿰옄뿉꽌쓽 泥대궡 궛솕 뒪듃젅뒪 젙룄 李⑥씠媛 슂궛怨 븙젰쓽 愿怨꾩뿉 쁺뼢쓣 二쇱뿀쓣 媛뒫꽦씠 엳떎.

蹂 뿰援щ뒗 紐 媛吏 젣븳젏쓣 媛吏怨 엳떎. 蹂 뿰援щ뒗 떒硫 뿰援ъ꽕怨꾨줈 씤븯뿬 紐낇솗븳 씤怨쇨怨꾨 꽕紐낇븯湲 뼱졄떎. 삉븳 援誘쇨굔媛뺤쁺뼇議곗궗뿉꽌 긽옄쓽 슂궛 냽룄뿉 쁺뼢쓣 以 닔 엳뒗 슂궛 븯 빟젣 蹂듭슜 뿬遺뿉 븳 議곗궗 빆紐⑹ 뾾뿀쑝誘濡, 빐떦 빟젣瑜 蹂듭슜 以묒씤 씤援щ룄 긽옄뿉 룷븿릺뼱 슂궛怨 븙젰씠 쓬쓽 뿰愿꽦쓣 媛뽯뒗 蹂 뿰援ъ쓽 寃곌낵瑜 씪遺 긽뇙떆耳곗쓣 媛뒫꽦씠 엳떎. 洹몃━怨 궛솕 뒪듃젅뒪쓽 깮솕븰쟻 吏몴媛 룊媛릺吏 븡븘, 슂궛怨 븙젰쓽 뿰愿꽦쓣 궛솕쟻 뒪듃젅뒪媛 留ㅺ컻븯뒗吏瑜 紐낇솗엳 諛앺옄 닔 뾾떎. 洹몃읆뿉룄 遺덇뎄븯怨 蹂 뿰援щ뒗 援궡쓽 몴꽦 엳뒗 옄猷뚮 諛뷀깢쑝濡 洹쒕え 씤援щ 긽쑝濡 媛뒫븳 紐⑤뱺 援먮蹂닔瑜 蹂댁젙븯뿬 寃곌낵瑜 룄異쒗븯떎뒗 뜲 쓽쓽媛 엳떎. 뼢썑 슂궛怨 븙젰쓽 愿怨꾨 꽕紐낇븷 닔 엳뒗 湲곗쟾쓣 諛앺엳湲 쐞빐 異붽쟻씤 쟾뼢쟻 뿰援ш 븘슂븷 寃껋쑝濡 깮媛곷맂떎.

蹂 뿰援ъ뿉꽌뒗 20꽭 씠긽쓽 꽦씤뿉꽌 슂궛怨 긽 븙젰 쓬쓽 뿰愿꽦씠 엳뿀쑝硫, 궓 紐⑤몢뿉꽌 슂궛씠 利앷븷닔濡 긽 븙젰씠 궙븘吏뒗 슜웾 諛섏쓳 愿怨꾨 蹂댁떎. 씠뒗 슂궛씠 꽦蹂꾩뿉 愿怨 뾾씠 洹쇰젰 媛먯냼뿉 쁺뼢쓣 二쇰뒗 룆由쎌쟻씤 씤옄濡 옉슜븷 닔 엳쓬쓣 떆궗븳떎.

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Author Contributions

Conceptualization: YBS. Writing–original draft: YBS. Writing–review & editing: YSY.

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