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Association between Muscle Strength and Anemia in the Rural Middle Age and Older Adults
Korean J Sports Med 2022;40:120-127
Published online June 1, 2022;  https://doi.org/10.5763/kjsm.2022.40.2.120
© 2022 The Korean Society of Sports Medicine.

DooYong Park, YeonSoo Kim

Department of Physical Education, College of Education, Seoul National University, Seoul, Korea
Correspondence to: YeonSoo Kim
Department of Physical Education, College of Education, Seoul National University, Sports and Culture Research Bldg 71-1, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
Tel: +82-2-880-7794, Fax: +82-2-872-2867, E-mail: kys0101@snu.ac.kr
Received August 24, 2021; Revised November 4, 2021; Accepted December 17, 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: This study aimed to investigate the association between relative muscle strength and serum hemoglobin levels.
Methods: In this study, 3,234 adults living in rural areas were surveyed from 2007 to 2014 and the data was analyzed on 1,987 adults. Anemia (<12 g/dL for women and <13 g/dL for men) was defined by examining serum hemoglobin concentration. Muscle strength was measured by using Takei dynamometer about grip strength and leg strength. To identify the association between relative strength and anemia, odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression analysis (p<0.05).
Results: As confounding variables were adjusted, relative leg strength (high level: OR, 0.55; 95% CI, 0.34–0.88) and relative grip strength (middle level: OR, 0.57; 95% CI, 0.37–0.88; high level: OR, 0.50; 95% CI, 0.30–0.84) were associated with OR of anemia risk. Relative grip strengths were significantly associated with risk of anemia in the ≥ 65-year age group (middle level: OR, 0.43; 95% CI, 0.23–0.78; high level: OR, 0.32; 95% CI, 0.14–0.72), but not in the < 65-year age group. Also, ≥ 65-year age group, who have both high relative grip strength and high relative leg strength (OR, 0.44; 95% CI, 0.21–0.93) or only high relative grip strength (OR, 0.41; 95% CI, 0.18–0.96), was only significantly associated with the prevalence of anemia.
Conclusion: Improvement of relative muscle strength is a key factor that can lower the risk of anemia and it is recommended in order to reduce the health risk of elderly life.
Keywords : Aging, Anemia, Hand strength, Muscle strength, Sarcopenia
꽌 濡

鍮덊삁 삁以 뿤紐④濡쒕퉰씠굹 쟻삁援 닔移섍 젙긽 닔以蹂대떎 以꾩뼱뱾뼱 궛냼 슫諛섎뒫젰 媛먯냼 뿰愿맂 쁽湲곗쬆, 떎떊, 삁븬, 뵾濡, 吏㏃ 샇씉 벑쓽 利앹긽쓣 蹂댁씠뒗 긽깭瑜 留먰븳떎1. 꽑뻾뿰援ъ뿉 뵲瑜대㈃ 삁以 뿤紐④濡쒕퉰 닔移섍 뿬꽦씤 寃쎌슦 12 g/dL 誘몃쭔, 궓꽦씤 寃쎌슦 13 g/dL 誘몃쭔씪 븣 鍮덊삁쓣 吏꾨떒븯怨, 쟾꽭怨 씤援ъ쓽 25%뿉 빐떦븯뒗 씤援ш 鍮덊삁씠 엳쓬쓣 떆궗븯硫 鍮덊삁쓽 떖媛곸꽦쓣 媛뺤“븯떎2. 씠윭븳 鍮덊삁 뿰졊 利앷, 뿼利앹꽦 留덉빱쓽 利앷, 떊泥닿린뒫쓽 뇿눜, 媛먯냼맂 젣吏諛⑸웾, 쁺뼇떎議 諛 泥좊텇 遺議, 留뚯꽦吏덊솚씠굹 븫쑝濡 씤빐 굹궇 닔 엳쑝硫3, 듅엳 끂솕 뿰愿맂 鍮덊삁 삊떖利, 떖遺쟾, 留뚯꽦 떊옣吏덊솚, 留뚯꽦 룓뇙꽦룓吏덊솚怨 媛숈 떖媛곹븳 蹂묒쟻 긽깭 븿猿 굹굹뒗 寃껋쑝濡 蹂닿퀬븳 諛 엳떎1. 2019 援誘쇨굔媛뺥넻怨꾩뿉 뵲瑜대㈃ 留 30꽭 씠긽 꽦씤 以 8.4%媛 鍮덊삁쓣 媛吏怨 엳怨, 궓꽦(3.8%)蹂대떎뒗 뿬꽦(13.2%)씠 넂 鍮덊삁 쑀蹂묐쪧쓣 蹂댁씠硫, 70꽭 씠긽쓽 끂씤 以 20.4%媛 鍮덊삁濡 怨좏넻諛쏄퀬 엳떎4. 異붽쟻쑝濡 33媛쒖쓽 뿰援щ 遺꾩꽍븳 由щ럭 뿰援ъ뿉 뵲瑜대㈃ 議곗궗뿉 李멸븳 끂씤쓽 17%媛 鍮덊삁쓣 븪怨 엳쓬쓣 蹂닿퀬븯怨5, 씠젃寃 援젣쟻쑝濡 뿤紐④濡쒕퉰 媛먯냼뿉 痍⑥빟븳 끂씤뿉寃뚯꽌 굹굹뒗 鍮덊삁쓽 떖媛곸꽦쓣 씤吏븯硫댁꽌 理쒓렐 뿰援ъ옄猷뚯뿉꽌뒗 吏곸젒쟻쑝濡 鍮덊삁뿉 쁺뼢쓣 誘몄튂뒗 쟻삁援 닔瑜 利앷떆궎뒗 諛⑸쾿뿉 愿떖쓣 媛吏怨 엳쓬쓣 븣 닔 엳떎6.

씠윭븳 諛⑸쾿 以 쟻삁援 닔삁 鍮덊삁쓣 移섎즺븯뒗 媛옣 슚怨쇱쟻씤 移섎즺씠湲 븯吏留 媛먯뿼怨 닔삁諛섏쓳뿉 븳 쐞뿕 깮紐낆뿉 븳 쐞삊쑝濡 뿰寃곕릺뒗 쐞뿕븳 遺옉슜씠湲 븣臾몄뿉 理쒓렐뿉뒗 쟻삁援 利앷瑜 쐞븳 蹂댁“쟻 泥섏튂 以 遺옉슜씠 떎냼 쟻 諛⑸쾿쓣 媛뺢뎄븯怨 엳떎7. 뿤紐④濡쒕퉰쓣 利앹쭊븷 닔 엳뒗 蹂댁“쟻 諛⑸쾿 以묒뿉 슫룞 怨쇨굅遺꽣 쟾泥 뿤紐④濡쒕퉰 닔以怨 쟻삁援 깮꽦쓣 利앹쭊븯뒗 寃껋쑝濡 븣젮졇 엳쑝硫6, 씠뒗 슫룞쓣 넻븳 怨⑥닔쓽 옄洹 븣臾몄쑝濡 엫긽쟻쑝濡 쟻삁援 닔移섍 쓽誘 엳寃 利앷븿쓣 蹂닿퀬븳 諛 엳떎8. 떎젣濡 6二쇨컙쓽 以묎컯룄 빆슫룞쓣 떎떆븳 嫄닿컯븳 꽦씤 쟻삁援 뼇씠 利앷븯뒗 寃껋쓣 솗씤븯뒗뜲, 씠뒗 슫룞씠 쟻삁援 뼇 利앷瑜 媛냽솕븷 닔 엳쓬쓣 蹂댁뿬以떎9. 씠쟾 뿰援ъ뿉꽌룄 쟻삁援 깮궛뿉 쁺뼢쓣 誘몄튂뒗 怨 遺뵾뒗 洹쇱쑁 遺뵾 뿰愿꽦씠 엳뿀뒗뜲, 洹 씠쑀濡 洹쇱쑁 遺뵾 利앷濡 씤븳 洹쇰젰 利앷媛 堉덉뿉 援吏쟻씤 뒪듃젅뒪瑜 二쇱뼱 怨 삎꽦쓣 珥됱쭊븿쑝濡쒖뜥 쟻삁援 깮궛뿉 쁺뼢쓣 誘몄튂뒗 寃껋쑝濡 蹂닿퀬븯떎10. 븯吏留 씠윭븳 怨 遺뵾, 洹쇱쑁 遺뵾 뿰愿맂 洹쇰젰怨 鍮덊삁쓽 뿰愿꽦뿉 빐 쁽옱源뚯 吏꾪뻾맂 뿰援щ뒗 鍮덊삁濡 씤븳 솢룞꽦 媛먯냼濡 洹쇰젰 媛먯냼媛 뿰愿릺뼱 엳쓬쓣 媛뺤“븷 肉3, 洹쒖튃쟻씤 슫룞쓣 넻빐 쉷뱷븳 洹쇰젰 利앷 鍮덊삁 媛먯냼쓽 뿰愿꽦뿉 븳 뿰援щ뒗 냼닔뿉 遺덇낵븯떎. 洹 냼닔쓽 뿰援 以 12二쇨컙 二 3쉶 빆슫룞쓣 븳 씠썑 븯泥 洹 遺뵾 利앷濡 씤븳 議고삁옉슜쓽 利앷瑜 솗씤븳 뿰援щ뒗 議댁옱븯굹11, 洹쒖튃쟻씤 슫룞쑝濡 利앷맂 洹 遺뵾뿉 뵲瑜 洹쇰젰 利앷 옄泥닿 삁以 뿤紐④濡쒕퉰 닔移섏 뿰愿씠 엳뒗吏 솗씤븷 닔 뾾뿀怨, 鍮덊삁怨 洹쇰젰쓽 뿰愿꽦뿉 엳뼱 븯泥 洹쇰젰怨 긽泥 洹쇰젰 以 뼱뼡 寃껋씠 뜑 뿰愿꽦씠 엳쓣吏뿉 빐 솗씤븳 뿰援ш 遺議깊븳 떎젙씠떎.

뵲씪꽌 蹂 뿰援щ뒗 뿤紐④濡쒕퉰 媛먯냼뿉 痍⑥빟븳 40꽭 씠긽쓽 以묐뀈 꽦씤怨 끂씤쓣 긽쑝濡 슚怨쇱쟻씤 鍮덊삁 愿由щ 쐞빐 鍮덊삁 쐞뿕怨 긽 洹쇰젰씠 뼱뼚븳 뿰愿꽦씠 엳뒗吏 솗씤븯怨, 異붽쟻쑝濡 以묐뀈 꽦씤(40–64꽭)怨 끂씤(65꽭 씠긽)쑝濡 援щ텇븯뿬 뿰졊蹂 긽 洹쇰젰씠 鍮덊삁 쐞뿕뿉 뼱뼚븳 쁺뼢쓣 誘몄튂뒗吏 솗씤븯怨좎옄 븳떎.

뿰援 諛⑸쾿

1. 뿰援 긽

蹂 뿰援ъ뿉 궗슜븳 뜲씠꽣뒗 留뚯꽦 吏덊솚쓽 諛쒖깮怨 쑀쟾쟻 슂씤쓣 솗씤븯湲 쐞빐 떆옉맂 냽珥 湲곕컲 肄뷀샇듃 뿰援щ줈, 2007뀈遺꽣 2014뀈源뚯 議곗궗맂 40–88꽭쓽 뼇룊 吏뿭 嫄곗< 以묐뀈 꽦씤怨 끂씤쓣 긽쑝濡 뿰援щ 吏꾪뻾븯떎. 議곗궗뿉 李몄뿬븳 珥 3,234紐 以 怨쇨굅 븫, 떖洹쇨꼍깋 蹂묐젰씠 엳嫄곕굹 룆由쎈닔, 醫낆냽蹂닔瑜 룷븿븳 洹쇰젰怨 鍮덊삁뿉 쁺뼢쓣 誘몄튌 닔 엳뒗 二쇱슂 蹂닔뿉 寃곗륫移섍 엳뒗 긽옄 1,247紐낆쓣 젣쇅븳 1,987紐낆쓣 遺꾩꽍븯떎. 李몄뿬옄뿉寃 닔뻾븳 紐⑤뱺 꽕臾몄“궗 엫긽寃궗 궡슜 諛 諛⑸쾿 븳뼇븰援 쓽猷뚯썝 엫긽떆뿕쑄由ъ쐞썝쉶쓽 듅씤쓣 諛쏆븯떎(No. 2011-07-0005-010).

2. 痢≪젙 蹂씤

1) 洹쇰젰 痢≪젙

븙젰寃궗(grip strength test, kg)뒗 痢≪젙諛⑸쾿씠 鍮꾧탳쟻 媛꾨떒븯怨 떒떆媛꾩뿉 寃곌낵瑜 븣 닔 엳쑝硫, 떎젣濡 떎瑜 洹쇰젰怨 긽愿꽦씠 넂떎. 痢≪젙 옣鍮꾨뒗 몴쟻씤 諛⑸쾿쑝濡 TKK-5401 븙젰怨(Takei Scientific Instruments, Niigata, Japan)瑜 씠슜븯뿬 넀媛씫쓽 몢 踰덉㎏ 愿젅씠 븙젰怨꾩쓽 옟뒗 遺遺꾧낵 吏곴컖씠 릺룄濡 옟怨 뼇諛쒖쓣 뼱源⑤꼫鍮꾨쭔겮 踰뚮━怨 꽌꽌 뼇뙏쓣 옄뿰뒪읇寃 궡由 긽깭뿉꽌 痢≪젙븯뒗 뙏쓣 빟 15° 젙룄 踰뚮┛ 썑 醫·슦 援먮濡 2쉶뵫 痢≪젙븯뿬 룊洹좉컪쓣 湲곕줉븳떎.

媛곷젰寃궗(leg strength test, kg)뒗 븯吏쓽 벑泥숈꽦 理쒕 洹쇰젰 痢≪젙쓣 쐞빐 TKK-5402 媛곷젰怨(Takei Scientific Instruments)瑜 쓽옄뿉 遺李⑹떆궓 삎깭쓽 옣鍮꾨 궗슜븯떎. 뵾뿕옄뒗 쓽옄뿉 뿀由ъ 벑쓣 理쒕븳 媛源뚯씠 怨 븠 떎쓬 뼇諛쒖쓣 荑좎뀡뿉 怨 뼇넀쑝濡 쓽옄 쁿쓽 넀옟씠瑜 옟 긽깭뿉꽌 臾대쫷 愿젅쓣 理쒕 옒쑝濡 떊쟾븯寃 븯怨 씠븣 諛쒖깮븯뒗 옣젰쓣 痢≪젙븯뒗뜲, 2쉶 떎떆븯뿬 理쒕媛믪쓣 湲곕줉븯떎. 蹂 痢≪젙뿉 븵꽌 痢≪젙 옄꽭 諛⑸쾿쓣 援먯쑁븯怨 뿰뒿쓣 떆궓 썑뿉 痢≪젙쓣 떎떆븯떎. 蹂 뿰援ъ뿉꽌뒗 꽑뻾뿰援ъ뿉 뵲씪, 궛異쒕맂 븙젰, 媛곷젰쓣 泥댁쭏웾吏닔(body mass index, BMI; kg/m²)濡 굹늿 긽 洹쇰젰쑝濡 蹂솚븯뿬 궗슜븯떎12. 痢≪젙븳 긽 븙젰 諛 媛곷젰 젏닔뒗 꽦蹂꾨줈 援щ텇븯뿬 low, middle, high쓽 3遺꾩쐞濡 굹늿 뮘 遺꾩꽍뿉 씠슜븯떎. 異붽쟻쑝濡 긽 븙젰, 媛곷젰쓽 긽샇옉슜쓣 솗씤븯湲 쐞빐 꽦蹂꾨줈 low high쓽 2遺꾩쐞濡 굹늿 뮘 ‘궙 븙젰/궙 媛곷젰’, ‘궙 븙젰/넂 媛곷젰’, ‘넂 븙젰/궙 媛곷젰’, ‘넂 븙젰/넂 媛곷젰’쑝濡 珥 4媛쒖쓽 빆紐⑹쑝濡 援ъ꽦븯뿬 遺꾩꽍븯떎.

2) 삁븸 蹂씤 痢≪젙

삁泥쓣 梨꾩랬븯뿬 씪諛섑삁븸寃궗瑜 떆뻾븯떎. 뿬윭 寃궗 빆紐 以 蹂 뿰援ъ쓽 醫낆냽蹂닔씤 뿤紐④濡쒕퉰쓣 룷븿븳 C-諛섏쓳꽦 떒諛깆쭏(C-reactive protein, CRP), 삁以 겕젅븘떚땶, 洹몃━怨 怨듬났 떆 삁떦쓣 뿰援 옄猷뚮줈 솢슜븯떎. 寃泥 泥섎━ 諛 옣, 寃吏꾩쓣 넻븯뿬 梨꾩랬븳 삁븸뿉꽌 異붿텧맂 삁泥쓣 吏덈퀝愿由щ낯遺 쑀쟾泥댁뿰援ы뿉꽌 씪愿꾩쟻쑝濡 蹂닿븯떎. 鍮덊삁 꽑뻾뿰援ъ뿉꽌 궗留앸쪧 利앷, 궣쓽 吏 媛먯냼 뿰愿릺뿀떎怨 蹂닿퀬맂 鍮덊삁 湲곗뿉 洹쇨굅븯뿬 궓옄 13 mg/dL 誘몃쭔, 뿬옄 12 mg/dL 誘몃쭔씪 寃쎌슦 “鍮덊삁援”쑝濡 洹쒖젙븯怨, 湲곗移 씠긽씤 궗엺 “젙긽援”쑝濡 援щ텇븯떎13. 異붿젙 궗援ъ껜뿬怨쇱쑉(estimated glomerular filtration ratio) 鍮덊삁뿉 쁺뼢쓣 誘몄튂뒗 슂냼濡, 꽑뻾뿰援ъ뿉 洹쇨굅븯뿬 삁以 겕젅븘떚땶쓣 씠슜븳 Modification of Diet in Renal Disease (MDRD) 뿰援ъ쓽 怨듭떇(in mL/min/1.73 m2=175×serum creatinine–1.154×age–0.203×[0.742 if female])쑝濡 媛믪쓣 궛異쒗븯뿬 60 mL/min/1.73 m2 誘몃쭔씪 寃쎌슦 留뚯꽦 떊吏덊솚쑝濡 援щ텇븯떎14.

3) 꽕臾몄“궗 諛 湲고 蹂닔

議곗궗슂썝뿉 쓽븳 씪씪 硫댁젒 꽕臾몄쑝濡 떎떆븯怨 떦씪 議곗궗 썑 꽕臾몄쓣 寃넗瑜 븯뿬 닔젙 諛 蹂댁셿 옉뾽쓣 吏꾪뻾븯떎. 떊泥 怨꾩륫 닕젴맂 媛꾪샇궗媛 蹂댄샇옄 븿猿 媛踰쇱슫 샆쓣 엯怨 떎떆븯떎. 긽 븙젰 궛異쒖쓣 쐞븳 BMI뒗 痢≪젙맂 泥댁쨷(kg)뿉꽌 궎(m)쓽 젣怨깆쓣 굹늿 媛믪쑝濡 遺꾩꽍뿉 씠슜븯怨, 洹쇰젰뿉 쁺뼢쓣 誘몄튂뒗 젣吏諛⑸웾 깮泥 쟾湲 빆踰(Inbody 3.0; Biospace, Seoul, Korea)쓣 씠슜븯뿬 痢≪젙맂 젣吏諛⑸웾 臾닿쾶(kg)濡 遺꾩꽍뿉 씠슜븯떎. 蹂 뿰援ъ꽌 궗슜븳 꽕臾몄 鍮덊삁뿉 쁺뼢쓣 겮移 닔 엳뒗 蹂씤뱾쓣 꽑蹂꾪븯뿬 理쒖쥌쟻쑝濡 遺꾩꽍뿉 솢슜븯떎. 삁븸븰쟻쑝濡 鍮덊삁뿉 쁺뼢쓣 誘몄튂뒗 怨좏삁븬, 떦눊瑜 吏꾨떒諛쏆븯嫄곕굹 愿젴 빟쓣 蹂듭슜븯怨 엳쓣 寃쎌슦 ‘삁’, 洹몃젃吏 븡쓣 寃쎌슦 ‘븘땲삤’濡 援щ텇븯떎. 鍮꾪誘 B 寃고븤쑝濡 씤븳 鍮덊삁뿉 쁺뼢쓣 誘몄튂뒗 쑁瑜 꽠痍⑤ 솗씤븯湲 쐞빐 ‘쑁瑜(뇿怨좉린, 뤌吏怨좉린)瑜 援ъ썙 뱶떎 븣 뼱뒓 젙룄 援ъ슫 怨좉린瑜 二쇰줈 뱶떗땲源?’씪뒗 吏덈Ц뿉 ‘怨좉린瑜 嫄곗쓽 癒뱀 븡뒗떎’ 씠뿉 빐떦븯吏 븡뒗 蹂씤쓣 ‘븘땲떎’濡 援ъ꽦븯怨, 寃곗륫씤 寃쎌슦 ‘臾댁쓳떟’쑝濡 援щ텇븯떎. 뵾濡쒕줈 씤븳 鍮덊삁뿉 쁺뼢쓣 誘몄튂뒗 슂씤쓣 솗씤븯湲 쐞빐 룊긽떆 닔硫댁떆媛꾩뿉 빐 쓳떟븳 닔移섎 遺꾩꽍뿉 솢슜븯떎.

3. 넻怨 泥섎━

蹂 뿰援ъ뿉꽌뒗 옄猷 遺꾩꽍쓣 쐞빐 STATA/IC 14.1 (STATA Corp., College Station, TX, USA)쓣 궗슜븯쑝硫, 뿰援щ긽옄쓽 씤援ы븰쟻 듅꽦쓣 솗씤븯湲 쐞빐 鍮덈룄遺꾩꽍怨 湲곗닠遺꾩꽍쓣 떎떆븯떎(Table 1). 긽 븙젰, 긽 媛곷젰怨 鍮덊삁쓽 뿰愿꽦쓣 솗씤븯湲 쐞빐 濡쒖뒪떛 꽑삎쉶洹遺꾩꽍(logistic linear regression)쓣 궗슜븯뿬 援먯감鍮(odds ratio, OR) 95% 떊猶곌뎄媛(confidence interval, CI)쓣 궛異쒗븯怨 異붽濡 뿰졊蹂꾨줈 40–64꽭 65꽭 씠긽쑝濡 굹늻뼱 OR怨 CI瑜 궛異쒗븯떎(Table 2). 삉븳 뿰졊蹂 긽 븙젰, 긽 媛곷젰쓽 긽샇옉슜씠 鍮덊삁怨 뿰愿릺뼱 엳뒗吏 솗씤븯湲 쐞빐 洹쇰젰 닔以蹂 珥 4吏묐떒(궙 븙젰/궙 媛곷젰, 궙 븙젰/넂 媛곷젰, 넂 븙젰/궙 媛곷젰, 넂 븙젰/넂 媛곷젰)怨 鍮덊삁 쑀臾대 濡쒖뒪떛 꽑삎쉶洹遺꾩꽍쓣 궗슜븯뿬 OR怨 CI瑜 궛異쒗븯怨 異붽濡 뿰졊蹂 OR怨 CI瑜 궛異쒗븯떎(Table 3).

Table 1 . Baseline characteristics of study participants

Characteristic of risk factorTotal (n=1,987)Age<65 (n=1,195)Age≥65 (n=792)



Non anemiaAnemiap-valueNon anemiaAnemiap-valueNon anemiaAnemiap-value
No. of participants1,8111761,1029370983
Female sex (%)1,089 (60.1)143 (81.2)<0.001711 (64.5)87 (93.5)<0.001378 (53.3)*56 (67.4)*0.014
Age (yr)60.32±10.1060.81±11.590.54453.64±6.4151.52±7.440.00270.69±4.4771.21±4.6680.316
Leg strength/BMI (%)0.2510.7500.125
Low594 (32.8)67 (38.0)235 (21.3)22 (23.6)359 (50.6)45 (54.2)
Middle604 (33.3)59 (33.5)366 (33.2)32 (34.4)238 (33.5)27 (32.5)
High613 (33.8)50 (28.4)501 (45.4)39 (41.9)112 (15.8)11 (13.2)
Grip strength/BMI (%)0.1720.7830.771
Low592 (32.6)669 (39.2)247 (22.4)19 (20.4)345 (48.6)50 (60.2)
Middle613 (33.8)50 (28.4)378 (34.3)30 (32.2)235 (33.1)20 (24.1)
High606 (33.4)57 (32.3)477 (43.2)44 (47.3)129 (18.1)13 (15.6)
eGFR (mL/min/1.73 m2)69.01±9.5665.03±11.21<0.00170.72±8.6067.03±9.96<0.00166.34±10.3462.78±12.130.004
Sleep time <7 hr (%)599 (33.0)58 (32.9)0.974354 (32.1)33 (35.4)0.506245 (34.5)25 (30.1)0.420
Meat intake (%)1,194 (65.9)111 (63.0)0.628815 (73.9)66 (70.9)0.769379 (53.4)45 (54.2)0.628
Serum glucose (mL/dL)102.93±22.4397.67±20.030.003101.77±21.75*96.41±23.12*0.023104.73±23.34*99.07±15.89*0.032
History of diabetes mellitus (%)121 (6.7)11 (6.3)0.82666 (6.0)6 (6.5)0.85755 (7.8)5 (6.1)0.572
History of hypertension (%)361 (19.9)29 (16.4)0.270194 (17.6)11 (11.8)0.156167 (23.5)18 (21.6)0.704
BMI (kg/m2)24.51±3.1423.83±3.490.00724.89±3.1024.43±3.480.16723.90±3.12*23.16±3.40*0.045
Lean body mass (kg)42.02±7.7639.08±6.06<0.00143.34±7.9440.50±5.420.00139.97±7.0137.47±6.370.002

Values are presented as number only, number (%), or mean±standard deviation.

BMI: body mass index, eGFR: estimated glomerular filtration rate.

*p<0.05, p<0.01, p<0.001.


Table 2 . Association of relative leg strength and relative grip strength with anemia by age

Characteristic of risk factorTotal (n=1,987)Age <65 yr (n=1,195)Age ≥65 yr (n=792)
Relative leg strength
Low1.00 (Reference)1.00 (Reference)1.00 (Reference)
Middle0.78 (0.53–1.16)0.85 (0.46–1.56)0.84 (0.48–1.44)
High0.55 (0.34–0.88)0.45 (0.24–0.87)0.79 (0.37–1.69)
p-trend0.0130.0110.484
Relative grip strength
Low1.00 (Reference)1.00 (Reference)1.00 (Reference)
Middle0.55 (0.36–0.83)0.86 (0.45–1.65)0.43 (0.24–0.78)
High0.45 (0.27–0.73)0.66 (0.32–1.34)0.32 (0.14–0.72)
p-trend0.0010.2270.002

Values are presented as odds ratio (95% confidence interval).

Multivariable adjusted age, sex, sleep time, serum glucose, meat intake, human serum-C-reactive protein, body mass index, lean body mass, history of hypertension, history of diabetes mellitus, and estimated glomerular filtration rate.


Table 3 . Association of interaction between relative grip strength and relative legs strength with anemia by age

Characteristic of risk factorTotal (n=1,987)Age <65 yr (n=1,195)Age ≥65 yr (n=792)
Relative grip strength/relative leg strength
Low/Low1.00 (Reference)1.00 (Reference)1.00 (Reference)
Low/High0.73 (0.43–1.23)0.58 (0.25–1.34)1.20 (0.60–2.40)
High/Low0.67 (0.40–1.12)1.17 (0.54–2.54)0.44 (0.21–0.93)
High/High0.56 (0.35–0.91)0.70 (0.35–1.38)0.41 (0.18–0.96)
p-trend0.0280.5560.011

Values are presented as odds ratio (95% confidence interval).

Multivariable adjusted age, sex, sleep time, serum glucose, meat intake, human serum-C-reactive protein, body mass index, lean body mass, history of hypertension, history of diabetes mellitus, estimated glomerular filtration rate.



옄猷 遺꾩꽍 怨쇱젙뿉꽌 鍮덊삁뿉 쁺뼢쓣 二쇰뒗 蹂씤쓣 넻젣븯湲 쐞빐꽌 꽦蹂, 굹씠, 쑁瑜 꽠痍 뿬遺, 궗援ъ껜뿬怨쇱쑉, 怨듬났 떆 삁떦, CRP, 怨좏삁븬 蹂묐젰, 떦눊 蹂묐젰, 젣吏諛⑸웾, BMI, 닔硫댁떆媛 벑쓣 蹂댁젙 蹂닔濡 닾엯븯쑝硫 紐⑤뱺 쑀쓽 닔以 p<0.05濡 꽕젙븯떎.

寃 怨

蹂 뿰援ъ뿉꽌 긽 븙젰, 긽 媛곷젰 닔以怨 鍮덊삁 쐞뿕怨쇱쓽 뿰愿꽦쓣 솗씤븯湲 쐞븳 씤援ы넻怨꾩쟻 蹂씤 Table 1뿉 젣떆븯떎. 쟾泥댁쟻쑝濡 鍮덊삁쓣 媛吏 吏묐떒 넂 뿬꽦 鍮꾩쑉, 궙 궗援ъ껜뿬怨쇱쑉, 궙 삁떦 닔移, 궙 BMI, 궙 洹쇱쑁웾쓣 媛吏怨 엳뿀쑝硫 鍮덊삁씠 뾾뒗 吏묐떒怨 넻怨꾩쟻쑝濡 쑀쓽븳 李⑥씠瑜 솗씤븷 닔 엳뿀떎. 40–64꽭쓽 鍮덊삁쓣 媛吏 吏묐떒뿉꽌뒗 鍮덊삁씠 뾾뒗 吏묐떒蹂대떎 뿬꽦 鍮꾩쑉씠 넂怨 젇 뿰졊, 궙 궗援ъ껜뿬怨쇱쑉, 궙 삁떦 닔移, 궙 洹쇱쑁웾쓣 媛吏怨 엳뿀쑝硫 넻怨꾩쟻쑝濡 쑀쓽븳 李⑥씠瑜 蹂댁떎. 65꽭 씠긽쓽 鍮덊삁쓣 媛吏 吏묐떒뿉꽌뒗 鍮덊삁씠 뾾뒗 吏묐떒蹂대떎 뿬꽦 鍮꾩쑉씠 넂怨, 궙 궗援ъ껜뿬怨쇱쑉, 궙 삁떦 닔移, 궙 BMI, 궙 洹쇱쑁웾쓣 媛吏怨 엳뿀쑝硫 넻怨꾩쟻쑝濡 쑀쓽븳 李⑥씠瑜 솗씤븯떎. 洹 쇅 떎瑜 蹂씤뱾 鍮덊삁쓣 媛吏 吏묐떒怨 鍮덊삁씠 뾾뒗 吏묐떒 媛꾩뿉 넻怨꾩쟻쑝濡 쑀쓽븳 李⑥씠瑜 솗씤븷 닔 뾾뿀떎(p>0.05).

Table 2뿉꽌뒗 떎뼇븳 샎 蹂씤뱾쓣 蹂댁젙뻽쓣 븣 넂 긽 媛곷젰(긽쐞 33.37% 씠긽) 궙 긽 媛곷젰(긽쐞 66.74%–100%)뿉 鍮꾪빐 鍮덊삁 쐞뿕뿉 븳 OR씠 궙븘吏뒗 寃껋쓣 솗씤븯怨(OR, 0.55; 95% CI, 0.34–0.88), 긽 媛곷젰씠 넂븘吏덉닔濡 鍮덊삁 쐞뿕쓽 OR쓣 媛먯냼떆궎뒗 寃껋쓣 솗씤븯떎. 븯吏留 긽 븙젰씠 궙 吏묐떒(긽쐞 66.74–100%)뿉 鍮꾪빐 以묎컙 吏묐떒(긽쐞 33.38–66.73%), 넂 吏묐떒(긽쐞 33.37% 씠긽)쓽 鍮덊삁 쐞뿕뿉 븳 OR씠 媛곴컖 0.57 (95% CI, 0.37–0.88), 0.50 (95% CI, 0.30–0.84)濡 젏李 궙븘議뚯쑝硫, 씠뒗 넻怨꾩쟻쑝濡 쑀쓽븳 寃곌낵瑜 솗씤븷 닔 엳뿀떎.

40–64꽭 吏묐떒뿉꽌뒗 긽 媛곷젰씠 넂 洹몃9(긽쐞 33.37% 씠긽)씠 긽 媛곷젰씠 궙 洹몃9(긽쐞 66.74%–100%)蹂대떎 鍮덊삁 쐞뿕뿉 븳 OR씠 0.57 (95% CI, 0.37–0.88) 媛먯냼븯怨, 긽 媛곷젰씠 넂븘吏덉닔濡 鍮덊삁 쐞뿕씠 媛먯냼븯뒗 寃곌낵瑜 솗씤븷 닔 엳뿀떎. 븯吏留 긽 븙젰 鍮덊삁怨 넻怨꾩쟻쑝濡 쑀쓽븳 뿰愿꽦쓣 蹂댁씠吏 븡븯떎. 65꽭 씠긽 吏묐떒뿉꽌뒗 40–64꽭 吏묐떒怨 떖由 긽 媛곷젰怨 鍮덊삁怨쇱쓽 넻怨꾩쟻쑝濡 쑀쓽븳 뿰愿꽦쓣 솗씤븷 닔 뾾뿀쑝굹, 긽 븙젰 닔以씠 넂븘吏덉닔濡 鍮덊삁 쐞뿕쓽 OR씠 媛먯냼븯뒗 寃껋쓣 솗씤븷 닔 엳뿀떎(middle OR, 0.43; 95% CI, 0.24–0.78; high OR, 0.32; 95% CI, 0.14–0.72).

Table 3뿉꽌뒗 떎뼇븳 샎 蹂씤쓣 蹂댁젙븯怨 긽 媛곷젰怨 긽 븙젰쓽 긽샇옉슜씠 鍮덊삁뿉 뼱뼡 뿰愿꽦씠 엳뒗吏 솗씤븳 寃곌낵, 긽 븙젰怨 긽 媛곷젰씠 넂 洹몃9 긽 븙젰怨 긽 媛곷젰씠 紐⑤몢 궙 洹몃9뿉 鍮꾪빐 鍮덊삁 쐞뿕뿉 븳 OR씠 0.56 (95% CI, 0.35–0.91) 궙怨 긽 븙젰怨 긽 븙젰씠 넂쓣닔濡 鍮덊삁 쐞뿕씠 媛먯냼븷 닔 엳쓬쓣 솗씤븯떎. 40–64꽭 吏묐떒쓽 寃쎌슦 긽 븙젰, 긽 媛곷젰뿉 븳 긽샇옉슜씠 鍮덊삁 쐞뿕뿉 넻怨꾩쟻쑝濡 쑀쓽븳 뿰愿꽦쓣 媛吏吏 븡븯떎. 65꽭 씠긽 吏묐떒쓽 寃쎌슦 긽 븙젰留 넂 洹몃9怨 긽 븙젰, 긽 媛곷젰씠 紐⑤몢 넂 洹몃9뿉꽌 鍮덊삁 쐞뿕뿉 븳 OR씠 媛곴컖 0.44 (95% CI, 0.21–0.93), 0.41 (95% CI, 0.18–0.96) 媛먯냼븯怨 긽 븙젰怨 긽 媛곷젰씠 넂쓣닔濡 鍮덊삁 쐞뿕씠 媛먯냼븯뒗 寃곌낵瑜 솗씤븷 닔 엳뿀떎.

怨 李

蹂 뿰援ъ뿉꽌뒗 븳援 냽珥 吏뿭 以묐뀈 꽦씤怨 끂씤쓽 긽 洹쇰젰 닔以怨 鍮덊삁 쐞뿕뿉 븳 OR쓣 솗씤븯怨좎옄 븯怨 씠뿉 빐 떎쓬쓽 寃곌낵瑜 솗씤븷 닔 엳뿀떎. 泥 踰덉㎏, 洹쇰젰怨 鍮덊삁뿉 쁺뼢쓣 誘몄튂뒗 슂씤뱾뿉 빐 룆由쎌쟻쑝濡 긽 洹쇰젰 鍮덊삁 쐞뿕뿉 뿰愿꽦씠 엳쑝硫 씠뒗 뿰졊蹂 李⑥씠媛 議댁옱븯떎. 40–64꽭 以묐뀈 꽦씤쓽 寃쎌슦 鍮덊삁 쐞뿕 긽 媛곷젰怨 뿰愿꽦씠 엳뿀쑝굹 긽 븙젰 뿰愿꽦씠 뾾뿀怨, 65꽭 씠긽 끂씤쓽 寃쎌슦 鍮덊삁 쐞뿕 긽 븙젰怨 뿰愿꽦씠 議댁옱븳 諛섎㈃ 삤엳젮 긽 媛곷젰怨 뿰愿꽦씠 뾾뿀떎. 몢 踰덉㎏, 긽 븙젰怨 긽 媛곷젰씠 紐⑤몢 넂븯쓣 븣 鍮덊삁 쐞뿕씠 媛먯냼븯怨, 듅엳 65꽭 씠긽뿉꽌 븙젰留 넂븯쓣 븣 鍮덊삁 쐞뿕씠 媛먯냼븯쑝硫 븙젰怨 媛곷젰씠 紐⑤몢 넂븯쓣 븣 鍮덊삁 쐞뿕씠 뜑슧 媛먯냼븯뒗 寃곌낵瑜 솗씤븯떎.

끂솕濡 씤븳 鍮덊삁 븫씠굹 媛먯뿼 吏덊솚 諛 쁺뼇떎議, 샊 泥좊텇 遺議깆뿉 湲곗씤븯뿬 굹굹뒗 寃껋쑝濡 븣젮졇 엳쑝굹, 떎젣 鍮덊삁 諛쒖깮썝씤쓽 20%뒗 吏덈퀝씠 븘땶 떎뼇븳 슂씤엫씠 蹂닿퀬릺뼱 엳떎3. 씠윭븳 鍮덊삁 끂씤쓽 蹂묒쟻 긽깭, 떊泥닿린뒫 媛먯냼 뿰愿릺뼱 엳뒗뜲3, 쟾 꽭怨꾩쟻쑝濡 媛踰쇱슫 鍮덊삁쓣 븪怨 엳뒗 솚옄 삉븳 떎瑜 吏덈퀝怨 룆由쎌쟻쑝濡 끂씤쓽 蹂묒쟻 긽깭 궗留앸쪧쓣 넂씠뒗 寃껋쑝濡 蹂닿퀬븯떎1. 떎젣濡 65꽭 끂씤쓣 긽쑝濡 吏꾪뻾맂 肄뷀샇듃 뿰援 寃곌낵뿉 뵲瑜대㈃ 鍮덊삁 利앹긽씠 엳뒗 끂씤쓽 寃쎌슦 11 g/dL쓽 뿤紐④濡쒕퉰씠 媛먯냼븷 븣留덈떎 궗留 쐞뿕씠 39% 넂븘吏꾨떎뒗 蹂닿퀬媛 엳떎15. 鍮덊삁 끂씤뿉 엳뼱 紐⑤뱺 醫낅쪟쓽 궗留앸쪧 利앷, 떊泥닿린뒫 媛먯냼, 궣쓽 吏 媛먯냼, 洹쇰젰 媛먯냼뿉 룆由쎌쟻씤 쁺뼢쓣 誘몄튂뒗 寃껋쑝濡쒕룄 븣젮졇 엳떎16.

씠뿉 빐 슫룞 珥 뿤紐④濡쒕퉰 뼇怨 쟻삁援 뼇쓣 利앷떆궗 닔 엳뒗, 鍮덊삁 삁諛⑹뿉 슚怨쇱쟻씤 諛⑸쾿쑝濡, 슫룞씠 궛냼 슫諛 뒫젰쓣 뼢긽떆궎怨 議고삁옉슜쓣 怨쇱쬆떇떆궗 닔 엳쓬쓣 蹂닿퀬븯怨6, 빆 슫룞쓣 넻빐 利앹쭊릺뒗 洹쇰젰 洹쇱쑁웾蹂대떎 떊泥닿린뒫 옣븷, 떖옣吏덊솚, 궗吏덊솚 벑쓽 삁痢≪뿉 뜑 슚怨쇱쟻씤 슂냼濡, 洹쇰젰씠 넂쓣닔濡 떎뼇븳 吏덊솚뿉 빐 嫄닿컯쓣 蹂댄샇븷 닔 엳쓬쓣 媛뺤“븯怨 엳떎17.

긽 洹쇰젰怨 鍮덊삁 媛꾩쓽 湲곗쟾 紐낇솗엳 諛앺吏 諛붾뒗 뾾쑝굹, 꽑뻾뿰援ъ뿉꽌 洹쇰젰怨 洹쇱쑁諛룄뒗 鍮덊삁怨 留ㅼ슦 諛젒븯寃 뿰愿릺뼱 엳쓬쓣 媛뺤“븯怨3, 떎젣濡 20二쇨컙 빆꽦 듃젅씠떇 씠썑뿉 쟻삁援 꽭룷 깮궛씠 利앷뻽쓬쓣 솗씤븯뒗뜲, 씠뒗 議곌낏꽭룷쓽 솢꽦솕瑜 媛졇솕湲 븣臾몄쑝濡 蹂닿퀬븳 諛 엳떎18. 듅엳 닔異뺥븯뒗 洹쇱쑁 빆뿼利앹꽦 궗씠넗移댁씤쓣 泥대궡뿉꽌 빀꽦븯怨 遺꾨퉬븿쑝濡쒖뜥 怨⑥닔瑜 옄洹뱁븯뒗 以묎컙뿽 以꾧린꽭룷쓽 솢룞쓣 利앷떆耳 議고삁옉슜쓣 珥됱쭊븷 닔 엳쓬쓣 솗씤븯떎19. 蹂 뿰援ъ쓽 寃곌낵뿉꽌룄 鍮덊삁 吏묐떒怨 鍮덊삁씠 뾾뒗 吏묐떒 媛 젣吏諛⑸웾쓽 쑀쓽誘명븳 李⑥씠瑜 솗씤븯쑝誘濡, 寃곕줎쟻쑝濡 젣吏諛⑸웾뿉 쁺뼢쓣 諛쏅뒗 긽 洹쇰젰씠 堉덉뿉 諛섎났쟻쑝濡 媛뺥븳 닔異뺣젰쓣 二쇱뼱 議곌낏꽭룷瑜 옄洹뱁븯硫댁꽌 쟻삁援 깮꽦쓣 珥됱쭊븯湲 븣臾몄뿉18, 鍮덊삁 쐞뿕쓣 媛먯냼떆궗 닔 엳쓣 寃껋쑝濡 깮媛곷맂떎.

Table 2뿉꽌 鍮덊삁뿉 븳 쐞뿕씠 40–64꽭 以묐뀈 꽦씤쓽 寃쎌슦 긽 媛곷젰, 65꽭 씠긽 끂씤쓽 寃쎌슦 긽 븙젰뿉 媛곴컖 뿰愿꽦씠 떎瑜 씠쑀뒗 뿰졊蹂 긽吏 븯吏쓽 洹쇱쑁웾 媛먯냼 젙룄 궗슜 젙룄쓽 李⑥씠媛 엳湲 븣臾몄쑝濡 깮媛곷맂떎. 꽑뻾뿰援ъ뿉 뵲瑜대㈃ 끂솕뿉 뵲瑜 洹쇨컧냼利앹쓣 삁痢≫븯뒗 泥숇룄濡 븙젰 媛곷젰뿉 鍮꾪빐 끂솕濡 씤븳 洹쇨컧냼利앹쓣 삁痢≫븯湲 뼱젮슫뜲, 洹 씠쑀뒗 긽吏 洹쇱쑁씠 븯吏 洹쇱쑁뿉 鍮꾪빐 끂솕濡 씤븳 洹 媛먯냼媛 몢뱶윭吏寃 굹굹吏 븡湲 븣臾몄씠씪怨 븯떎20. 떎瑜 꽑뻾뿰援ъ뿉꽌뒗 끂솕濡 씤븳 洹쇰젰 냼떎뿉 빐 븯吏 洹쇰젰쓽 냼떎씠 긽吏 洹쇰젰쓽 냼떎蹂대떎 겙 씠쑀濡 끂씤쓽 긽吏 궗슜蹂대떎 븯吏 궗슜씠 뜑 媛먯냼뻽湲 븣臾몄엫쓣 紐낆떆븯떎21. 씠뿉 빐꽌뒗 끂씤뿉꽌 븯吏蹂대떎 긽吏 洹쇱닔異뺤씠 鍮덈쾲븯뿬 끂솕濡 씤븳 긽吏쓽 냽洹 媛먯냼瑜 吏뿰빐 二쇰뒗 寃껋쑝濡 蹂닿퀬븯떎22. 蹂 뿰援ъ뿉꽌룄 40–64꽭쓽 以묐뀈 꽦씤씠 60꽭 씠긽 끂씤蹂대떎 洹쇱쑁웾씠 넂 寃껋쓣 솗씤븯怨, 씠뒗 끂솕濡 씤븳 洹쇱쑁웾 媛먯냼媛 議고삁옉슜 媛먯냼濡 씠뼱吏 닔 엳떎뒗 뿰援 寃곌낵 씪移섑븳떎3. 뵲씪꽌 65꽭 씠긽 끂씤 以 긽吏 洹쇰젰씠 넂 궗엺쓽 寃쎌슦 긽吏瑜 留롮씠 궗슜븯뿬 긽吏 洹쇱닔異뺤쓽 옄洹뱀씠 븯吏 洹쇱닔異뺤쓽 옄洹밸낫떎 겕湲 븣臾몄뿉 끂솕뿉 븳 洹 媛먯냼媛 吏뿰릺怨22, 媛뺥븳 긽吏 洹쇱닔異뺣젰쓣 넻븳 議고삁옉슜 利앹쭊뿉 빐 以묐뀈 꽦씤蹂대떎 뜑 슚怨쇱쟻쑝濡 옉슜븷 寃껋쑝濡 깮媛곷맂떎18.

Table 3뿉꽌 65꽭 씠긽 끂씤뿉寃뚯꽌留 긽 븙젰怨 긽 媛곷젰쓽 긽샇옉슜뿉 븳 鍮덊삁 쐞뿕쓽 뿰愿꽦씠 굹굹뒗 씠쑀뒗 65꽭 씠긽 끂씤쓽 넂 洹쇰젰 닔以 鍮⑤씪吏뒗 끂솕濡 씤븳 嫄닿컯쓽 遺젙쟻 쁺뼢쓣 삁諛⑺븷 닔 엳湲 븣臾몄씠떎. 끂씤뿉寃뚯꽌 洹쇰젰 媛먯냼뒗 떊泥댁쟻 옣븷瑜 삁痢≫븷 닔 엳쑝硫, 븙젰 媛먯냼, 媛곷젰 媛먯냼 紐⑤몢 嫄룸뒗 냽룄瑜 媛먯냼떆궗 닔 엳뒗 以묒슂븳 泥숇룄媛 맆 닔 엳쓬쓣 蹂닿퀬븳 諛 엳怨, 媛곷젰肉먮쭔 븘땲씪 븙젰씠 蹂댄뻾뿉 以묒슂븳 슂냼엫쓣 媛뺤“븯怨 엳떎23. 삉븳 굹씠媛 利앷븿뿉 뵲씪 샇瑜대が뿉 븳 듃젅씠떇쓽 슚怨쇰뒗 媛먯냼븯硫 샇瑜대が뿉 議곗젅쓣 諛쏅뒗 議고삁 떆뒪뀥뿉 븳 듃젅씠떇 슚怨쇰룄 媛먯냼븯寃 맂떎24. 삉븳 鍮덊삁씠 엳뒗 끂씤뱾 CRP, interleukin-6, tumor necrosis factor-α 媛숈 뿼利앹꽦 留덉빱뱾쓽 利앷 쑀쓽븯寃 뿰愿릺뼱 엳뒗뜲, 씠윭븳 끂솕濡 씤븳 뿼利앹꽦 留덉빱쓽 利앷뒗 쟻삁援 쟾援ъ껜쓽 遺꾪솕 利앹떇쓣 뼲젣븯怨 泥좊텇 湲곗쟾쓣 議곗젅븯硫 뿉由ы듃濡쒗룷씠뿉떞(erythropoietin)쓽 깮궛쓣 뼲젣븯湲 븣臾몄뿉 鍮덊삁뿉 뜑 痍⑥빟븳 긽깭뿉 끂異쒕릺뼱 엳떎25. 씠젃寃 끂씤 以묐뀈 꽦씤蹂대떎 議고삁옉슜쓣 쐞븳 떊泥닿린뒫쓽 媛먯냼3, 議고삁옉슜쓣 諛⑺빐븯뒗 뿼利앹꽦 留덉빱쓽 利앷25 媛숈 끂솕뿉 븳 떎 슂씤꽦 鍮덊삁 諛쒖깮뿉 痍⑥빟븳 留뚰겮, 긽 븙젰怨 긽 媛곷젰뿉 븳 쟾泥댁쟻 利앷媛 以묐뀈 꽦씤蹂대떎 끂씤뿉寃 蹂댄뻾 利앷23, 빆뿼利앹꽦 궗씠넗移댁씤 利앷19 媛숈 嫄닿컯 愿젴 씠뱷쓣 젣怨듯븯뿬 議고삁옉슜뿉 뜑슧 湲띿젙쟻씤 쁺뼢쓣 誘몄튂뒗 寃껋쑝濡 깮媛곷맂떎.

蹂 뿰援щ뒗 긽 븙젰, 긽 媛곷젰怨 鍮덊삁 쐞뿕 媛꾩쓽 뿰愿꽦 諛 뿰졊蹂 李⑥씠瑜 솗씤븳 뿰援щ줈꽌 紐 媛吏 븳怨꾩젏씠 엳떎. 泥 踰덉㎏, 鍮덊삁 쐞뿕怨 긽 洹쇰젰 媛꾩쓽 뿰愿꽦쓣 슒떒뿰援щ줈 솗씤뻽湲 븣臾몄뿉 紐낅갚븳 씤怨쇨怨꾨 솗씤븷 닔뒗 뾾뿀떎. 븯吏留 떎뼇븳 샎 蹂씤쓣 蹂댁젙븯쑝硫 떦룄 떊猶곕룄媛 넂 痢≪젙룄援щ 궗슜븯뿬 뿰援 寃곌낵쓽 꽕뱷젰쓣 넂씠怨좎옄 븯떎. 몢 踰덉㎏, 鍮덊삁 쐞뿕怨 긽 洹쇰젰쓽 룆由쎌쟻씤 뿰愿꽦쓣 솗씤븯湲 쐞빐 떎뼇븳 샎 蹂닔瑜 遺꾩꽍뿉 솢슜븯쑝굹, 以묐뀈 꽦씤怨 끂씤쓽 솢룞꽦쓣 鍮꾧탳븷 떊泥댄솢룞뿉 븳 蹂닔瑜 룷븿븯吏 紐삵븯떎. 洹몃윭굹 긽吏 洹쇰젰怨 븯吏 洹쇰젰쓣 굹늻뼱 鍮덊삁뿉 븳 뿰愿꽦쓣 솗씤븯怨, 긽 洹쇰젰뿉 媛옣 겙 쁺뼢쓣 誘몄튂뒗 洹쇱쑁웾쓣 샎 蹂씤쑝濡 蹂댁젙븯湲 븣臾몄뿉 긽 洹쇰젰怨 鍮덊삁 쐞뿕쓽 룆由쎌쟻씤 뿰愿꽦쓣 솗씤븯뒗 뜲뿉 湲곗뿬븯떎. 異뷀썑 뿰援щ 넻븯뿬 媛 醫낅쪟蹂(媛궗끂룞, 씪긽깮솢 솢룞, 怨꾪쉷맂 슫룞) 떊泥댄솢룞 李몄뿬 떆媛꾩쓣 룷븿븯뿬 떊泥댄솢룞 닔以蹂 긽 洹쇰젰씠 鍮덊삁뿉 誘몄튂뒗 쁺뼢쓣 솗씤빐蹂 븘슂媛 엳떎. 꽭 踰덉㎏, 以묐뀈 꽦씤怨 끂씤쓽 鍮덊삁쓽 쑀蹂묐쪧뿉 엳뼱꽌 뿬꽦씠 궓꽦蹂대떎 넻怨꾩쟻쑝濡 쑀쓽븯寃 넂 鍮덊삁 쑀蹂묐쪧쓣 媛吏怨 엳뿀怨, 씠뒗 꽑뻾뿰援ъ 씪移섑븯뒗 寃곌낵4瑜 蹂댁쑝굹 蹂 뿰援ъ뿉꽌뒗 꽦蹂 긽 洹쇰젰怨 鍮덊삁怨쇱쓽 뿰愿꽦쓣 솗씤븷 닔 뾾뿀쑝誘濡 異뷀썑 뿰援ъ뿉꽌뒗 씠瑜 솗씤빐蹂 븘슂媛 엳떎. 留덉留됱쑝濡 以묐뀈 꽦씤怨 끂씤쓽 洹쇱쑁웾쓽 李⑥씠뒗 솗씤븯쑝굹 븙젰怨 媛곷젰쓣 寃곗젙븯뒗 긽吏 洹쇱쑁웾怨 븯吏 洹쇱쑁웾쓣 援щ텇븯뿬 鍮꾧탳븷 닔 뾾뿀떎. 異뷀썑 뿰援ъ뿉꽌뒗 긽吏洹쇱쑁웾怨 븯吏洹쇱쑁웾쓣 媛곴컖 痢≪젙븯뿬 넂 븙젰, 넂 媛곷젰씠 긽吏 洹쇱쑁怨 븯吏 洹쇱쑁쓽 냽洹 媛먯냼瑜 吏뿰떆耳 끂솕濡 씤븳 鍮덊삁쓣 삁諛⑺븷 닔 엳뒗吏瑜 솗씤븷 븘슂媛 엳떎.

蹂 뿰援ъ뿉꽌뒗 긽 洹쇰젰怨 鍮덊삁 쐞뿕 뿰졊蹂 떎瑜 뿰愿꽦씠 議댁옱븯怨, 듅엳 끂씤쓽 寃쎌슦 븙젰, 媛곷젰 닔以쓽 利앷媛 끂솕뿉 븳 鍮덊삁쓽 쐞뿕쓣 궙異 닔 엳쓬쓣 솗씤븯떎. 끂솕뒗 씤媛꾩쑝濡 깭뼱굹 寃れ뼱빞 븯뒗 븘닔怨쇱젙쑝濡 洹쇨컧냼利 諛 떊泥닿린뒫 븯濡 씤븳 떎뼇븳 蹂묒쟻 긽깭뿉 끂異쒕릺寃 맂떎. 떎뼇븳 蹂묒쟻 긽깭 뿰愿맂 鍮덊삁 궣쓽 吏덉쓣 媛먯냼떆궗 닔 엳湲 븣臾몄뿉, 끂솕뿉 븳 鍮덊삁 쐞뿕쓣 以꾩씠湲 쐞빐꽌뒗 긽吏 洹쇰젰怨 븯吏 洹쇰젰쓣 媛뺥솕븷 닔 엳뒗 빆슫룞씠 븘슂븯떎. 異뷀썑 뿰援ъ뿉뒗 嫄닿컯븳 끂씤쓣 긽쑝濡 뿰졊蹂, 꽦蹂 洹쇰젰 닔以쓽 李⑥씠媛 삁以 뿤紐④濡쒕퉰 닔移섏뿉 쁺뼢쓣 誘몄튂뒗吏 솗씤븯뒗 뿰援ш 븘슂븯떎.

Conflict of Interest

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

Author Contributions

Conceptualization: DYP. Formal analysis: DYP. Writing–original draft: DYP. Writing–review & editing: YSK.

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