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Associations of Step Volume and Intensity with Metabolic Syndrome among Korean Adults: A Cross-sectional Observational Study
Korean J Sports Med 2024;42:126-135
Published online June 1, 2024;  https://doi.org/10.5763/kjsm.2024.42.2.126
© 2024 The Korean Society of Sports Medicine.

Yeon Soo Kim1,2, Geonhui Kim3, Hoyong Sung4, Byung-Cheol Kim5, Jeh-Kwang Ryu6, Sowon Hahn7

1Department of Physical Education, Seoul National University, Seoul, 2Institute of Sport Science, Seoul National University, Seoul, 3Department of Aero Fitness, Korea Air Force Academy, Cheongju, 4Department of Physical Education, Korea Military Academy, Seoul, 5School of Software Engineering, Joongbu University, Goyang, 6Department of Physical Education, Dongguk University, Seoul, 7Department of Psychology, Seoul National University, Seoul, Korea
Correspondence to: Sowon Hahn
Department of Psychology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
Tel: +82-2-880-6439, Fax: +82-2-877-6428, E-mail: swhahn@snu.ac.kr
Received April 11, 2024; Revised May 16, 2024; Accepted May 20, 2024.
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 was performed to investigate the association between step volume and intensity with the prevalence of metabolic syndrome (MS) in Korean adults.
Methods: The study analyzed 2,038 adults from the 2014 to 2017 Korea National Health and Nutrition Examination Survey, defining MS based on waist circumference, blood pressure, triglycerides, glucose, and high-density lipoprotein cholesterols. Step volume and intensity were calculated using average number of steps per day and peak 30-minute cadence, respectively. Logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of MS by tertiles of step volume and intensity. A joint analysis was conducted to examine the combined association between step volume and intensity with the prevalence of MS. We divided the participants into nine groups according to their step volume (tertiles) and intensity (tertiles).
Results: There were 478 MS cases. Compared to the lowest tertile of volume, the ORs of MS were 1.06 (95% CI, 0.79–1.42) and 0.64 (95% CI, 0.47–0.88) in the middle and highest tertile of volume. Compared to the lowest tertile of intensity, the ORs were 1.02 (95% CI, 0.76–1.36) and 0.74 (95% CI, 0.55–1.01) in the middle and highest tertile of intensity. In the joint analysis, compared to the group with both lowest volume and intensity, the ORs were significantly lower in all groups with the highest volume, except the group with the lowest intensity.
Conclusion: Although only greater step volume, not intensity, was independently related to MS, both step volume and intensity appear to be important for preventing MS.
Keywords : Walking, Exercise, Cardiometabolic risk factors
꽌 濡

궗利앺썑援곗 蹂듬鍮꾨쭔, 넂 삁븬怨 삁떦 諛 삁以묒吏 씠긽 벑쓽 떖삁愿怨꾩쭏솚 쐞뿕슂씤씠 蹂듯빀쟻쑝濡 議댁옱븯뒗 긽깭瑜 쓽誘명븯硫, 떖삁愿吏덊솚 諛 뇤삁愿吏덊솚쓽 諛쒕퀝 諛 궗留 쐞뿕怨 愿젴씠 엳떎1-3. 쟾 꽭怨꾩쟻쑝濡 궗利앺썑援 쑀蹂묐쪧 吏냽쟻쑝濡 긽듅븯뒗 異붿꽭濡4, 븳援쓽 寃쎌슦뿉룄 쑀蹂묐쪧 빟 30%뿉 떖븯硫, 씠뒗 吏냽쟻쑝濡 쑀吏릺嫄곕굹 넂븘吏怨 엳떎5. 꽭怨꾨낫嫄닿린援(World Health Organization, WHO)뿉꽌뒗 떊泥댄솢룞 遺議깆쓣 궗利앺썑援 諛쒕퀝 쐞뿕쓣 넂씠뒗 二쇱슂 슂씤 以 븯굹濡 瑗쎄퀬 엳쑝硫, 궗利앺썑援 삁諛⑹쓣 쐞빐 洹쒖튃쟻씤 떊泥댄솢룞뿉 李몄뿬븯湲곕 沅뚭퀬븯怨 엳떎6. 떎젣濡 洹쒖튃쟻씤 떊泥댄솢룞 뿀由щ몮젅, 삁븬, 삁떦, 吏吏 벑 궗利앺썑援 愿젴 슂씤뱾쓣 媛쒖꽑븯硫, 궗利앺썑援 諛쒕퀝 쐞뿕쓣 媛먯냼떆궎뒗 寃껋쑝濡 굹궃떎7.

蹂댄뻾 吏곸뾽, 뿬媛 솢룞 벑 嫄닿컯븳 媛쒖씤쓽 씪긽깮솢 以 媛옣 씪諛섏쟻쑝濡 닔뻾릺뒗 떊泥댄솢룞쓽 삎깭濡8,9, 媛쒖씤쓽 떊泥댄솢룞웾쓣 굹궡뒗 몴쟻씤 吏몴濡 궗슜릺怨 엳떎. 뿬윭 뿰援ъ뿉꽌 蹂댄뻾웾怨 떎뼇븳 吏덊솚쓽 諛쒕퀝 쐞뿕 媛 쑀쓽븳 愿젴꽦쓣 蹂닿퀬븯쑝硫10-12, 궗利앺썑援 쐞뿕怨쇰룄 넂 뿰愿꽦씠 엳뒗 寃껋쑝濡 굹궗떎13-15. 蹂댄뻾웾씠 留롮 궗엺 쟻 궗엺뿉 鍮꾪빐 궗吏덊솚 愿젴 쐞뿕씠 쟻쑝硫, 궗利앺썑援 諛쒕퀝 쐞뿕 삉븳 궙 寃껋쑝濡 굹궗떎16.

洹몃윭굹 2018뀈룄 誘멸뎅 떊泥댄솢룞 吏移 옄臾몄쐞썝쉶쓽 蹂닿퀬꽌뿉꽌뒗 蹂댄뻾웾怨 떖삁愿吏덊솚 諛 떦눊蹂 媛 愿젴꽦뿉 愿븳 洹쇨굅뒗 븘吏 젣븳쟻씠硫, 씠윭븳 愿젴꽦씠 씤醫 삉뒗 誘쇱”뿉 뵲씪 李⑥씠媛 엳뒗吏 뙋떒븷 닔 엳뒗 洹쇨굅媛 遺덉땐遺꾪븯떎怨 蹂닿퀬븯떎7. 슦由ш 븘뒗 븳 理쒓렐源뚯쓽 뿰援щ뒗 遺遺 誘멸뎅 샊 쑀읇씤쓣 긽쑝濡 닔뻾릺뿀쑝硫, 븳援씤쓣 긽쑝濡 媛냽룄怨꾨 씠슜븯뿬 媛앷쟻쑝濡 痢≪젙븳 蹂댄뻾웾怨 궗利앺썑援 媛꾩쓽 愿젴꽦쓣 솗씤븳 뿰援щ뒗 뾾떎. 뵲씪꽌 蹂 뿰援ъ뿉꽌뒗 理쒖큹濡 븳援씤쓽 媛앷쟻씤 蹂댄뻾웾怨 궗利앺썑援 媛꾩쓽 愿젴꽦쓣 議곗궗븯뿬 異붽쟻씤 洹쇨굅瑜 젣떆븯怨좎옄 븳떎.

WHO뿉꽌뒗 꽦씤쓣 쐞븳 떊泥댄솢룞 吏移⑥쑝濡 以∙怨좉컯룄 떊泥댄솢룞뿉 二쇰떦 理쒖냼 150–300遺 李몄뿬븯湲곕 沅뚭퀬븯怨 엳떎6. 씠뒗 嫄닿컯쓣 쐞븳 떊泥댄솢룞 李몄뿬 떆 뼇肉 븘땲씪 媛뺣룄 삉븳 以묒슂븯寃 怨좊젮빐빞 븳떎뒗 寃껋쓣 떆궗븳떎. 洹몃윭굹, 蹂댄뻾웾 媛믪 솢룞쓽 媛뺣룄瑜 援щ텇븯吏 븡뒗떎. 1씪 珥앸낫뻾웾뿉뒗 以∙怨좉컯룄 蹂댄뻾 솢룞肉먮쭔 븘땲씪 媛뺣룄쓽 蹂댄뻾 솢룞 삉븳 룷븿릺뼱 엳떎. 뵲씪꽌, 蹂댄뻾 솢룞쓣 넻븳 떊泥댄솢룞쓽 吏移⑥쓣 젣떆븯湲 쐞빐꽌뒗 蹂댄뻾웾怨 蹂댄뻾 媛뺣룄瑜 蹂듯빀쟻쑝濡 怨좊젮븳 洹쇨굅瑜 留덈젴븯뒗 寃껋씠 븘슂븯떎.

蹂댄뻾쓽 媛뺣룄뒗 二쇰줈 遺꾨떦 蹂댄뻾 닔瑜 쓽誘명븯뒗 耳씠뜕뒪(cadence) 媛믪쓣 궗슜븯뿬 굹궡뒗뜲, 씠뒗 떊泥댄솢룞 媛뺣룄쓽 몴쟻 吏몴씤 궗떦웾怨 넂 긽愿愿怨꾨 蹂댁씤떎17. 듅엳 븯猷 以 愿李곕맂 耳씠뜕뒪 以 鍮꾩뿰냽쟻씤 긽쐞 30媛쒖쓽 耳씠뜕뒪 媛믪쓽 룊洹좎쑝濡 젙쓽븯뒗 “理쒕 30遺 耳씠뜕뒪(peak 30-min cadence)”뒗 씪긽깮솢 以 굹굹뒗 蹂댄뻾 솢룞쓽 理쒕 媛뺣룄瑜 쓽誘명븯硫18, 씪遺 뿰援ъ뿉꽌 궗留앹쐞뿕, 궗吏덊솚 슂씤怨쇱쓽 쑀쓽誘명븳 愿젴꽦쓣 蹂닿퀬븯떎19-21.

理쒓렐 씪遺 뿰援ъ뿉꽌 蹂댄뻾웾 諛 蹂댄뻾 媛뺣룄 吏덊솚 媛꾩쓽 蹂듯빀쟻씤 愿젴꽦쓣 솗씤븯怨좎옄 븯쑝硫, 留롮 蹂댄뻾웾뿉 뜑븯뿬 뜑 넂 媛뺣룄뿉꽌쓽 蹂댄뻾 뜑 궙 궗留 諛 떖삁愿吏덊솚 諛쒕퀝 쐞뿕怨 愿젴씠 엳떎뒗 寃곌낵瑜 蹂닿퀬븯뿬22,23 궗利앺썑援곌낵룄 쑀쓽븳 愿젴꽦씠 엳쓣 寃껋쑝濡 삁긽릺굹, 븘吏 異⑸텇븳 뿰援ш 씠猷⑥뼱吏吏 븡븯떎. 뵲씪꽌, 蹂 뿰援ъ뿉꽌뒗 媛냽룄怨꾨줈 痢≪젙븳 븳援 꽦씤 蹂댄뻾웾, 蹂댄뻾 媛뺣룄 궗利앺썑援 媛꾩쓽 媛쒕퀎쟻씤 愿젴꽦쓣 솗씤븯怨, 蹂댄뻾웾怨 蹂댄뻾 媛뺣룄瑜 蹂듯빀쟻쑝濡 怨좊젮븯쓣 븣 궗利앺썑援곌낵쓽 愿젴꽦씠 뼱뼸寃 굹굹뒗吏 솗씤븯怨좎옄 븳떎.

뿰援 諛⑸쾿

1. 뿰援 긽

蹂 뿰援ъ뿉꽌뒗 븳援씤쓽 嫄닿컯怨 쁺뼇 긽깭瑜 議곗궗븯怨좎옄 吏덈퀝愿由ъ껌뿉꽌 1998뀈遺꽣 떆뻾븯怨 엳뒗 援誘쇨굔媛뺤쁺뼇議곗궗 옄猷뚮 궗슜븯떎. 援誘쇨굔媛뺤쁺뼇議곗궗뿉꽌뒗 븳援씤쓽 떊泥댄솢룞쓣 遺꾩꽍븯湲 쐞빐 2014뀈룄遺꽣 援誘쇨굔媛뺤쁺뼇議곗궗 李멸옄 以 씪遺瑜 긽쑝濡 媛냽룄怨꾨 씠슜븳 떊泥댄솢룞 뜲씠꽣瑜 닔吏묓븯怨 엳떎. 蹂 뿰援ъ뿉꽌뒗 媛냽룄怨꾨 넻빐 닔吏묓븳 떊泥댄솢룞 뜲씠꽣瑜 젣怨듯븯뒗 젣6湲 2, 3李⑤뀈룄(2014–2015) 젣7湲 1, 2李⑤뀈룄(2016–2017) 썝떆옄猷뚮 솢슜븯떎. 젣6湲 2, 3李⑤뀈룄 젣7湲 1李⑤뀈룄 議곗궗뿉꽌뒗 64꽭 誘몃쭔쓽 꽦씤쓣 긽쑝濡 媛냽룄怨 뜲씠꽣瑜 닔吏묓븯쑝硫, 媛곴컖 977紐, 791紐, 575紐낆씠 뿰援ъ뿉 李몄뿬븯떎. 젣7湲 2李⑤뀈룄 議곗궗뿉꽌뒗 65꽭 씠긽쓽 끂씤 474紐낆쓣 긽쑝濡 媛냽룄怨 뜲씠꽣瑜 닔吏묓븯떎.

蹂 뿰援ъ뿉꽌뒗 媛냽룄怨 李⑹슜뿉 룞쓽븳 2,927紐 以 媛냽룄怨 遺꾩떎, 誘몄갑슜, 怨좎옣, 뜲씠꽣 삤瑜 벑쓽 궗쑀濡 뜲씠꽣瑜 젣怨듯븯吏 紐삵븳 110紐낆쓣 젣쇅븳 2,817紐낆쓽 옄猷뚮 삩씪씤쓣 넻빐 젣怨듬컺븯떎. 씠 以 異붽쟻씤 遺꾩꽍 怨쇱젙뿉꽌 媛냽룄怨 뜲씠꽣뿉 삤瑜섍 굹궃 3紐낃낵 媛냽룄怨꾨 븯猷 10떆媛 씠긽 李⑹슜븳 궇씠 4씪 誘몃쭔씤 377紐낆쓣 遺꾩꽍뿉꽌 젣쇅븯떎. 삉븳, 븫, 떖옣吏덊솚, 뇤삁愿吏덊솚 蹂묐젰씠 엳뒗 213紐낃낵 醫낆냽蹂씤 諛 怨듬씤뿉 寃곗륫씠 엳뒗 186紐낆쓣 젣쇅븯怨 理쒖쥌쟻쑝濡 2,038紐낆쓣 遺꾩꽍뿉 룷븿븯떎. 蹂 뿰援щ뒗 꽌슱븰援 깮紐낆쑄由ъ떖쓽쐞썝쉶쓽 떖쓽 硫댁젣 듅씤쓣 諛쏆븯쑝硫(IRB No. E2105/001-005), 썑뼢쟻 옄猷 遺꾩꽍쑝濡 뿰援ъ갭뿬옄쓽 꽌硫 룞쓽뒗 硫댁젣릺뿀떎.

2. 媛냽룄怨 옄猷 泥섎━

媛냽룄怨꾨 솢슜븳 떊泥댄솢룞 痢≪젙 嫄닿컯꽕臾몄“궗瑜 셿猷뚰븳 긽옄 以 媛냽룄怨 李⑹슜뿉 룞쓽븳 궗엺쓣 긽쑝濡 紐⑥쭛븯뿬 떎떆븯떎. 뿰援 李몄뿬옄뒗 媛냽룄怨 李⑹슜뿉 룞쓽븳 떎쓬 궇遺꽣 7씪媛 醫뚯륫(삉뒗 슦痢) 뿀由ъ뿉 媛냽룄怨(ActiGraph GT3X竊, ActiGraph)瑜 李⑹슜븯쑝硫, 닔쁺씠굹 깶썙 떆媛꾩쓣 젣쇅븯怨 湲곗긽 吏곹썑遺꽣 痍⑥묠 쟾源뚯 媛냽룄怨꾨 李⑹슜븯룄濡 븯떎. 李멸옄쓽 솢룞뿉 뵲瑜 媛냽룄怨 痢≪젙 뜲씠꽣뒗 1遺 떒쐞濡 닔吏묓븯뿬 슂빟븯떎(1/60 Hz).

옄猷 遺꾩꽍쓣 쐞빐 援誘쇨굔媛뺤쁺뼇議곗궗뿉꽌 젣怨듯븯뒗 SAS 遺꾩꽍 肄붾뱶瑜 궗슜븯쑝硫, 꽑뻾뿰援щ 李멸퀬븯뿬 媛냽룄怨 李⑹슜 諛 誘몄갑슜 떆媛꾩쓣 遺꾨쪟븯떎24,25. 뿰援 李몄뿬옄 媛쒖씤쓽 7씪媛 痢≪젙 뜲씠꽣 以 븯猷 媛냽룄怨 李⑹슜 떆媛꾩씠 10떆媛 誘몃쭔씤 궇쓽 뜲씠꽣뒗 쑀슚븯吏 븡 媛믪쑝濡 遺꾨쪟븯뿬 遺꾩꽍뿉꽌 젣쇅븯쑝硫, 理쒖냼 4씪 씠긽쓽 媛냽룄怨 痢≪젙 뜲씠꽣媛 엳뒗 긽옄留 룷븿븯떎. 媛냽룄怨 李⑹슜 뿬遺뒗 媛냽룄怨꾩뿉꽌 痢≪젙맂 遺꾨떦 떊泥댄솢룞 슏닔(counts per minute, CPM)瑜 湲곗쑝濡 뙋떒븯쑝硫, CPM씠 60遺 씠긽 뿰냽쟻쑝濡 0씪 寃쎌슦 李⑹슜븯吏 븡 떆媛꾩쑝濡 遺꾨쪟븯떎. 삉븳, 誘몄갑슜 떆媛 以묒뿉 굹궃 떒떆媛꾩쓽 媛뺣룄 떊泥댄솢룞(2遺 誘몃쭔 룞븞 100 誘몃쭔쓽 CPM) 李⑹슜븳 寃껋쑝濡 遺꾨쪟븯吏 븡븯떎.

3. 蹂댄뻾웾 諛 蹂댄뻾 媛뺣룄

蹂댄뻾웾 븯猷 10떆媛 씠긽 李⑹슜븳 궇쓽 遺꾨떦 蹂댄뻾 닔 媛믪쓣 빀븳 뮘 李⑹슜씪 닔濡 굹늻뼱 븯猷 룊洹 蹂댄뻾웾쓣 怨꾩궛븯떎. 蹂댄뻾웾 뿰援 李몄뿬옄 媛쒖씤蹂 븯猷 룊洹 蹂댄뻾웾쓣 겕湲곗뿉 뵲씪 3遺꾩쐞濡 踰붿<솕븯뿬 궗슜븯떎.

蹂댄뻾 媛뺣룄뒗 븯猷 以 1遺꾧컙 蹂댄뻾 닔媛 媛옣 넂 鍮꾩뿰냽쟻씤 긽쐞 30遺꾧컙쓽 遺꾨떦 蹂댄뻾 닔瑜 굹궡뒗 理쒓퀬 30遺 耳씠뜕뒪瑜 궗슜븯쑝硫, 李⑹슜씪 媛꾩쓽 理쒓퀬 30遺 耳씠뜕뒪쓽 룊洹좉컪쓣 궗슜븯떎. 理쒓퀬 30遺 耳씠뜕뒪瑜 겕湲곗뿉 뵲씪 3遺꾩쐞濡 遺꾨쪟븯뿬 遺꾩꽍뿉 궗슜븯떎.

4. 궗利앺썑援

궗利앺썑援 諛 愿젴 쐞뿕슂씤 誘멸뎅 援由쎌퐳젅뒪뀒濡ㅺ탳쑁봽濡쒓렇옩(National Cholesterol Education Program)怨 븳鍮꾨쭔븰쉶 鍮꾨쭔 吏꾨즺吏移⑥쓽 궗利앺썑援 吏꾨떒 湲곗쓣 궗슜븯뿬 젙쓽븯떎. 떎쓬쓽 5媛吏 湲곗뿉 뵲씪 궗利앺썑援 쐞뿕슂씤씤 蹂듬鍮꾨쭔, 怨좏삁븬, 怨좏삁떦, 怨좎쨷꽦吏諛⑺삁利, 怨좊룄吏떒諛(high-density lipoprotein, HDL) 삁利앹쓣 媛곴컖 遺꾨쪟븯怨, 씠 以 3媛 씠긽쓽 쐞뿕슂씤쓣 媛吏 긽옄뒗 궗利앺썑援 쑀蹂묒옄濡 遺꾨쪟븯떎26,27: (1) 蹂듬鍮꾨쭔: 뿀由щ몮젅媛 궓꽦 90 cm 씠긽, 뿬꽦 85 cm 씠긽씤 寃쎌슦, (2) 怨좏삁븬: 닔異뺢린 삁븬씠 130 mm Hg 씠긽씠嫄곕굹 씠셿湲 삁븬씠 85 mm Hg 씠긽씠嫄곕굹 怨좏삁븬 移섎즺젣瑜 궗슜 以묒씤 寃쎌슦, (3) 怨좏삁떦: 怨듬났 삁떦씠 100 mg/dL 씠긽씠嫄곕굹 떦눊蹂 移섎즺젣瑜 궗슜 以묒씤 寃쎌슦, (4) 怨좎쨷꽦吏諛⑺삁利: 以묒꽦吏諛⑹씠 150 mg/dL 씠긽씠嫄곕굹 씠긽吏吏덊삁利 移섎즺젣瑜 궗슜 以묒씤 寃쎌슦, (5) HDL삁利: HDL 肄쒕젅뒪뀒濡ㅼ씠 궓꽦 40 mg/dL 誘몃쭔, 뿬꽦 50 mg/dL 誘몃쭔씠嫄곕굹 씠긽吏吏덊삁利 移섎즺젣瑜 궗슜 以묒씤 寃쎌슦.

5. 怨듬씤

蹂 뿰援ъ뿉꽌뒗 蹂댄뻾怨 궗利앺썑援곗쓽 愿젴꽦뿉 쁺뼢쓣 誘몄튌 닔 엳뒗 뿰졊, 꽦蹂, 泥댁쭏웾吏닔(body mass index, BMI), 쓬二 鍮덈룄, 씉뿰 뿬遺, 援먯쑁 닔以, 냼뱷 닔以, 뿉꼫吏 꽠痍⑤웾쓣 옞옱쟻씤 怨듬씤쑝濡 꽑젙븯뿬 遺꾩꽍뿉 룷븿븯떎5,28. 뿰졊, BMI, 뿉꼫吏 꽠痍⑤웾 뿰냽 蹂씤쑝濡 궗슜븯떎. 쓬二 鍮덈룄뒗 “吏湲덇퉴吏 궡븘삤硫댁꽌 1옍 씠긽쓽 닠쓣 留덉떊 쟻씠 엳뒿땲源?” “理쒓렐 1뀈 룞븞 닠쓣 뼹留덈굹 옄二 留덉떗땲源?”씪뒗 꽕臾 臾명빆뿉 븳 쓳떟쓣 湲곗쑝濡 닠쓣 留덉뀛蹂 쟻 뾾쓬, 븳 떖뿉 2–4쉶 씠븯, 씪二쇱씪뿉 2쉶 씠긽쑝濡 踰붿<솕븯떎. 씉뿰 뿬遺뒗 “吏湲덇퉴吏 궡븘삤뒗 룞븞 뵾슫 떞諛곗쓽 뼇 珥 뼹留덈굹 맗땲源?”, “쁽옱 떞諛곕 뵾슦떗땲源?”씪뒗 꽕臾 臾명빆뿉 븳 쓳떟쓣 湲곗쑝濡 誘명씉뿰옄, 怨쇨굅 씉뿰옄, 쁽옱 씉뿰옄濡 遺꾨쪟븯떎. 援먯쑁 닔以 理쒖쥌 븰젰뿉 뵲씪 珥덈벑븰援 議몄뾽 씠븯, 以묓븰援 議몄뾽, 怨좊벑븰援 議몄뾽, 븰援 議몄뾽 씠긽쑝濡 遺꾨쪟븯떎. 냼뱷 닔以 뿰媛 媛援 珥 냼뱷쓣 4遺꾩쐞濡 굹늻뼱 븯, 以묓븯, 以묒긽, 긽쑝濡 遺꾨쪟븯떎. 뿉꼫吏 꽠痍⑤웾 떇뭹꽠痍⑤퉰룄議곗궗瑜 넻빐 궛異쒕맂 1씪 珥 뿉꼫吏 꽠痍⑤웾쓣 궗슜븯떎.

6. 넻怨 遺꾩꽍

뿰援 긽옄쓽 듅꽦 궗利앺썑援 쑀臾대줈 遺꾨쪟븯뿬 굹궡뿀쑝硫, 뿰냽 蹂씤 룊洹좉낵 몴以렪李, 踰붿< 蹂씤 鍮덈룄 鍮꾩쑉쓣 넻빐 湲곗닠븯떎. 蹂댄뻾 닔 諛 蹂댄뻾 媛뺣룄쓽 닔以怨 궗利앺썑援 媛꾩쓽 愿젴꽦쓣 솗씤븯湲 쐞빐 濡쒖뒪떛 쉶洹遺꾩꽍쓣 닔뻾븯떎. 蹂댄뻾 닔 삉뒗 蹂댄뻾 媛뺣룄媛 媛옣 궙 吏묐떒(tertile 1)쓣 湲곗쑝濡 븯뿬 떎瑜 吏묐떒쓽 듅궛鍮꾩 95% 떊猶곌뎄媛꾩쓣 궛異쒗븯떎. 씠뿉 뜑븯뿬 뿰냽 蹂씤 삎깭쓽 蹂댄뻾 닔 諛 蹂댄뻾 媛뺣룄 궗利앺썑援 媛 愿젴꽦쓣 솗씤븯怨좎옄 몴以렪李 떒쐞떦 궗利앺썑援 쑀蹂묐쪧뿉 븳 듅궛鍮꾩 95% 떊猶곌뎄媛꾩쓣 궛異쒗븯떎.

삉븳 궗利앺썑援곗뿉 븳 蹂댄뻾 닔 蹂댄뻾 媛뺣룄쓽 蹂듯빀쟻씤 愿젴꽦쓣 솗씤븯怨좎옄 蹂댄뻾 닔 蹂댄뻾 媛뺣룄쓽 닔以뿉 뵲씪 9媛 吏묐떒쑝濡 遺꾨쪟븯뿬, 蹂댄뻾 닔 蹂댄뻾 媛뺣룄媛 媛옣 궙 吏묐떒쓣 湲곗쑝濡 궗利앺썑援 쑀蹂묒뿉 븳 듅궛鍮꾩 95% 떊猶곌뎄媛꾩쓣 궛異쒗븯떎.

寃 怨

理쒖쥌쟻쑝濡 遺꾩꽍뿉 룷븿맂 2,038紐낆쓽 븳援 꽦씤 궓 以 478紐낆씠 궗利앺썑援 쑀蹂묒옄쑝硫, 씠뒗 빟 23.5%뿉 빐떦븯떎. Table 12뿉꽌뒗 쟾泥 뿰援 李몄뿬옄 븯猷 룊洹 蹂댄뻾 닔 삉뒗 븯猷 理쒓퀬 30遺 耳씠뜕뒪 닔以뿉 뵲씪 3遺꾩쐞濡 遺꾨쪟븳 吏묐떒蹂 씤援ы넻怨꾩쟻 듅꽦쓣 굹궡뿀떎. 쟾泥 뿰援 李몄뿬옄쓽 룊洹 뿰졊 47.7꽭(±15.3꽭)쑝硫, 쟾泥 씤썝 以 빟 62.8%媛 뿬꽦씠뿀떎. 룊洹 BMI뒗 23.7 kg/m2 (±3.4 kg/m2)쑝硫, 뿰援 李몄뿬옄쓽 빟 67.9%뒗 씉뿰 寃쏀뿕씠 뾾뿀떎. 뿰援 李몄뿬옄 以 빟 81.5%媛 二쇰떦 1쉶 誘몃쭔쓽 쓬二쇰 븯쑝硫, 빟 77.0%媛 怨좊벑븰援 議몄뾽 씠긽쓽 븰젰쓣 蹂댁쑀븯떎. 븯猷 珥 뿉꼫吏 꽠痍⑤웾쓽 쟾泥 룊洹좎 2,065.7 kcal (±919.1 kcal)쑝硫, 븯猷 룊洹 蹂댄뻾웾 빟 7,654.6蹂(±3,517.4蹂), 븯猷 룊洹 理쒓퀬 30遺 耳씠뜕뒪뒗 80.9 (±24.5)뿉 빐떦븯떎.

Table 1 . Characteristics of study participants by tertiles of steps per day

CharacteristicTotalTertiles of steps per day
Tertile 1 (lowest)Tertile 2Tertile 3 (highest)
No. of subjects2,038674681683
Age (yr)47.7±15.348.2±16.246.5±14.748.5±14.8
Female sex1,279 (62.8)456 (67.7)433 (63.6)390 (57.1)
Body mass index (kg/m2)23.7±3.423.7±3.723.9±3.423.6±2.9
Smoking status
Never1,384 (67.9)466 (69.1)469 (68.9)449 (65.7)
Past smoker401 (19.7)118 (17.5)133 (19.5)150 (22.0)
Current smoker253 (12.4)90 (13.4)79 (11.6)84 (12.3)
Alcohol drinking
Never222 (10.9)82 (12.2)72 (10.6)68 (10.0)
≤Once a week1,438 (70.6)471 (69.9)481 (70.6)486 (71.2)
>Once a week378 (18.5)121 (18.0)128 (18.8)129 (18.9)
Education level
≤Elementary school270 (10.2)93 (13.8)81 (11.9)96 (14.1)
Middle school199 (9.8)61 (9.1)67 (9.8)71 (10.4)
High school765 (37.5)224 (33.2)260 (38.2)281 (41.1)
>High school804 (39.5)296 (43.9)273 (40.1)235 (34.4)
Household income
Quartile 1 (lowest)244 (12.0)105 (15.6)76 (11.2)63 (9.2)
Quartile 2553 (27.1)190 (28.2)187 (27.5)176 (25.8)
Quartile 3632 (31.0)198 (29.4)215 (31.6)219 (32.1)
Quartile 4 (highest)609 (29.9)181 (26.9)203 (29.8)225 (32.9)
Energy intake (kcal/day)2,065.7±919.11,910.9±783.42,065.7±930.12,218.4±1,004.1
Steps per day (steps/day)7,654.6±3,517.44,294.5±1,194.37,172.3±791.211,451.2±3,015.9
Peak 30-min cadence (steps/min)80.9±24.557.9±18.683.6±15.5100.9±16.8

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


Table 2 . Characteristics of study participants by tertiles of peak 30-min cadence

CharacteristicTotalTertiles of peak 30-min cadence
Tertile 1 (lowest)Tertile 2Tertile 3 (highest)
No. of subjects2,038680671687
Age (yr)47.7±15.348.8±15.247.5±14.446.9±16.2
Female1,279 (62.8)442 (65.0)397 (59.2)440 (64.0)
Body mass index (kg/m2)23.7±3.424.1±3.823.8±3.223.3±3.1
Smoking status
Never1,384 (67.9)442 (65.0)443 (66.0)499 (72.6)
Past smoker401 (19.7)139 (20.4)136 (20.3)126 (18.3)
Current smoker253 (12.4)99 (14.6)92 (13.7)62 (9.0)
Alcohol drinking
Never222 (10.9)88 (12.9)69 (10.3)65 (9.5)
≤Once a week1,438 (70.6)450 (66.2)479 (71.4)509 (74.1)
>Once a week378 (18.5)142 (20.9)123 (18.3)113 (16.4)
Education level
≤Elementary school270 (10.2)108 (15.9)83 (12.4)79 (11.5)
Middle school199 (9.8)72 (10.6)65 (9.7)62 (9.0)
High school765 (37.5)245 (36.0)249 (37.1)271 (39.4)
>High school804 (39.5)255 (37.5)274 (40.8)275 (40.0)
Household income
Quartile 1 (lowest)244 (12.0)103 (15.1)74 (11.0)67 (9.8)
Quartile 2553 (27.1)212 (31.2)169 (25.2)172 (25.0)
Quartile 3632 (31.0)194 (28.5)213 (31.7)225 (32.8)
Quartile 4 (highest)609 (29.9)171 (25.1)215 (32.0)223 (32.5)
Energy intake (kcal/day)2,065.7±919.12,005.9±899.42,048.9±890.02,141.3±961.6
Steps per day (steps/day)7,654.6±3,517.44,877.5±1,930.67,592.2±2,548.710,464.3±3,339.1
Peak 30-min cadence (steps/min)80.9±24.553.3±13.982.1±6.5107.1±10.3

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



Table 3뿉꽌뒗 蹂댄뻾 닔쓽 3遺꾩쐞 吏묐떒 以 媛옣 쟻 吏묐떒쓣 湲곗쑝濡 蹂댄뻾 닔媛 뜑 留롮 吏묐떒쓽 궗利앺썑援 쑀蹂묐쪧뿉 븳 듅궛鍮꾩 95% 떊猶곌뎄媛꾩쓣 궛異쒗븯뿬 굹궡뿀떎. 옞옱쟻 怨듬씤쓣 蹂댁젙븯吏 븡怨 遺꾩꽍븳 寃곌낵, 븯猷 룊洹 蹂댄뻾 닔媛 媛옣 쟻 吏묐떒(tertile 1)뿉 鍮꾪빐 以묎컙 닔以쓽 吏묐떒怨 蹂댄뻾 닔媛 媛옣 留롮 吏묐떒쓽 듅궛鍮(95% 떊猶곌뎄媛)뒗 媛곴컖 0.99 (0.77–1.26), 0.64 (0.49–0.83)濡 굹궗떎. 遺꾩꽍 紐⑤뜽 2 3뿉꽌뒗 怨듬씤쓣 蹂댁젙븯뿬 遺꾩꽍븯쓬뿉룄 듅궛鍮꾨뒗 遺꾩꽍 紐⑤뜽 1怨 쑀궗븯寃 굹궗떎. 異붽濡 紐⑤뱺 옞옱쟻 怨듬씤쓣 蹂댁젙븯쓣 븣, 蹂댄뻾 닔쓽 1 몴以렪李 떒쐞떦 궗利앺썑援 쑀蹂묒뿉 븳 듅궛鍮꾨뒗 0.80 (0.79–0.91)쑝濡 굹궗떎.

Table 3 . ORs and 95% CIs of metabolic syndrome by tertiles of steps per day

VariableNo. of subjectsNo. of casesOR (95% CI)
Model 1Model 2Model 3
Steps per day2,038478
Tertile 1 (lowest)6741761 (Reference)1 (Reference)1 (Reference)
Tertile 26811760.99 (0.77−1.26)1.09 (0.84−1.40)1.06 (0.79−1.42)
Tertile 3 (highest)6831260.64 (0.49−0.83)0.61 (0.47−0.80)0.64 (0.47−0.88)
p-value for trend<0.001<0.0010.005
Per SD in steps per day0.79 (0.70−0.88)0.77 (0.69−0.87)0.80 (0.70−0.91)

Model 1 was unadjusted. Model 2 was adjusted for sex and age. Model 3 was adjusted for Model 2 plus body mass index, smoking status, alcohol drinking status, education level, household income level, and energy intake.

OR: odds ratio, CI: confidence interval, SD: standard deviation.

A 1 SD in steps per day is equivalent to 3,517.4 steps/day.



Table 4뿉꽌뒗 理쒓퀬 30遺 耳씠뜕뒪쓽 3遺꾩쐞 吏묐떒 以 媛옣 궙 吏묐떒쓣 湲곗쑝濡 理쒓퀬 30遺 耳씠뜕뒪媛 뜑 넂 吏묐떒쓽 궗利앺썑援 쑀蹂묐쪧뿉 븳 듅궛鍮꾩 95% 떊猶곌뎄媛꾩쓣 굹궡뿀떎. 遺꾩꽍 寃곌낵, 怨듬씤쓣 蹂댁젙븯吏 븡븯嫄곕굹 꽦蹂 諛 뿰졊留 蹂댁젙븳 遺꾩꽍 紐⑤뜽 1怨 2뿉꽌뒗 理쒓퀬 30遺 耳씠뜕뒪媛 媛옣 궙 吏묐떒뿉 鍮꾪빐 媛옣 넂 吏묐떒쓽 궗利앺썑援 쑀蹂묒쓽 듅궛鍮꾧 쑀쓽븯寃 궙븯떎. 洹몃윭굹, 옞옱쟻 怨듬씤쓣 蹂댁젙븳 遺꾩꽍 紐⑤뜽 3뿉꽌뒗 쑀쓽븳 愿젴꽦씠 굹굹吏 븡븯떎. 諛섎㈃ 紐⑤뱺 옞옱쟻 怨듬씤쓣 蹂댁젙븯쓣 븣, 理쒓퀬 30遺 耳씠뜕뒪쓽 1 몴以렪李 떒쐞떦 궗利앺썑援 쑀蹂묒뿉 븳 듅궛鍮꾨뒗 0.86 (0.76–0.97)쑝濡 굹궗떎.

Table 4 . ORs and 95% CIs of metabolic syndrome by tertiles of peak 30-min cadence

VariableNo. of subjectsNo. of casesOR (95% CI)
Model 1Model 2Model3
Peak 30-min cadence2,038478
Tertile 1 (lowest)6801931 (Reference)1 (Reference)1 (Reference)
Tertile 26711600.79 (0.62−1.01)0.83 (0.64−1.07)1.02 (0.76−1.36)
Tertile 3 (highest)6871250.56 (0.43−0.72)0.57 (0.43−0.74)0.74 (0.55−1.01)
p-value for trend<0.001<0.0010.061
Per SD in peak 30-min cadence0.76 (0.69−0.84)0.77 (0.69−0.85)0.86 (0.76−0.97)

Model 1 was unadjusted. Model 2 was adjusted for sex and age. Model 3 was adjusted for Model 2 plus body mass index, smoking status, alcohol drinking status, education level, household income level, and energy intake.

OR: odds ratio, CI: confidence interval, SD: standard deviation.

A 1 SD in peak 30-min cadence is equivalent to 24.5 steps/min.



蹂댄뻾웾, 蹂댄뻾 媛뺣룄 궗利앺썑援 媛꾩쓽 蹂듯빀쟻씤 愿젴꽦쓣 솗씤븯怨좎옄 蹂댄뻾 닔뿉 뵲씪 굹늿 3遺꾩쐞 吏묐떒怨 理쒓퀬 30遺 耳씠뜕뒪쓽 겕湲곗뿉 뵲씪 굹늿 3遺꾩쐞 吏묐떒쓣 議고빀븯뿬 9媛쒖쓽 吏묐떒쑝濡 遺꾨쪟븳 뮘, 蹂댄뻾웾씠 媛옣 쟻嫄곕굹 蹂댄뻾 媛뺣룄媛 媛옣 궙 吏묐떒쓣 湲곗쑝濡 떎瑜 吏묐떒쓽 듅궛鍮꾩 95% 떊猶곌뎄媛꾩쓣 궛異쒗븯떎(Fig. 1). 洹 寃곌낵, 蹂댄뻾웾怨 蹂댄뻾 媛뺣룄媛 紐⑤몢 궙 吏묐떒怨 鍮꾧탳븯뿬 蹂댄뻾웾씠 留롮 吏묐떒 以 蹂댄뻾 媛뺣룄媛 궙 吏묐떒쓣 젣쇅븳 몢 吏묐떒뿉꽌 쑀쓽븯寃 궙 듅궛鍮꾧 굹궗떎. 蹂댄뻾웾씠 留롮쑝硫 蹂댄뻾 媛뺣룄媛 以묎컙 닔以씤 吏묐떒쓽 듅궛鍮(95% 떊猶곌뎄媛)뒗 0.58 (0.36–0.94)씠뿀쑝硫, 蹂댄뻾웾씠 留롮쑝硫 蹂댄뻾 媛뺣룄 삉븳 넂 吏묐떒 0.66 (0.49–0.94)쑝濡 굹궗떎.

Fig. 1. Joint associations between step volume and intensity with the prevalence of metabolic syndrome in Korean adults. OR: odds ratio, CI: confedince interval.

蹂댄뻾웾씠 3遺꾩쐞뿉 빐떦븯硫 蹂댄뻾 媛뺣룄媛 1遺꾩쐞씤 吏묐떒쓽 듅궛鍮(95% 떊猶곌뎄媛)뒗 0.40 (0.14–1.02), 蹂댄뻾 媛뺣룄媛 2遺꾩쐞씤 吏묐떒 0.58 (0.36–0.94), 洹몃━怨 蹂댄뻾 媛뺣룄媛 3遺꾩쐞씤 吏묐떒 0.66 (0.46–0.94)쑝濡 굹굹, 븯猷 룊洹 蹂댄뻾 닔媛 留롮쑝硫 理쒓퀬 30遺 耳씠뜕뒪뒗 以묎컙 닔以씠嫄곕굹 넂쓣 寃쎌슦뿉 湲곗 吏묐떒뿉 鍮꾪빐 궗利앺썑援 쑀蹂묒뿉 븳 듅궛鍮꾧 쑀쓽븯寃 궙寃 굹궗떎. 蹂댄뻾웾씠 궙嫄곕굹 以묎컙 닔以씤 吏묐떒 蹂댄뻾 媛뺣룄 臾닿븯寃 紐⑤뱺 吏묐떒쓽 듅궛鍮꾨뒗 湲곗 吏묐떒怨 쑀쓽븳 李⑥씠媛 굹굹吏 븡븯떎.

怨 李

蹂 뿰援ъ뿉꽌뒗 媛냽룄怨꾨 솢슜븯뿬 媛앷쟻쑝濡 닔吏묓븳 븳援 꽦씤 궓쓽 蹂댄뻾웾 諛 蹂댄뻾 媛뺣룄 궗利앺썑援 媛꾩쓽 愿젴꽦쓣 솗씤븯떎. 씠瑜 쐞빐 蹂댄뻾웾, 蹂댄뻾 媛뺣룄 궗利앺썑援곗쓽 媛쒕퀎쟻씤 愿젴꽦쓣 솗씤븯怨, 蹂댄뻾웾, 蹂댄뻾 媛뺣룄 궗利앺썑援 媛꾩쓽 蹂듯빀쟻씤 愿젴꽦쓣 솗씤븯떎. 蹂 뿰援ъ쓽 寃곌낵뒗 떎쓬怨 媛숇떎. 泥レ㎏, 뜑 留롮 蹂댄뻾웾 궙 궗利앺썑援 쑀蹂묐쪧怨 쑀쓽븳 愿젴씠 엳뿀떎. 몮吏, 蹂댄뻾 媛뺣룄뒗 궗利앺썑援 쑀蹂묐쪧怨 쑀쓽븳 愿젴씠 굹굹吏 븡븯떎. 留덉留됱쑝濡, 留롮 蹂댄뻾웾 궙 궗利앺썑援 쑀蹂묐쪧怨 愿젴씠 엳뿀쑝굹, 궙 蹂댄뻾 媛뺣룄뿉꽌뒗 쑀쓽븳 愿젴꽦씠 굹굹吏 븡븯떎.

蹂댄뻾웾怨 궗利앺썑援 쑀蹂묐쪧 媛꾩쓽 遺쟻 愿젴꽦뿉 빐꽌뒗 씠쟾뿉 닔뻾맂 떎瑜 뿰援щ뱾룄 룞씪븳 寃곌낵瑜 蹂닿퀬븯떎16,29-31. 誘멸뎅 꽦씤 1,500뿬 紐낆쓣 긽쑝濡 媛냽룄怨꾨 씠슜븯뿬 1씪 蹂댄뻾웾쓣 痢≪젙븳 寃곌낵, 1씪 蹂댄뻾웾씠 1,000蹂댁뵫 留롮쓣닔濡 궗利앺썑援곗쓽 듅궛鍮꾧 10%뵫 궙븯쑝硫16, 留뚮낫怨꾨 궗슜븯뿬 誘멸뎅씤怨 씪蹂몄씤 꽦씤 궓꽦쓽 蹂댄뻾웾쓣 遺꾩꽍븳 뿰援ъ뿉꽌룄 뜑 留롮 蹂댄뻾웾 뜑 궙 궗利앺썑援 쑀蹂묎낵 愿젴씠 엳떎뒗 寃곌낵瑜 蹂닿퀬븯떎31. 씠윭븳 뿰援 寃곌낵瑜 醫낇빀븳 理쒓렐쓽 泥닿퀎쟻 臾명뿄怨좎같 寃곌낵, 紐⑤뱺 愿李 뿰援ъ뿉꽌 씪愿맂 遺쟻 愿젴꽦쓣 蹂닿퀬븯뿬 슦由ъ쓽 뿰援 寃곌낵瑜 뮮諛쏆묠븳떎29.

씠 諛섎濡, 理쒓퀬 30遺 耳씠뜕뒪 媛믪쑝濡 굹궦 蹂댄뻾 媛뺣룄뒗 궗利앺썑援 쑀蹂묐쪧怨 쑀쓽븳 愿젴꽦씠 굹굹吏 븡븯떎. 씠뒗 씠쟾쓽 쑀궗븳 뿰援ъ뿉꽌 蹂닿퀬븳 寃곌낵뱾怨쇰뒗 긽諛섎맂 寃곌낵씠떎. 60꽭 씠긽쓽 끂씤 吏묐떒쓣 긽쑝濡 븳 뿰援ъ뿉꽌뒗 理쒕 30遺 耳씠뜕뒪 궗利앺썑援 젏닔 媛꾩쓽 쑀쓽븳 遺쟻 愿젴꽦쓣 蹂닿퀬븯쑝硫32, 理쒕 30遺 耳씠뜕뒪뒗 뿀由щ몮젅, 씤뒓由, HDL, 삁븬 벑 궗吏덊솚 쐞뿕슂씤怨 쑀쓽븳 愿젴씠 엳떎怨 굹굹33,34, 넂 蹂댄뻾 媛뺣룄媛 궗吏덊솚 쑀蹂묎낵 遺쟻 愿젴꽦쓣 媛吏꾨떎뒗 寃곌낵瑜 蹂댁떎. 떎留, 슦由ъ쓽 뿰援ъ 룞씪븳 궗利앺썑援 쑀蹂묒쓣 솗씤븳 뿰援щ뒗 뾾뼱 吏곸젒쟻씤 寃곌낵瑜 鍮꾧탳븯湲곕뒗 뼱졄떎.

理쒓렐쓽 떊泥댄솢룞 吏移⑥뿉꽌뒗 以묎컯룄 씠긽쓽 쑀궛냼꽦 떊泥댄솢룞뿉 李몄뿬븯湲곕 沅뚭퀬븯뒗뜲6, 以묎컯룄 씠긽쓽 蹂댄뻾 솢룞 遺꾨떦 100蹂 씠긽쓽 耳씠뜕뒪뿉 빐떦븳떎35. 슦由ъ쓽 뿰援ъ뿉꽌뒗 理쒕 30遺 耳씠뜕뒪媛 媛옣 넂 吏묐떒쓽 理쒕 30遺 耳씠뜕뒪쓽 룊洹좎 遺꾨떦 빟 107.1蹂댁뿉 빐떦븯뿬, 룊洹좎쟻쑝濡 以묎컯룄뿉 빐떦븳떎뒗 寃껋쓣 븣 닔 엳떎. 뵲씪꽌, 理쒕 30遺 耳씠뜕뒪媛 넂 吏묐떒 룊洹좎쟻쑝濡 븯猷 以 30遺 씠긽쓣 以묎컯룄 씠긽쓽 떊泥댄솢룞뿉 李몄뿬븳떎怨 蹂 닔 엳쑝硫, 씠뒗 씠쟾쓽 떊泥댄솢룞 吏移⑥쓽 湲곗쓣 異⑹”븯뒗 닔移섏뿉 빐떦븳떎36. 寃뚮떎媛, 떖옣궗吏덊솚 쐞뿕뿉 븳 理쒓퀬 30遺 耳씠뜕뒪쓽 엫怨꾧컪쓣 議곗궗븳 뿰援ъ뿉꽌뒗 遺꾨떦 66–72蹂댁쓽 耳씠뜕뒪뿉꽌 떖옣궗吏덊솚 쐞뿕씠 궙븘吏꾨떎뒗 寃곌낵瑜 蹂닿퀬븯뿬19 理쒕 30遺 耳씠뜕뒪媛 넂 吏묐떒뿉꽌 쑀쓽븯寃 궙 궗利앺썑援 쑀蹂묐쪧씠 굹궇 寃껋쑝濡 삁긽븯쑝굹, 蹂 뿰援ъ뿉꽌뒗 쑀쓽븳 愿젴꽦씠 굹굹吏 븡븯떎.

씠윭븳 寃곌낵쓽 썝씤쓣 紐낇솗엳 꽕紐낇븯湲곕뒗 뼱졄떎. 떎留 Table 4뿉꽌 굹궃 諛붿 媛숈씠, 理쒓퀬 30遺 耳씠뜕뒪媛 1 몴以렪李 넂븘吏 븣留덈떎 궗利앺썑援 쑀蹂묒쓽 듅궛鍮꾨뒗 0.14뵫 쑀쓽븯寃 媛먯냼븯뒗 寃껋쑝濡 굹굹, 踰붿<삎 蹂닔濡 굹궦 寃곌낵뒗 떎瑜 寃곌낵瑜 蹂댁떎. 삉븳, 蹂 뿰援ъ뿉꽌 蹂꾨룄쓽 寃곌낵瑜 젣떆븯吏뒗 븡븯쑝굹, 理쒓퀬 30遺 耳씠뜕뒪瑜 3遺꾩쐞媛 븘땶 4遺꾩쐞, 5遺꾩쐞濡 遺꾨쪟븯뿬 遺꾩꽍뻽쓣 븣 理쒓퀬 30遺 耳씠뜕뒪媛 媛옣 넂 吏묐떒뿉꽌留 쑀쓽븯寃 궙 듅궛鍮꾨 蹂댁뿬, 뜑 넂 蹂댄뻾 媛뺣룄뿉꽌뒗 쑀쓽븳 愿젴꽦씠 굹궇 寃껋쑝濡 삁긽맂떎. 씠뒗 3遺꾩쐞濡 굹늿 蹂댄뻾 媛뺣룄媛 吏묐떒蹂 李⑥씠瑜 蹂댁씠湲곗뿉 異⑸텇븯吏 븡븯湲 븣臾몄씪 닔 엳쑝硫, 뼢썑 궗利앺썑援 쑀蹂묐쪧씠 쑀쓽븯寃 궙寃 굹굹뒗 쟻젙 蹂댄뻾 媛뺣룄뿉 븳 異붽 뿰援щ 넻븳 솗씤씠 븘슂븯떎.

蹂 뿰援ъ뿉꽌뒗 蹂댄뻾 솢룞쑝濡 遺꾩꽍븳 떊泥댄솢룞쓽 뼇怨 媛뺣룄쓽 궗利앺썑援 媛 蹂듯빀쟻씤 愿젴꽦쓣 솗씤븯怨좎옄 븯쑝硫, 蹂댄뻾웾씠 留롮 吏묐떒뿉꽌 蹂댄뻾 媛뺣룄媛 以묎컙 닔以씠嫄곕굹 넂 吏묐떒뿉꽌 쑀쓽븯寃 궙 궗利앺썑援곗쓽 듅궛鍮꾨 솗씤븯떎. 슦由ш 븘뒗 븳 븘吏곴퉴吏 씠 뿰援ъ 룞씪븯寃 蹂댄뻾웾怨 蹂댄뻾 媛뺣룄瑜 紐⑤몢 怨좊젮븯뿬 궗利앺썑援곌낵쓽 蹂듯빀쟻씤 愿젴꽦쓣 솗씤븳 뿰援щ뒗 뾾떎. 洹몃윭굹, 떊泥댄솢룞웾씠 留롪퀬 媛뺣룄媛 넂쓣 寃쎌슦뿉 뜑슧 留롮 嫄닿컯긽쓽 씠젏쓣 뼸쓣 닔 엳떎뒗 寃껋 씡엳 븣젮吏 궗떎씠떎7. 씠뿉 뵲씪 理쒓렐쓽 떊泥댄솢룞 吏移⑥뿉꽌뒗 以묎컯룄 씠긽쓽 떊泥댄솢룞뿉 씪젙 떆媛 씠긽 李멸븯湲곕 沅뚭퀬븯怨 엳떎6. Fig. 1뿉꽌 굹궦 諛붿 媛숈씠, 蹂댄뻾웾씠 留롮 3媛쒖쓽 吏묐떒 以 蹂댄뻾 媛뺣룄媛 궙 吏묐떒쓽 理쒓퀬 30遺 耳씠뜕뒪쓽 룊洹좎 遺꾨떦 64.0蹂대줈 굹궗쑝硫, 蹂댄뻾 媛뺣룄媛 以묎컙씤 吏묐떒 遺꾨떦 84.1蹂, 넂 吏묐떒 遺꾨떦 109.5蹂대줈 굹궗떎. 씪諛섏쟻쑝濡 遺꾨떦 100蹂 씠긽쓽 蹂댄뻾 냽룄媛 以묎컯룄뿉 빐떦븯誘濡, 遺꾨떦 60蹂댁쓽 蹂댄뻾냽룄뒗 씪떆쟻씤 吏곸엫 샊 留ㅼ슦 뒓由 蹂댄뻾뿉 빐떦븳떎18. 뵲씪꽌, 蹂댄뻾웾씠 留롮쑝굹 蹂댄뻾 媛뺣룄媛 궙 吏묐떒 븯猷 以 理쒓퀬濡 넂 媛뺣룄 닔뻾븳 솢룞씠 뒓由 蹂댄뻾뿉 빐떦븯誘濡 씪긽깮솢 以 솢룞씠 媛뺣룄濡쒕쭔 援ъ꽦릺뼱 엳떎뒗 寃껋쓣 굹궦떎. 諛섎㈃, 蹂댄뻾 媛뺣룄媛 以묎컙씠嫄곕굹 넂 吏묐떒 留롮 蹂댄뻾웾怨 븿猿 긽쟻쑝濡 넂 媛뺣룄쓽 솢룞뱾씠 룷븿릺뼱 엳뼱꽌 궙 궗利앺썑援 쑀蹂묐쪧씠 굹궃 寃껋쑝濡 깮媛곷맂떎. 諛섎㈃, 蹂댄뻾 媛뺣룄뒗 넂쑝굹 蹂댄뻾웾씠 以묎컙 닔以씠嫄곕굹 궙 吏묐떒뿉꽌뒗 쑀쓽븳 愿젴꽦씠 굹굹吏 븡븯떎. 몢 吏묐떒쓽 룊洹 蹂댄뻾 媛뺣룄뒗 遺꾨떦 100蹂 궡쇅濡 룊洹좎쟻쑝濡 以묎컯룄뿉 빐떦븯쑝굹, 븯猷 룊洹 蹂댄뻾웾씠 媛곴컖 5,266.9蹂, 7,572.3蹂대줈 굹굹, 궗利앺썑援 쑀蹂묐쪧쓣 궙異붽린 쐞빐꽌뒗 蹂댄뻾웾怨 蹂댄뻾 媛뺣룄瑜 紐⑤몢 怨좊젮빐빞 븿쓣 떆궗븳떎.

슦由ш 븘뒗 븳, 蹂 뿰援щ뒗 븳援 꽦씤쓣 긽쑝濡 媛냽룄怨꾨줈 痢≪젙븳 蹂댄뻾웾 諛 蹂댄뻾 媛뺣룄 궗利앺썑援 媛꾩쓽 愿젴꽦쓣 遺꾩꽍븳 理쒖큹쓽 뿰援ъ씠硫, 꽕臾 옄猷뚮 二쇰줈 솢슜븳 씠쟾쓽 뿰援ъ 떖由 媛앷쟻쑝濡 닔吏묓븳 蹂댄뻾 옄猷뚮 궗슜븳 뿰援щ씪뒗 젏뿉꽌 媛뺤젏쓣 媛吏꾨떎. 븯吏留 紐 媛吏 젣븳젏룄 媛吏怨 엳떎. 癒쇱, 媛냽룄怨 怨좎옣 쐞뿕쑝濡 씤빐 깶썙 샊 닔以 솢룞 떆뿉 李⑹슜쓣 젣븳븯湲 븣臾몄뿉 씪遺 솢룞쓽 뜲씠꽣뒗 蹂 뿰援 옄猷뚯뿉꽌 늻씫릺뿀떎. 삉븳, 媛냽룄怨 옄泥댁쓽 삤瑜섎줈 씤빐 솢룞 뜲씠꽣媛 삩쟾엳 닔吏묐릺吏 紐삵븯怨 늻씫릺뿀쓣 媛뒫꽦룄 엳떎. 몮吏몃줈, 蹂 뿰援ъ뿉꽌뒗 理쒖냼 4씪 씠긽, 理쒕 7씪 궡 쑀슚븳 궇쓽 媛냽룄怨 뜲씠꽣瑜 遺꾩꽍븯쑝誘濡 媛쒖씤쓽 룊긽떆 떎젣 蹂댄뻾 뒿愿씠 젙솗엳 諛섏쁺릺뿀떎怨 븷 닔 뾾쑝硫, 꽑뻾뿰援щ 洹쇨굅濡 10떆媛 씠긽 李⑹슜븳 뜲씠꽣瑜 쑀슚븳 媛믪쑝濡 遺꾨쪟븯뿬 遺꾩꽍뿉 룷븿븯쑝굹 媛쒖씤蹂 李⑹슜 떆媛꾩뿉 李⑥씠媛 엳쑝誘濡 뜲씠꽣쓽 렪뼢씠 엳쓣 닔 엳떎뒗 젣븳젏쓣 媛吏꾨떎. 뀑吏몃줈, 媛냽룄怨꾨 李⑹슜븷 寃껋뿉 룞쓽븳 뿰援 李몄뿬옄뱾쓽 옄猷뚮 遺꾩꽍븯쑝誘濡 蹂 뿰援ъ쓽 寃곌낵媛 븳援 꽦씤 쟾泥대 몴븳떎怨 蹂닿린 뼱졄떎. 삉븳 옄諛쒖쟻쑝濡 媛냽룄怨꾨 李⑹슜븳 긽옄瑜 紐⑥쭛븯湲 븣臾몄뿉 寃곌낵쓽 렪뼢씠 議댁옱븷 닔 엳떎. 꽬吏몃줈, 떊泥댄솢룞쓽 紐⑹쟻뿉 뵲씪 궗利앺썑援곗뿉 誘몄튂뒗 쁺뼢씠 떎瑜 닔 엳떎. 吏곸뾽쟻 솢룞뿉 鍮꾪빐 뿬媛 솢룞씠 嫄닿컯긽 뜑 씠뱷쓣 빞湲고븯뒗 寃껋쑝濡 굹궃떎37. 蹂 뿰援ъ뿉꽌 솢슜븳 媛냽룄怨 뜲씠꽣뒗 媛쒖씤蹂 蹂댄뻾 솢룞쓽 紐⑹쟻쓣 遺꾨쪟븷 닔 뾾쑝誘濡, 씠윭븳 李⑥씠瑜 뿰援 寃곌낵뿉 諛섏쁺븷 닔 뾾뿀떎. 留덉留됱쑝濡, 蹂 뿰援щ뒗 슒떒뿰援ъ씠誘濡 蹂댄뻾웾 諛 媛뺣룄 궗利앺썑援 媛꾩쓽 씤怨쇨怨꾨 꽕紐낇븷 닔 뾾뼱, 뼢썑뿉뒗 肄뷀샇듃 뿰援щ 넻빐 몢 蹂씤 媛꾩쓽 紐낇솗븳 씤怨쇨怨꾨 遺꾩꽍븯뒗 寃껋씠 븘슂븯떎.

寃곕줎쟻쑝濡, 蹂 뿰援ъ뿉꽌뒗 媛냽룄怨꾨 궗슜븯뿬 媛앷쟻쑝濡 닔吏묓븳 븳援 꽦씤쓽 蹂댄뻾웾, 蹂댄뻾 媛뺣룄 궗利앺썑援 媛꾩쓽 룆由쎌쟻, 蹂듯빀쟻 愿젴꽦쓣 遺꾩꽍븯떎. 洹 寃곌낵, 留롮 蹂댄뻾웾 궙 궗利앺썑援 쑀蹂묎낵 愿젴씠 엳뿀쑝굹, 蹂댄뻾 媛뺣룄뒗 궗利앺썑援 쑀蹂묎낵 愿젴씠 뾾뿀떎. 蹂댄뻾웾怨 蹂댄뻾 媛뺣룄瑜 蹂듯빀쟻쑝濡 遺꾩꽍븳 寃곌낵, 蹂댄뻾웾씠 留롮 吏묐떒뿉꽌 긽쟻쑝濡 궙 궗利앺썑援 쑀蹂묐쪧쓣 蹂댁쑝굹, 蹂댄뻾 媛뺣룄媛 궙 吏묐떒뿉꽌뒗 愿젴꽦씠 굹굹吏 븡븯떎. 씠뒗 궗利앺썑援 쑀蹂묐쪧쓣 궙異붽린 쐞빐꽌뒗 蹂댄뻾웾怨 蹂댄뻾 媛뺣룄媛 紐⑤몢 怨좊젮빐빞 븿쓣 떆궗븯吏留, 뼢썑 醫낅떒꽕怨꾩쓽 뿰援щ 넻빐 씤怨쇨怨꾨 솗씤븷 븘슂媛 엳떎.

Conflict of Interest

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

Acknowledgments

This work was supported by Seoul National University Research Grant in 2021.

Author Contributions

Conceptualization, Formal analysis, Funding acquisition, Methodology: all authors. Data curation: YSK, GK, JKR. Inves-tigation: HS. Project administration, Supervision: YSK, SH. Resources: SH. Visualization: GK, HS. Writing–original draft: YSK, GK, HS. Writing–review & editing: YSK, HS, BCK, JKR, SH.

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