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1 Journal of the Korea Academia-Industrial cooperation Society Vol. 19, No. 12 pp , ISSN / eissn 손원목, 오덕자 * 부산대학교체육교육과 Effects of circulation exercise on Health Related Fitness and metabolic syndrome risk factors in obese middle age women Won-Mok Son, Deuk-Ja Oh * Department of Physical Education, Pusan National University 요약본연구의목적은 12주간을알아보기위하여실시하였다. BMI 25 kg/m 2 이상인 40대비만중년여성중순환운동군 (10명), 대조군 (10명) 으로총 20명을대상으로실시하였으며, 모든검사항목은동일한방법과조건으로건강체력및대사증후군관련인자대하여사전, 사후총 2회측정하였다. 순환운동은 12주간, 주3회, 30~40분, 60~80%HRR 강도로실시하였다. 측정변인에대해평균값과표준편차 (M±SD) 를산출한후사전운동군과대조군의신체적특성과각측정변인에대한동질성검정을위하여독립 t-test를, 집단내의사전 사후평균치변화에대한차이검증은종속 t-test를, 집단간차이에대한주효과검정및집단간시기간상호작용효과는반복측정분산분석을이용하였다. 건강체력에서체지방률 (p<.01) 은유의하게감소하였으며, 제지방량 (p<.05), 근지구력 (p<.01), 유연성 (p<.01) 및심폐지구력 (p<.001) 은유의하게증가하였다. 대사증후군위험인자중허리둘레 (p<.05), SBP(p<.05), Glucose(p<.05) 및 TG(p<.001) 는유의하게감소하였으며, HDL-C(p<.001) 는유의하게증가하였다. 순환운동이비만중년여성의건강체력및대사증후군위험인자의개선에도움을줄수있을것으로사료된다. Abstract The purpose of this study was to investigate the effects of circulation exercise on health related fitness and metabolic syndrome risk factors obese in middle age women. Twenty, obese middle age women(bmi<25 kg/m 2 ) composed of circulation exercise group(ex, n=10), the control group(con, n=10). The variables of health related fitness, metabolic syndrome risk factors were measured in all the subjects before the start and after the end of 12 week circulation exercise program(60~80 %HRR, 3 times per week, 30~40 mins). The test data were analyzed by paired t-test and repeated ANOVA, and the alpha level of p<.05 was set for all tests of significance. Health related fitness and metabolic syndrome risk factors were measured pre and 12 weeks of post exercise training. %body fat(p <.01) was significantly decreased in EX group compared to CON group. LBM(p <.05), muscular endurance(p <.05), flexibility(p <.05) and cardiorespiratory endurance(p <.001) were significantly increased in EX group compared to CON group. WC(p <.05), SBP(p <.01), DBP(p <.05), Glucose(p <.05) and TG(p <.05) were significantly decreased in EX group compared to CON group. HDL-C(p <.01) was significantly increased in EX group compared to CON group. These results suggest that 12 weeks of circulation exercise training improves health related fitness and metabolic syndrome risk factors. Thus, this newly proposed circulation exercise modality can be a useful therapy to improve both health related fitness and metabolic syndrome risk factors in obese middle age women. Keywords : Circulation exercise, health related fitness, middle age women, metabolic syndrome, obese * Corresponding Author : Deuk-Ja Oh(Pusan National Univ.) Tel: podj2004@pusan.ac.kr Received September 12, 2018 Revised (1st October 11, 2018, 2nd October 23, 2018) Accepted December 7, 2018 Published December 31,

2 1. 서론중년여성은젊은성인에서노년의시기로넘어가는단계로갱년기및폐경등과같은다양한신체적변화가발생하면서체력은급속히저하되며 [1], 신체조성의변화로체중및체지방률의증가는비만으로이어지게되는데이러한비만으로인해대사성질환의위험에노출된다 [2]. 비만은대사증후군 (metabolic syndrome) 이라는 2차적인질환유발의큰문제점을가지고있으며 [3], 우리나라의대사증후군유병률은매년증가추세로연령증가에따른높은유병률경향을보였다 [4]. 성인여성을대상으로체중과대사증후군발생률을비교한연구결과에서과체중그룹은 5.4배, 비만그룹은 17.1배정상체중보다높은것으로나타났다 [5]. 대사증후군은복부비만, 고혈압, 고혈당, 고중성지방혈증및낮은고밀도콜레스테롤중 3가지이상이존재할때대사증후군으로정의한다 [6]. 중년여성의건강증진을위한가장좋은방법으로규칙적인신체활동이추천되며, 규칙적인신체활동은근육량감소방지와근대사기능활성화로중년여성의기초대사량및체력저하방지에효과적이다 [7]. 선행연구에서다양한형태의운동이중년여성의건강체력및대사증후군위험인자에개선에효과적이라고보고하였다 [8,9]. 다양한형태의운동중체중부하를이용한순환운동은부상위험이적으며, 장소의제약을받지않으면서지속적인운동이가능하고, 저항성운동과유산소성운동을휴식없이교대로실시하는운동으로짧은시간에여러체력요소를동시에향상시킬수있다 [10,11]. 또한유산소성운동이나저항성운동과같은단독적인운동보다는흥미를느끼면서지속적으로운동이가능한장점이있다 [12]. 중년여성의경우여러대사질환을예방하기위한건강관리가중요시기일것으로생각된다. 이에본연구는순환운동이중년여성의건강체력및대사증후군위험인자의변화를알아보고노화와갱년기증상으로인해신체기능이떨어진중년여성들의효과적인운동프로그램의개발에기초자료를제공하고자한다. 2.1 연구대상 2. 연구방법 본연구는 B광역시거주자로규칙적인운동을하지않고, 특정한질환이없는 BMI 25 kg/m 2 이상의 40대비만중년여성중연구목적을설명후참가희망자로순환운동군 (10명), 대조군 (10명) 총 20명을대상으로실시하였다. 연구대상자의신체적특징은 <Table 1> 과같다. Table 1. Characteristics of subject EX CON Age(yrs) 43.11± ±2.17 Height(cm) ± ±3.82 Weight(kg) 69.79± ±6.53 BMI(kg/m 2 ) 27.07± ±2.52 Values are M±SD EX : exercise group, CON : control group 2.2 측정항목및방법 모든검사항목은동일한방법과조건으로건강체력및대사증후군관련인자대하여사전, 사후총 2회, 12시간동안공복상태를유지후오전 8시 10시사이에측정하였다 신체조성신장, 체중및체지방률은최대한간편한복장으로착용한후 X-SCAN PLUS (JAWON Medical, Korea) 으로측정하였다 건강체력근력은악력측정기 (TAKEI, Japan) 를이용하여 2회측정한후최고기록을 0.1 kg 단위로기록하였다. 근지구력 ( 윗몸일으키기 ) 은 60초간실시한횟수를기록하였다. 유연성 ( 앉아윗몸앞으로굽히기 ) 은제자리에앉아서상체를천천히굽히면서측정기구의아래로손을뻗쳐, 피검자의손가락끝이 2초정도멈춘지점을, 0.1 cm 단위로기록하였다. 심폐지구력 (20 m 왕복오래달리기 ) 은 20 m 구간을계속해서달리다가신호음에맞춰뛰는것이불가능하거나포기할때까지왕복한횟수를기록하였다. 171

3 한국산학기술학회논문지제 19 권제 12 호, 대사증후군위험인자 NCEP-ATPⅢ7(National Cholesterol Education Program Adult Treatment Panel III) 의대사증후군정의는복부둘레남자 90cm 이상, 여자 80cm 이상, 혈압 130/85 mmhg 이상, 공복시혈당 100 mg/dl 이상, TG(triglyceride) 150 mg/dl 이상및 HDL-C(high density lipoprotein cholesterol) 남자 40 mg/dl 미만, 여자 50 mg/dl 미만중 3가지이상일때대사증후군으로정의한다 [6]. 허리둘레는장골능선과 12번갈비뼈사이중간지점경계선사이의둘레를측정하였고, 혈압은안정을취한상태에서전자혈압측정기 ES-H55(Terumo, Japan) 를이용하여좌측상완에서측정하였다. 공복혈당은글루코스측정용 Kit(Glu-hk, 아산제약, Korea) 를사용하여 Hexokinase(HK) 법으로측정하였으며, HDL-C는 SIEMENS(Georgia, USA) 사의시약으로 ADVIA-1650(Georgia, USA) 자동생화학분석기를이용하여분석하였고, TG는 SIEMENS(Georgia, USA) 사의시약으로 ADVIA-1650(Georgia, USA) 자동생화학분석기를이용하여분석하였다. 2.3 순환운동프로그램순환운동프로그램은상체와하체로운동부위를나누어맨손운동 7종목을 1-5주는종목당 40초간 12~15 회 3세트, 6-12주는종목당 50초간 12~15회 3세트반복실시하였다. 세트간휴식은 2분으로통제하였다. 운동시간은준비운동 5분, 본운동 20~30분, 정리운동 5분으로구성하여총 30~40분으로실시하였으며, 운동중심박수계측기기인손목시계형 POLAR(Polar RS400sd, APAC, USA) 를통해심박수변화량을확인하여 1-5주는 60-70%HRR, 6-12주는 70-80%HRR 설정하였다. 순환운동프로그램의내용은 <Table 2> 와같다. 2.4 자료처리 SPSS 23.0을이용하여각측정변인에대해평균값과표준편차 (M±SD) 를산출한후사전운동군과대조군의신체적특성과각측정변인에대한동질성검정을위하여독립 t-test를, 집단내의사전 사후평균치변화에대한차이검증은종속 t-test를, 집단간차이에대한주효과검정및집단간시기간상호작용효과는반복측정분산분석 (repeated ANOVA) 을이용하였다. 3. 연구결과 3.1 건강체력의변화체지방률은시기간주효과 (p<.01), 상호작용효과 (p<.01) 가나타났으며, 운동군이유의하게감소하였다 (p<.01). 제지방량은상호작용효과 (p<.05) 가나타났으며, 운동군이유의하게증가하였다 (p<.05). 근지구력은시기간주효과 (p<.01), 상호작용효과 (p<.05) 가나타났으며, 운동군이유의하게증가하였다 (p<.01). 유연성은상호작용효과 (p<.001) 가나타났으며, 운동군이유의하게증가하였다 (p<.01). 심폐지구력은시기간주효과 (p<.001), 그룹간주효과 (p<.05), 상호작용효과 (p<.001) 가나타났으며, 운동군이유의하게증가하였다 (p<.001). 3.2 대사증후군위험인자의변화허리둘레는상호작용효과 (p<.05) 가나타났으며, 운동군이유의하게감소하였다 (p<.05). SBP는시기간주효과 (p<.05), 상호작용효과 (p<.01) 가나타났으며, 운동군이유의하게감소하였다 (p<.05). DBP는상호작용효과 (p<.001) 가나타났다. Glucose는상호작용효과 (p<.05) 가나타났으며, 운동군이유의하게감소하였다 (p<.05). TG는그룹간주효과 (p<.01), 상호작용효과 Table 2. circulation exercise program Weeks Order Intensity Duration Time Warm-up (5 min) Stretching 1-12 Main exercise (20~30 min) Half push up abdominal curl squat Back extension core exercise side lunge burpee test 60-70%HRR 12~15rep/3set 70-80%HRR 12~15rep/3set times /weeks Cool-down (5 min) Stretching 172

4 Table 3. The changed of Health Related Fitness Variable Group Pre Post t-value F-value EX 34.41± ± ** Time ** %BF (%) LBM (kg) grip-strength (kg) sit-ups (time/60secs) sit and reach (cm) 20 m shuttle run (laps) CON 32.71± ± Group Time Group ** t-value EX 45.70± ± * Time CON 44.58± ± Group Time Group * t-value EX 25.97± ± ** Time CON 24.06± ± Group Time Group t-value EX 16.78± ± *** Time *** CON 16.89± ± Group Time Group * t-value EX 10.93± ± ** Time ** CON 11.22± ± Group Time Group * t-value EX 16.00± ± *** Time *** CON 15.78± ± t-value ** Values are M±SD, * p <.05, ** p <.01, *** p <.001 EX : exercise group, CON : control group Group * Time Group *** (p<.01) 가나타났으며, 운동군이유의하게감소하였다 (p<.001). HDL-C는상호작용효과 (p<.01) 가나타났으며, 운동군이유의하게증가하였다 (p<.001). 4. 논의 4.1 건강체력건강체력은신체조성, 근력, 근지구력, 유연성및심폐지구력으로구성되며 [13], 신체활동저하와잘못된식습관은부적절한신체구성의변화유발, 급격한체력저하및건강상태악화를야기시킨다 [14]. 하지만지속적인신체활동은지방감소, 제지방의생성및증가를유도한다 [15,16]. 선행연구에서 40~50대직장남성을대상으로 8주간순환운동을실시한결과체지방률이유의하게감소하였으며 [17], 근감소증노인여성을대상으로 12주간순환운동을실시한결과제지방량이유의하게증가하였다 [18]. 본연구결과운동군에서체지방률이유의하게감소하였으며, 제지방량은유의하게증가하였다. 이는순환운동을통한근육량증가및기초대사량향상으로지방 대사율이증가되어체지방이감소 [19] 한것으로생각된다. 체력은신체활동을수행하는데필요한능력으로체력의저하는대사기능의저하및생활습관병의발병률을증가시키는위험인자이지만규칙적인신체활동에의해남녀노소관계없이향상될수있다 [20,21]. 근력과근지구력은일상생활에서의신체적인활동을향상시켜주는가장기본적인체력으로구분된다 [22]. 선행연구에서중년비만여성을대상으로 12주간순환운동을실시한결과근력에유의한차이가나타나지않았으며 [23], 본연구결과근력에서유의한차이는나지않았지만다소증가하는경향을보였으며, 이는꾸준한순환운동을통해근력이향상될수있을것으로생각된다. 중년여성을대상으로 12주간순환운동을실시한결과근지구력이유의하게증가하였으며 [24], 본연구결과운동군에서유의하게증가하였다. 이는휴식없이교대로실시하는순환운동의반복적인근육사용에의해근지구력이증가한것으로생각된다. 유연성이란관절의가동범위로신축력과항장력에대한근, 건, 인대및관절의상태이며 [25], 유연성이좋은사람은육체적활동에효과적으로적응하고, 근육의경직을예방할수있다 [26]. 선행연구에서근감소증노 173

5 한국산학기술학회논문지제 19 권제 12 호, 2018 인여성을대상으로 12주간순환운동을실시한결과유연성이유의하게증가하였다 [27]. 본연구결과운동군에서유의하게증가하였으며, 이는본운동전 후실시한스트레칭에따른근육의긴장완화와관절의가동범위증가에의해유연성이증가한것으로생각된다. 심폐지구력은중요한체력요소중하나로장시간동안중강도에서고강도로대근육군을이용하여운동을수행할수있는능력으로호흡계, 심혈관계및골격계의기능적상태에따라달라지며 [28], 심폐지구력의저하는체중및체지방량의증가로이어져비만이될가능성이높은것으로알려져있다 [29]. 선행연구에서 50대비만중년여성을대상으로 8주간순환운동을실시한결과심폐지구력이유의하게증가하였다 [30]. 본연구결과운동군에서유의하게증가하였으며, 이는순환운동을통한호흡환기량증가에의해심폐지구력이증가한것으로생각된다. 이상의결과휴식없이교대로실시하는순환운동은건강체력향상에긍정적인영향을미치는나타났으며, 규칙적인순환운동은비만중년여성들의건강체력개선에도움이될것으로사료된다. 4.2 대사증후군위험인자대사증후군이란복부비만, 고혈압, 고혈당증, 고지혈증및저고밀도지단백증등과같은위험인자들이복합적으로나타나는것을말하며 [31], 규칙적인신체활동의감소및영양불균형은대사증후군유병률을증가시킨다 [32]. 하지만규칙적인운동은체중과지방의효과적인감소와중성지방의농도감소로대사질환과관련된요인을개선시킨다 [33]. 또한규칙적인신체활동 ( 주당 60분이상 ) 을하는사람들은좌업생활을하는사람들보다대사증후군위험인자의감소가높은것으로나타나규칙적인신체활동을강조하였다 [34]. 복부비만진단지표인허리둘레는대사증후군, 제2형당뇨병및심혈관질환을진단하는유용한지표이다 [35]. 선행연구에서 65세이상여성을대상으로순환운동을실시한결과허리둘레가유의하게감소하였다 [36]. 본연구결과운동군에서유의하게감소하였으며, 이는순환운동을통한체지방감소에의해허리둘레가감소한것으로생각된다. 혈압은혈관내의압력을의미하며, 혈압증가의원인은심박출량이많을수록, 혈관직경과탄성이적고혈관 Table 4. The changed of Metabolic Syndrome Risk Factors Variable Group Pre Post t-value F-value WC (cm) SBP (mmhg) DBP (mmhg) Glucose (mg/dl) TG (mg/dl) HDL-C (mg/dl) EX 83.80± ± * Time CON 80.44± ± Group Time Group 5.512* t-value EX ± ± * Time 7.008* CON ± ± Group Time Group 9.734** t-value EX 79.33± ± Time CON 74.56± ± Group Time Group 7.078* t-value EX 85.11± ± * Time CON 78.44± ± Group Time Group 7.575* t-value EX ± ± *** Time CON ± ± Group 9.641** Time Group ** t-value *** EX 55.83± ± * Time CON 51.54± ± *** Group Time Group ** t-value * Values are M±SD, * p <.05, ** p <.01, *** p <.001 EX : exercise group, CON : control group 174

6 저항이클수록증가한다 [37]. 선행연구에서 20-40세남성직장인을대상으로 12주간순환운동을실시한결과수축기혈압유의하게감소하였고 [38], 비만중년여성을대상으로 12주간순환운동을실시한결과이완기혈압이유의하게감소하였다 [39]. 본연구결과수축기혈압은운동군에서유의하게감소하였으며이는순환운동을통해말초혈관저항및심박출량감소 [40] 로인해수축기혈압이감소한것으로생각된다. 혈당은간에서혈당공급량과말초조직에서의혈당사용량과의균형으로조절되며, 각종호르몬 ( 인슐린, 글루카곤, 코르타손및갑상선호르몬등 ) 의상호작용으로유지된다 [41]. 선행연구에서 65세이상노인비만여성을대상으로 12주간순환운동을실시한결과혈당유의하게감소하였다 [42]. 본연구결과운동군에서유의하게감소하였으며, 이는순환운동을통한근육의막과세포의자극으로포도당의흡수증가 [43] 에의해혈당이감소한것으로생각된다. TG의지속적인증가는기간경과에따라혈관이막혀심혈관계질환을유발하게된다 [44]. 선행연구에서노인여성을대상으로 12주간순환운동을실시한결과 TG가유의하게감소하였다 [45]. 본연구결과운동군에서유의하게감소하였으며, 이는순환운동을통한 TG의운동에너지동원율증가 [46] 에의해 TG가감소한것으로생각된다. HDL-C 농도의감소는다른심혈관계질환의위험인자들과독립으로심뇌혈관질환의발생빈도를높이는요인으로작용한다 [47]. 선행연구에서 40~50대남성을대상으로 8주간순환운동을실시한결과 HDL-C 유의하게증가하였다 [48]. 본연구결과운동군이유의하게증가하였으며, 이는순환운동을통한지방의에너지비율증가 [49] 에의해 HDL-C가증가한것으로생각된다. 이상의결과순환운동이대사증후군위험인자개선에도움을주는것으로나타났으며, 꾸준한순환운동의실천은비만발생률의감소와대사증후군위험인자의개선및예방에도움이될것으로사료된다. 5. 결론본연구는 12주간을알아보기 위해비만중년여성 20 명을대상으로순환운동군 10 명, 대조군 10명을분류하여실시한결과다음같은결과가나타났다. 체지방률은운동군이유의하게감소하였다. 제지방량은근지구력, 유연성, 및심폐지구력은운동군이유의하게증가하였다. 허리둘레, SBP, Glucose 및 TG는운동군이유의하게감소하였으며, HDL-C는운동군이유의하게증가하였다. 이상의결과를살펴볼때순환운동은건강체력및대사증후군위험인자의개선에도움이되는것으로나타났다. 따라서다양한신체변화를경험하는시기인중년여성들의건강한삶의유지에도움을줄수있는다양한운동프로그램개발에관한연구가필요할것으로사료된다. References [1] H. K. Chang, B. K. Cha, Influencing factors of climacteric women s depression, Journal of Korean Academy of Nursing, Vol.33, No.7, pp , DOI: [2] J. H. Choi, J. H. Yang, J. P. Han, A comparative analysis of body composition and blood lipid profile during exercise and detraining in exercise type in the middle-aged obese women, The Korean Journal of Physical Education, Vol.45, No.3, pp , [3] C. H. Ha, S. Ha, W. Y. So, Effects of a 12-week combined exercise training program on the body composition, physical fitness levels, and metabolic syndrome profiles of obese women, Journal of Korean Public Health Nursing, Vol.26, No.3, pp , DOI: [4] National health insurance service, National health screening statistical yearbook, Seoul : Deawon press, [5] D. I. Kim, Relationships between walking, body mass index, and risk factors of metabolic syndrome among korean adults: data from the fifth korea national health and nutrition examination survey ( ), The Korean Journal of Obesity, Vol.24, No.4, pp , DOI: [6] C, Lorenzo, K. Williams, K. J. Hunt, S. M. Haffner, The National Cholesterol Education Program - Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes, Diabetes Care, Vol. 30, No.1, pp. 8-13, DOI: [7] K. J. Bae, I. H. Chang, Effect of pilates exercise on body shape, physical fitness and trunk muscle activity in menopause, non-menopause middle-aged woman, 175

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한국성인에서초기황반변성질환과 연관된위험요인연구

한국성인에서초기황반변성질환과 연관된위험요인연구 한국성인에서초기황반변성질환과 연관된위험요인연구 - - i - - i - - ii - - iii - - iv - χ - v - - vi - - 1 - - 2 - - 3 - - 4 - 그림 1. 연구대상자선정도표 - 5 - - 6 - - 7 - - 8 - 그림 2. 연구의틀 χ - 9 - - 10 - - 11 -