일부 만성질환의 징후발현과 위험요인에 관한 코호트 연구

초록

The incidence and risk factors for the manifestations of some chronic diseases were determined in 956 healthy employees of a hospital who had no diseases in a cohort study conducted between 1984 and 1994. The body measurements, laboratory, chest X-ray and questionnaire survey were performed in order to estimate the exposures or risk factor that was study entry age, sex, body mass index, systolic and diastolic blood pressure, fasting blood sugar, serum total cholesterol, serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, hepatitis B surface antigen(HBsAg), family history smoking history, alcohol history, salty food intake, meat intake, exercise, and weight gain. And then they were followed up through the health examinations and questionnaire survey annually, and ascertained whether they had the manifestations of chronic diseases or not. The incidence rates were calculated by the concept of the incidence density because each of the study subjects had different follow-up periods. The results were as follows. 1. The study subjects were 324 males(33.9%) and 632 females (66.1%). The distribution of study entry age is 680 persons(71.1%) below 29 years of age, 165 persons(17.3%) between 30-39% years of age and 111 persons(11.6%) over 40 years of age. The observational person-years of study subjects were all 4,193 person-years. 2. Manifestation of chronic diseases newly diagnosed were 129 cases. There were 53 cases (41.4%) of hypercholosterolemia, 37 cases (28.7%) of liver disease, 24 cases (18.6%) of hypertension, 6 cases (4.7%) of diabetes mellitus, 6 cases (4.7%) of pulmonary tuberculosis, and 3 cases (2.2%) of urine abnormality. 3. The incidence density of manifestations of chronic diseases were 30.8 per 1,000 person-years, Age-standardized incidence density were 48.5 per l, 000 person-years for male and 21.1 per 1,000 person-years for female, and the relative risk were 2.3(95% confidence interval 1.4-3.8). The incidence densities were increased with the study entry age. There were 17.9 per 1,000 person-years below 29 years of age, 51.9 per 1,000 person-years between 30-39 years of age and 53.3 per 1,000 person-years over 40 years of age. The incidence density was highest as 71.3 per 1,000 person-years between 30-39 years of age for male and 65.2 per 1,000 person-years over 40 years of age for female. 4. The incidence density of hypercholesterolemia was 12.6 per 1,000 person-years, liver disease 8.8 per 1,000 person-years, hypertension 5.7 per 1,000 person-years, diabetes mellitus 1.4 per 1,000 person-years, pulmonary tuberculosis 1.4 per 1,000 person-years and urine abnormality 0.7 per 1,000 person-years. 5. The significant independent risk factors to be identified from the stepwise logistic regression analysis were body mass index and study entry age for hyperchole-sterolemia, male sex, HBsAg and weight gain for liver disease, and male sex and study entry age for hypertension. For the prevention of chronic diseases, it was very important to control the body mass index, weight gain and HBsAg that are reversible factors among the risk factors affecting to manifestations of some chronic diseases, whereas sex and age are irreversible factors.