2019년 당뇨병 임상진료지침(의료용) - Ⅰ. 당뇨병의 총론: 대사증후군의 진단기준
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4. 대사증후군의 진단기준
권고 적용군 (Population) | 제2형 당뇨병환자 | 진료환경 (Healthcare setting) | 외래 |
중재/실행지표 (Intervention) | 신체계측, 혈액검사 | ||
비교지표 (Comparator) | 신체계측, 혈액검사 미 시행 | ||
결과물 (Outcome) | 심혈관질환 예방 | ||
권고 내용 |
• 대사증후군¹ 은 인슐린저항성을 기반으로 하며 비만, 고혈당, 고혈압, 이상지질혈증 등을 총체적으로 포함한다. |
• 대사증후군의 진단기준² 은 복부비만을 필수 요소로 하며, 허리둘레가 남자 90 cm, 여자 85 cm 이상인 경우를 복부비만으로 한다. |
☎ ¹ : 대사증후군은 흔히 당뇨병, 고혈압, 비만, 죽상경화증, 이상지질혈증,
심혈관질환 등을 총체적으로 지칭하는 개념입니다.
대사증후군의 중심에는 인슐린저항성이 있습니다.
²:1988년 Reaven에 의해 인슐린저항성과 고혈압, 이상지질혈증,
내당능장애 및 복부비만과의 개념이 처음 제시된 것을 바탕으로 1999년에
세계보건기구(WHO)에서 대사증후군에 대한 정의를 처음으로 제시하였습니
다. 대사증후군 자체가 심혈관질환으로 인한 이환율과 사망률을 증가시킬
뿐만 아니라, 여러 대사질환과 심혈관질환의 위험성에 대한 높은 예측률
가지고 있습니다.
표 1. 미국심장학회와 세계당뇨병연맹의 대사증후군 진단기준험인자 진단기준
위험인자 | 진단기준 |
1. 복부비만 허리둘레 남자 ≥ 90 cm 여자 ≥ 85 cm | |
2. 중성지방 | ≥ 150 mg/dL 또는 치료제를 복용중인 경우 |
3. HDL-콜레스테롤 남자 < 40 mg/dL 또는 치료제를 복용중인 경우 여자 < 50 mg/dL 또는 치료제를 복용중인 경우 | |
4. 혈압 ≥ 130/85 mmHg 또는 치료제를 복용중인 경우 | |
5. 공복혈당 | ≥ 100 mg/dL 또는 치료제를 복용중인 경우 |
* 위 기준 중 3개 이상에 해당될 때 대사증후군으로 진단할 수 있음 | |
표 2. 한국인 대사증후군의 진단 권고안
위험인자 | 진단기준 |
1. 복부비만 허리둘레 남자 ≥ 90 cm 여자 ≥ 85 cm | |
2. 중성지방 | ≥ 150 mg/dL 또는 이상지혈증 치료제를 복용중인 경우 |
3. HDL-콜레스테롤 남자 < 40 mg/dL 또는 이상지혈증 치료제를 복용중인 경우 여자 < 50 mg/dL 또는 이상지혈증 치료제를 복용중인 경우 | |
4. 혈압 ≥ 130/85 mmHg 또는 고혈압 치료제를 복용중인 경우 | |
5. 공복혈당 | ≥ 100 mg/dL 또는 당뇨병 치료제를 복용중인 경우 |
* 위 기준 중 3개 이상에 해당될 때 대사증후군으로 진단할 수 있음 | |
* 대사증후군을 진단함으로서 여러 대사질환과 심혈관 질환을 예측하고
심혈관 이환율과 사망률을 감소 시킬 수 있습니다.
- 대한의학회 -
- 이전글2019년 당뇨병 임상진료지침(의료용) - Ⅰ. 당뇨병의 총론: 당뇨병의 선별검사 및 예방 15.07.24
- 다음글2019년 당뇨병 임상진료지침(의료용) - Ⅰ. 당뇨병의 총론: 당뇨병의 분류 및 진단기준 15.07.24
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