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Relationship of Metabolic Diseases with Physical Activity Depending on Age
Korean J Clin Lab Sci 2018;50:144-154  
Published on June 30, 2018
Copyright © 2018 Korean Society for Clinical Laboratory Science.

Hyo Kyung Lim1, Jae Woong Sull2,3, Beom Seok Park2,3, Ji Young Mun2,3, Min Hwa Hong4, Yoori Lee4, Min Ji Hwang1, Mi Na Lee1, Ji Young Lee1, and In Sik Kim1,4

1Department of Biomedical Laboratory Science, School of Medicine, Eulji University, Daejeon, Korea,
2Department of Biomedical Laboratory Science, College of Health Science, Eulji University, Seongnam, Korea,
3Department of Senior Healthcare, BK21 plus program, Graduate School, Eulji University, Seongnam, Korea,
4Department of Senior Healthcare, BK21 plus program, Graduate School, Eulji University, Daejeon, Korea
Correspondence to: In Sik Kim
Department of Biomedical Laboratory Science, School of Medicine, Eulji University, Gyeryoung-ro 771-77, Jung-Gu, Daejeon 34824, Korea Tel: 82-42-259-1753 Fax: 82-42-259-1759 E-mail: orientree@eulji.ac.kr
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

Metabolic disease is associated with abdominal obesity, high blood pressure, and dyslipidemia. Physical activity has beneficial effects on a variety of diseases. This study examined the relationship between metabolic diseases and physical activity according to age. Among a total of 7,295 subjects, the data from 382 individuals in the normal group and 1,525 persons in the metabolic disease group were analyzed. The data were analyzed statistically by one-way ANOVA, the Pearson’s correlation coefficient, and multiple regression analysis. The levels of hemoglobin (HB), hematocrit (HCT), and creatinine (CR), were elevated when a high-intensity physical activity was performed, but they were reduced when a low-intensity physical activity was performed in the normal group aged 10∼29 years and the metabolic disease group aged 50∼69 years. In the normal group and metabolic disease group aged 30∼49 years, the level of high density lipoprotein cholesterol (HDL-C) was elevated when high-intensity physical activity was conducted, whereas it was reduced when low-intensity physical activity was performed. No difference in the level of HDL-C depending on age and exercise intensity was observed in the normal group; the level of HDL-C decreased with age and increased with exercise intensity in the metabolic disease group. Physical activity has different effects in metabolic disease depending on age.

Keywords : Age, Metabolic disease, Physical activity
INTRODUCTION

Metabolic disease, which refers to a constellation of abdominal obesity, high blood pressure, dyslipidemia, and impaired fasting glucose (IFG) occurring in a single person, is known to increase the risk of developing cardiovascular disease and type 2 diabetes [1, 2]. Although the pathogenesis of metabolic diseases has not yet been fully elucidated, it is known to be related to obesity, blood pressure, lipid levels, and body mass index [3, 4]. The prevalence of metabolic syndrome was 23% in a survey of 8,814 persons in urban areas of the United States according to the NCEP-ATPIII criteria, while it was 16.7% in a survey among the Hong Kong population [5]. Additionally, the 4th Korea National Health and Nutrition Examination Survey found that the prevalence of metabolic syndrome in adults in Korea is 32.4%, which is very high compared with the prevalence rates of other countries throughout the world [6].

Efforts to manage chronic diseases have led to attempts to change behaviors related to personal lifestyle, and the most important health-promoting behavior has been found to be physical activity [7]. Moreover, previous studies have shown that physical activity reduces the risk of metabolic diseases [8-10]. Regular physical activity has beneficial effects that improve cardiopulmonary functions and delays metabolic diseases associated with aging and chronic degenerative diseases [11-14]. There are many types of regular physical activity that adults can participate in. Regular walking is one of the easiest physical activities that can be performed safely anywhere at any time. In addition, several previous studies have reported that regular walking for 30 minutes or more a day reduces the risk of developing metabolic diseases [15, 16]. However, the effects of high-intensity physical activity including regular walking vary greatly. Participation in high-intensity physical activity is known to have more positive effects on physical strength (cardiovascular fitness), body composition and biochemical changes than participation in low- intensity or moderate-intensity physical activity [17, 18]. In particular, if the amount of energy consumed during physical activity is constant, participation in high intensity physical activity can lead to more effective improvement in risk factors associated with cardiovascular diseases than participation in low intensity or moderate intensity physical activity [19]. Rennie et al found that the group participating in high intensity physical activity showed a greater decrease in the risk of developing metabolic disease than the group not participating in physical activity [20]. Moreover, reductions in physical activity have been reported to be closely related to the incidence of metabolic diseases and many adult diseases [21, 22]. Nevertheless, there is a lack of research regarding the age-related association between metabolic diseases and physical activity. Therefore, this study was conducted to investigate the parameters of metabolic diseases in groups participating in high-intensity, moderate-intensity, and low-intensity physical activity according to age.

MATERIALS AND METHODS

1. Ethical approval

The study was reviewed and approved by the Ethics Committee of the Korea Centers for Disease Control and Prevention (Approval Number 2013-12EXP-03-5C).

2. Subjects

This study was conducted using the second-year survey data of the 6th Korea National Health and Nutrition Examination Survey (KNHANES VI-2) conducted from January to December in 2014. The data used in this study were provided according to the procedures presented in the KNHANES homepage ( https://knhanes.cdc.go.kr) [23]. Out of a total of 9,701 respondents aged 19 or older, 2,506 were excluded. Reasons for exclusion included an absence of data regarding physical activity or parameters known to be associated with metabolic diseases, such as blood pressure (BP), waist circumference (WC), body mass index (BMI) and the levels of red blood cells (RBC), hemoglobin (HB), hematocrit (HCT), white blood cells (WBC), platelets (PLT), fasting blood sugars (FBS), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransaminase (ALT), total cholesterol (TC), blood urea nitrogen (BUN), and creatinine (CR). Thus, the data from 7,295 subjects were analyzed. Among these, 382 persons in the normal group and 1,525 persons in the metabolic disease group were analyzed to investigate the relationship between metabolic diseases and physical activity of low- intensity, moderate-intensity and high-intensity according to age using physical, hematological and biochemical parameters.

3. Investigation

The criteria for the diagnosis of metabolic diseases were defined using the guidelines presented in the National Cholesterol Education Program Adults Treatment Panel III; NCEP ATP III [24]. Briefly, the criteria for diagnosis of metabolic diseases were fasting blood glucose (≥110 mg/dL), Asian waist circumference (male ≥90 cm, female >80 cm), blood pressure (systolic/diastolic blood pressure ≥130/85 mmHg), triglycerides (≥150 mg/dL), and high density lipoprotein cholesterol (male <40 mg/dL, female <50 mg/dL) When three or more of the criteria were met, the patient was diagnosed with metabolic disease.

Physical activity was measured using a Korean-version short-form self-report measure of the International Physical Activity Questionnaire developed for the purpose of comprehensive and objective assessment of daily physical activity in everyday life as well as health-related physical activity [25]. The measurement tool was designed to respond to the vigorous physical activity, moderate physical activity, and walking time of 10 minutes or more during the 7 days before the questionnaire survey. Vigorous physical activity was considered activity that makes you breathe much more heavily than usual, and included carrying heavy objects, running, aerobic exercises, climbing, and cycling at a fast speed. Moderate physical activity was defined as activity that led to slightly heavier breath than usual, such as carrying light items, biking at a normal speed, dancing, etc. Walking included walking during recreational activities, sports, exercise, and leisure time, as well as walking at work, home, and while using transportation. The amount of physical activity was converted into the continuous index and categorical index according to the Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire. The continuous index is for determining the Metabolic Equivalent Task (MET) to compare levels of energy consumption by multiplying the MET level by each activity time. The MET level of each physical activity is 8 for vigorous physical activity, 4 for moderate physical activity, and 3.3 for walking. The categorical index indicates the division of subjects into three levels according to the following criteria. The inactive group, Group 1 (low- intensity), was the group of people who perform the lowest degree of physical activity. This group includes those who do not belong to Group 2 (moderate-intensity) or Group 3 (high- intensity) or do not perform physical activity. Group 2, which was the minimum physical activity group, included people that satisfy any one of the following three criteria: vigorous physical activity for at least 20 minutes per day for at least three days a week; moderate physical activity or walking for at least 30 minutes per day for at least five days a week; physical activity of at least 600 MET-min/week through walking at least 5 days a week or through any combination of moderate or vigorous physical activity. Finally, Group 3, which was the health promoting activity group, included people that satisfied one of the following two criteria: consume at least 1,500 MET-min/week through vigorous activity at least three days per week, or consume at least 3,000 MET-min/week through walking 7 days a week or through any combination of moderate or vigorous physical activity [26]. The amount of physical activity was calculated by measuring the time of vigorous physical activity, moderate physical activity, walking, and sedentary activity in the past 7 days, and then converting them to MET (min/week) values to derive the continuous index and categorical index. The total physical activity score of the continuous score was calculated as the sum of the MET values of walking, moderate-activity, and vigorous activity, while physical activity of less than 10 minutes was considered to be equivalent to no physical activity.

4. Statistical analysis

The data collected in this study were statistically analyzed using the SPSS version 20 program. Descriptive statistics were used to determine the general characteristics of the subjects. ANOVA (analysis of variance) was performed to examine the differences between the normal and metabolic disease groups according to age and the differences depending on physical activity according to age. Correlations between age and metabolic parameters in the normal and metabolic disease groups were confirmed using Pearson’s correlation coefficient. An independent sample t-test was conducted to examine the differences between normal and metabolic disease groups. Multiple regression analysis was conducted to investigate the effects of age and physical activity intensity on parameters of metabolic diseases in the normal and metabolic disease groups.

RESULTS

1. Correlation between age and metabolic parameters in the normal and metabolic disease groups

For physical, hematological, and biochemical characteristics according to age in the normal and metabolic disease groups, there were statistically significant differences in the levels of various factors (Table 1). In the normal group, SBP (P<0.01), WBC (P<0.01), RBC (P<0.01), HB (P< 0.05), and HCT (P<0.01) were found to be negatively correlated with age (Table 2). Additionally, WC (P<0.01), BMI (P<0.01), DBP (P<0.01), TC (P<0.01), BUN (P< 0.01), AST (P<0.01) and ALT (P<0.01) were found to be positively correlated with age. In the metabolic disease group, WBC (P<0.01), RBC (P<0.01), HB (P<0.01), HCT (P<0.01), PLT (P<0.01), and HDL-C (P <0.01) were found to be negatively correlated with age. WC (P <0.01), SBP (P<0.01), FBS (P<0.01), BUN (P<0.01), CR (P<0.01), and AST (P<0.05) were found to have a positive correlation with age.

General characteristics of the normal and metabolic disease groups according to age

Age Characteristic10∼2930∼4950∼69FP
PhysicalNormalN21714421
WC70.37±7.2372.69±7.0179.63±9.2217.478**0.000
BMI20.69±2.5221.26±2.5723.14±2.689.696**0.000
SBP103.18±6.91100.76±6.88103.95±7.975.819**0.003
DBP65.57±6.1867.49±5.4469.43±6.037.299**0.001
MetabolicN97486942
WC76.43±13.2185.14±9.5385.03±8.7838.627**0.000
BMI23.17±5.0225.34±3.5224.87±3.1116.764**0.000
SBP114.29±12.24118.29±15.43125.71±16.9047.338**0.000
DBP71.69±11.2980.23±11.4078.31±10.3325.890**0.000
HematologicalNormalN21714421
WBC6.25±1.195.75±1.165.96±1.107.826**0.000
RBC4.62±0.394.44±0.344.37±0.3311.329**0.000
HB13.99±1.2713.57±1.1214.01±1.115.443**0.005
HCT41.46±3.2240.38±2.7941.25±2.955.574**0.004
PLT263.08±44.39258.62±50.81255.33±42.770.5550.575
MetabolicN97486942
WBC6.93±1.516.87±1.766.38±1.7814.732**0.000
RBC4.97±0.434.82±0.434.60±0.4168.580**0.000
HB14.68±1.4814.80±1.6114.36±1.4214.375**0.000
HCT43.25±3.7043.60±4.1142.40±3.7116.079**0.000
PLT288.01±56.95267.07±55.32249.5±57.2430.318**0.000
BiochemicalNormalN21714421
FBS86.87±5.4287.10±6.8388.71±5.770.9060.405
TC157.91±21.73166.75±20.08169.05±19.128.985**0.000
TG64.26±22.9466.92±23.2374.4±19.482.1560.117
HDL56.79±9.3657.69±10.7653.18±10.171.9330.146
BUN11.42±2.9212.31±3.0613.95±3.229.114**0.000
CR0.73±0.120.73±0.120.72±0.130.1620.851
AST16.71±3.8816.84±3.2621.14±3.6914.347**0.000
ALT12.42±5.5112.74±4.5317.14±6.317.884**0.000
MetabolicN97486942
FBS106.80±26.06115.10±34.00117.12±28.965.225**0.005
TC174.58±44.37207.25±39.76200.33±40.3526.627**0.000
TG109.26±71.89196.15±170.24167.91±112.1019.571**0.000
HDL53.67±11.2749.62±12.0249.28±11.745.833**0.003
BUN12.77±3.8113.87±4.0815.77±4.5143.881**0.000
CR0.77±0.180.84±0.170.85±0.294.454*0.012
AST20.43±11.7324.02±15.7625.33±15.664.918**0.007
ALT21.89±22.0428.38±22.8325.42±18.595.712**0.003

*P<0.05

**P<0.01.

Abbreviations: N, number; WC, waist circumference; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; WBC, white blood cell, RBC, red blood cell; HB, hemoglobin; HCT, hematocrit; PLT, platelet; FBS, fasting blood sugars; TC, total cholesterol; TG, triglycerides; HDL, high density lipoprotein; BUN, blood urea nitrogen; CR, creatinine; AST, aspartate aminotransferase; ALT, alanine aminotransaminase.

Correlation between age and metabolic parameters in the normal and metabolic disease groups

ParametersNormal (N=382)Metabolic (N=1,525)
rPrP
WC0.279**0.0000.159**0.000
BMI0.217**0.0000.0430.091
SBP−0.142**0.0060.237**0.000
DBP0.204**0.0000.0050.831
WBC−0.195**0.000−0.115**0.000
RBC−0.270**0.000−0.305**0.000
HB−0.117*0.022−0.125**0.000
HCT−0.135**0.008−0.132**0.000
PLT−0.0830.105−0.198**0.000
FBS0.0020.9710.096**0.000
TC0.250**0.0000.0340.186
TG0.0600.2390.0110.681
HDL-C0.0390.453−0.097**0.000
BUN0.235**0.0000.250**0.000
CR0.0320.5270.088**0.001
AST0.139**0.0070.064*0.012
ALT0.133**0.009-0.0370.145

*P<0.05

**P<0.01.

2. The relationship between physical activity and parameters of metabolic diseases by age

The relationship of metabolic diseases with physical activity according to age was examined. Among people aged 10∼29 years in the normal group, the levels of significant variables of metabolic diseases (RBC, HB, HCT, CR, and BUN) increased when high-intensity physical activity was performed and decreased when low-intensity physical activity was performed. No significant variables were identified in the metabolic disease group. Among those aged 30∼49 years in the normal group and metabolic disease groups, HDL-C, which is a significant variable for metabolic diseases, increased when high-intensity physical activity was performed and decreased when low-intensity physical activity was performed. No significant variables of metabolic diseases were identified in 50∼69 year olds of the normal group. In the metabolic disease group, significant variables of metabolic diseases (HB, HCT, CR) were elevated when high-intensity physical activity was performed and reduced when low-intensity physical activity was performed. The relationships between parameters of metabolic diseases and physical activity according to age in the normal group and metabolic disease group are summarized in Tables 3∼6.

The relationship between physical activity and parameters of metabolic diseases by age

Age GroupMetabolic disease parametersPhysical activity results
10∼29 yrsNormalRBC, HB, HCT, CR, BUNHigh intensity↑, Low intensity↓
Metabolic--
30∼49 yrsNormalHDL-CHigh intensity↑, Low intensity↓
MetabolicHDL-CHigh intensity↑, Low intensity↓
50∼69 yrsNormal--
MetabolicHB, HCT, CRHigh intensity↑, Low intensity↓

Physical, hematological, and biochemical characteristics according to physical activity by age (10∼29 years)

CharacteristicLowModerateHighFP
PhysicalNormalN1227817
Age21.46±5.2119.45±4.8019.53±4.724.205*0.016
WC69.77±7.1870.8±7.3472.66±6.831.4280.242
BMI20.49±2.4520.85±2.6821.39±2.191.1890.307
SBP102.79±7.03103.79±7.06103.12±5.280.5050.604
DBP65.77±6.5965.50±5.6864.41±5.490.3650.694
MetabolicN572812
Age17.63±5.9719.07±5.4018.25±5.100.6000.551
WC75.33±12.3779.5±13.8274.5±15.501.0850.342
BMI22.72±4.9024.35±5.1322.59±5.261.0950.339
SBP113.47±12.20116.14±13.57113.83±9.230.4510.639
DBP70.77±11.8274.18±11.4470.25±7.500.9670.384
HematologicalNormalN1227817
WBC6.13±1.146.39±1.276.45±1.101.3620.258
RBC4.56±0.364.67±0.414.75±0.463.149*0.045
HB13.82±1.2014.10±1.3014.66±1.423.861*0.023
HCT40.98±3.0141.91±3.3242.88±3.673.850*0.023
PLT262.56±41.87264.37±48.27260.94±45.970.0610.941
MetabolicN572812
WBC7.08±1.546.72±1.456.76±1.580.6190.541
RBC4.99±0.414.89±0.465.11±0.441.1500.321
HB14.64±1.4714.6±1.6315.01±1.220.3430.711
HCT43.1±3.7143.1±3.9844.33±2.990.5790.562
PLT287.28±61.86285.39±50.52297.58±49.350.2000.819
BiochemicalNormalN1227817
FBS86.52±5.5487.15±5.4788.12±4.210.8150.444
TC158.92±21.00156.27±23.21158.18±20.630.3530.703
TG63.52±22.3465.17±24.1765.41±22.480.1440.866
HDL56.83±9.3056.68±9.9257.04±7.400.0120.988
BUN11.25±2.7311.15±3.0113.88±2.966.927**0.001
CR0.72±0.120.74±0.130.82±0.144.752**0.010
AST16.73±4.0116.79±3.8616.18±3.130.1790.836
ALT12.61±6.1211.97±4.6413.06±4.700.4430.643
MetabolicN572812
FBS108.07±30.59105.46±21.34103.92±4.960.1750.840
TC169.93±36.85189.43±53.66162.00±48.542.4340.093
TG113.96±79.51105.36±62.3496.00±55.100.3630.697
HDL53.47±11.5252.96±10.0256.15±13.300.3480.707
BUN13.09±4.2612.68±3.4111.50±1.880.8700.422
CR0.74±0.180.79±0.200.83±0.131.6130.205
AST20.05±8.7321.46±17.8819.83±4.860.1510.860
ALT20.40±17.8425.82±31.9419.75±7.710.6270.537

*P<0.05

**P<0.01.

Physical, hematological, and biochemical characteristics according to physical activity by age (30∼49 years)

CharacteristicLowModerateHighFP
PhysicalNormalN88497
Age37.55±5.3537.08±4.8738.57±5.530.3000.741
WC72.62±7.0072.77±7.2873.06±6.060.0180.983
BMI21.06±2.3221.56±3.0421.66±2.170.6600.519
SBP99.99±7.07102.04±6.49101.57±6.481.4620.235
DBP66.69±5.7168.76±4.9268.57±3.952.4550.090
MetabolicN35111124
Age41.14±5.5740.68±5.1140.21±5.330.5510.577
WC85.59±9.7384.19±9.1382.86±7.781.6370.196
BMI25.38±3.5525.32±3.5624.97±2.940.1560.855
SBP118.09±14.92118.61±16.15119.71±19.620.1540.857
DBP80.03±10.7580.73±13.0380.67±13.010.1750.840
HematologicalNormalN88497
WBC5.89±1.035.48±1.265.92±1.792.0000.139
RBC4.48±0.364.42±0.314.18±0.162.5820.079
HB13.72±1.1513.40±1.1112.84±0.262.8460.061
HCT40.70±2.8140.05±2.8438.53±0.792.5210.084
PLT259.61±48.72259.92±54.74237.00±50.510.6640.517
MetabolicN35111124
WBC6.98±1.726.62±1.946.54±1.332.2070.111
RBC4.84±0.434.77±0.424.85±0.451.0670.345
HB14.87±1.5814.56±1.6714.95±1.621.6420.195
HCT43.77±4.0642.98±4.2144.01±4.211.6840.187
PLT265.88±56.58271.03±51.14266.29±56.580.3640.695
BiochemicalNormalN88497
FBS87.01±6.3086.78±7.8090.43±6.000.8930.412
TC166.80±20.30166.49±18.81168.00±28.320.0180.983
TG69.08±24.6864.86±20.3054.29±21.201.6220.201
HDL56.78±10.16757.03±9.01073.86±17.009.276**0.000
BUN12.17±3.2812.47±2.7213.00±2.520.3330.717
CR0.73±0.120.73±0.110.64±0.121.8990.154
AST16.25±2.8417.80±3.7817.57±3.103.864*0.023
ALT12.39±4.4513.57±4.8011.43±2.641.3980.251
MetabolicN35111124
FBS114.23±29.08118.13±43.32113.92±50.120.5630.570
TC206.00±40.41208.77±37.67218.50±39.011.2160.297
TG199.24±162.29184.50±167.88204.29±273.200.3420.711
HDL48.90±11.1250.89±14.3154.28±11.912.976*0.050
BUN13.84±4.0914.05±4.1113.58±3.820.1690.844
CR0.84±0.170.86±0.190.85±0.160.6710.512
AST23.87±12.9324.83±23.6122.50±6.070.2710.763
ALT28.79±22.7628.95±24.8619.88±8.871.7610.173

*P<0.05

**P<0.01.

Physical, hematological, and biochemical characteristics according to physical activity by age (50∼69 years)

CharacteristicLowModerateHighFP
PhysicalNormalN165-
Age57.31±5.8152.60±3.72-2.8670.107
WC77.59±7.0386.16±13.05-3.7410.068
BMI22.64±2.5224.72±2.81-2.4660.133
SBP104.13±9.10103.40±2.51-0.0300.864
DBP69.44±6.6669.40±3.91-0.0000.991
MetabolicN72317742
Age59.59±5.5659.15±5.4359.79±5.610.4920.612
WC85.16±8.9384.60±8.2284.54±8.600.3560.701
BMI24.92±3.2024.81±2.7324.21±2.971.0870.338
SBP126.21±17.29123.11±15.32128.02±15.662.8250.060
DBP78.18±10.3978.36±10.0080.24±10.550.7900.454
HematologicalNormalN165-
WBC6.16±1.055.32±1.11-2.3690.140
RBC4.35±0.284.47±0.49-0.5280.476
HB13.91±0.9614.36±1.58-0.6260.439
HCT41.02±2.6941.98±3.96-0.3910.539
PLT250.88±41.46269.60±48.65-0.7200.407
MetabolicN72317742
WBC6.42±1.756.19±1.836.50±2.121.3510.259
RBC4.59±0.414.60±0.414.74±0.422.5970.075
HB14.31±1.4514.46±1.2814.93±1.304.440*0.012
HCT42.27±3.7442.55±3.5944.01±3.404.559*0.011
PLT251.00±57.40244.97±54.19243.45±66.321.0370.355
BiochemicalNormalN165
FBS88.63±5.9589.00±5.79-0.0150.903
TC167.69±21.20173.40±10.55-0.3290.573
TG74.81±21.2673.20±14.18-0.0250.876
HDL53.75±10.7051.36±9.07-0.2030.658
BUN14.25±3.4013.00±2.65-0.5630.462
CR0.70±0.130.77±0.12-1.0690.314
AST20.63±3.5222.80±4.15-1.3450.260
ALT17.06±6.8117.40±5.03-0.0100.920
MetabolicN72317742
FBS117.50±30.10116.25±26.41114.17±17.100.3590.698
TC200.93±40.99200.08±38.15191.02±38.031.2010.301
TG171.88±117.50155.44±89.54152.26±98.781.9620.141
HDL48.98±11.8749.92±10.3351.78±14.801.4240.241
BUN15.79±4.5815.61±3.9016.02±5.570.1850.831
CR0.84±0.250.84±0.191.04±0.809.472**0.000
AST25.44±16.6324.66±11.6226.43±13.200.2810.755
ALT25.81±19.8624.27±13.4823.52±14.180.7120.491

*P<0.05

**P<0.01.

3. Effects of age and physical activity intensity on HDL-C in the normal and metabolic disease groups

Table 7 shows the effects of age and physical activity intensity on HDL-C in the normal and metabolic disease groups. The results of the analysis showed that there was no statistically significant difference in HDL-C depending on age and exercise intensity in the normal group, and regression equation was not significant. However, in the metabolic disease group, the HDL-C level was found to decrease with age (β=−0.09) and increase with physical activity intensity (β=0.07). In other words, in the metabolic disease group, as more physical activities were performed the HDL-C level was elevated, the regression equation became significant and the explanatory power was 1.3%.

Effects of age and physical activity intensity on HDL-C in the normal and metabolic disease groups

GroupIndependent variableNon-standardization factorStandardization factortCollinearity statisticF
BSeβtoleranceVIF
NormalConstant53.421.9827.015**1.888
Age0.050.040.051.0100.9781.022
Activity1.510.840.091.7910.9781.022
R2= 0.010, adjusted R2=0.005, DW=1.936
MetabolicConstant51.761.4835.077**11.010**
Age−0.080.02−0.09−3.462**.9901.011
Activity1.530.550.072.798*.9901.011
R2= 0.015, adjusted R2=0.013, DW=1.905

*P<0.05

**P<0.01.

Abbreviation: VIF, Variance inflation factor.
DISCUSSION

This study was conducted to investigate the relationship between parameters of metabolic diseases and physical activity according to age in normal adults and those with metabolic disease, as well as to provide basic data for prevention of metabolic diseases depending on physical activity according to age. Overall, about 45% of adults engage in low-intensity physical activity, while 19.7% perform moderate-intensity physical activity, and 35.4% engage in high-intensity physical activity. Participation in high-intensity physical activity has been reported to have a positive effect on various parameters of metabolic diseases [27]. In a study of 612 adult males with no metabolic disease by Laaksonen et al [28], which was controlled for age and BMI, the incidence rate of metabolic disease decreased to 63% (OR: 0.37, 95% CI: 0.21∼0.65) in the group that participated in high-intensity physical activity for 60 minutes or more per week compared to the group that participated for less than 10 minutes per week. The incidence of metabolic disease still decreased to 64% (OR : 0.36, 95% CI : 0.19∼0.70) when the study was controlled for the age, body mass index, blood pressure, insulin, fasting glucose level and family history of diabetes. It has been reported that physical activity contributes to decreased levels of TC and TG, which are related to various cardiovascular and metabolic diseases, including arteriosclerosis, as well as to an increase in HDL-C, which helps prevent diseases [29]. In this study, high-intensity physical activity was found to induce statistically significant differences in HDL-C in both the normal group (P<0.01) and the metabolic disease group (P<0.05) of 30∼49 year olds. These results are consistent with those reported [30-32]. Overall, these findings show that high-intensity physical activity increases HDL-C and is effective at preventing coronary artery diseases and metabolic diseases among 30∼49 year olds. In addition, several previous studies have reported that high-intensity physical activity affects the composition and function of erythrocytes that constitute blood [33]. In the present study, we also found an increase in erythrocyte-related parameters in the normal group of 10∼29 year olds and the metabolic disease group of 50∼69 year olds when high-intensity physical activity was performed. The effects of regular physical activity vary depending on the intensity of physical activity. Participation in high- intensity physical activity has a greater effect on reducing the risk of developing high cholesterol, diabetes, and hypertension, which are associated with metabolic diseases, than low-intensity or moderate-intensity physical activity. In a study of 49,005 adults, Williams and Thompson showed that the group participating in running, which is a high-intensity physical activity, had a lower risk of developing various diseases than the group participating in walking, which is a moderate-intensity physical activity [34]. Specifically, the risk of developing hypertension was 38% (Hazard Ratios (HR): 0.62, 95% CI: 0.55∼0.70) and the risk of developing diabetes was 71% (HR: 0.29, 95% CI: 0.21∼0.40). Regular physical activity has been shown to improve health, prevent chronic illnesses and have positive effects on mental health. As a result, the World Health Organization (WHO) and many countries, including the United States, Canada, Australia and Japan, have announced physical activity recommendations. It should be noted that the present study has the following limitations. The physical activity intensity of walking varies according to the speed of walking. For example, it can be 2.5 METs when you walk at 3.2 kph and 8.0 METs when you walk at 8 kph. Moreover, it is affected by diverse factors, including weight of the load, carrying a baby, and geographical factors such as slope [34]. Therefore, it is not desirable to calculate the physical activity intensity of walking on the basis of METs of a single person. To enable more accurate measurement of the total physical activity, the validity of the method of calculating intensity of moderate-intensity physical activity, that is, the validity of calculating physical activity intensity in terms of average METs, needs to be discussed in the future research. Deriving the MET-min or kcal by calculating the intensity in terms of the average METs does not reflect the fact that a level of physical activity intensity may actually refer to a range of considerably different levels of intensity. While there was no difference in the levels of HDL-C observed according to age and physical activity intensity in the normal group, the level of HDL-C decreased with increasing age and increased with exercise intensity in the metabolic disease group. Physical activity has a different effect depending on age in the metabolic disease.

요약

본 연구의 목적은 2014년 조사되어진 제 6기 2차 국민건강영양조사 자료를 바탕으로 연령별 신체활동에 따른 대사성질환과의 관계를 파악하여 연령별 신체활동에 따른 대사성질환과의 관련성을 규명하여 예방적 기초자료를 제공하기 위한 연구이다. 본 연구는 제 6기 2차(2014) 국민건강영양조사의 자료를 이용하여 수행되었다. 정상군의 382명과 대사질환군의 1,525명을 총 9,701명의 설문 응답자 중 관련 자료가 없는 2,506명을 제외하고 총 7,295명을 분석했다. 본 연구에서 신체활동은 국제신체활동 설문지 (IPAQ)를 기반으로 재분류 되었다. 대사증후군의 정의는 2004년 개정 된 NCEP-ATP III에 근거하여 다음과 같은 결론을 얻었다. 연령에 따른 대사성질환과 신체활동과의 관계에서 10∼29세 정상군과 50∼69세의 대사질환군에서 혈색소, 적혈구용적, 크리아티닌의 수치는 고강도 신체활동이 수행되었을 때 증가했고 저강도 신체활동을 수행되었을 때 감소했다. 30∼49세의 정상군과 대사질환군에서 고밀도 지단백 콜레스테롤 수치는 고강도 신체활동이 수행되었을 때 증가했지만, 저강도 신체활동이 수행되었을 때 감소하였다. 따라서 연령과 운동강도가 고밀도 지단백 콜레스테롤 수치에 미치는 영향을 조사하였다. 결과는 정상군에서 연령과 운동강도에 따라 고밀도 지단백 콜레스테롤 수치에 차이는 없었지만 대사질환군에서는 연령에 따라 고밀도 지단백 콜레스테롤 수치가 감소하였고 운동강도에 따라 증가하였다. 종합하면, 본 연구의 결과는 대사질환군에서 고밀도 지단백 콜레스테롤 수치는 고강도 신체활동에서 긍정적인 효과를 나타내고 연령은 부정적인 효과를 나타냈다. 이러한 결과는 우리가 신체활동과 연령에 따라 대사성질환을 더 잘 이해하는데 도움이 될 수 있다.

Acknowledgements

None

Conflict of interest

None

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