研究者詳細 - 大石　充

論文 - 大石　充

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Kanda Daisuke, Miyata Masaaki, Ikeda Yoshiyuki, Tokushige Akihiro, Sonoda Takeshi, Arikawa Ryo, Anzaki Kazuhiro, Kosedo Ippei, Yoshino Satoshi, Takumi Takuro, Ohishi Mitsuru . ストロングスタチン服用の安定狭心症患者における新たな病変の予測にはnon-HDLコレステロールによる評価を優先すべきである(The Priority of Non-HDL-C Assessment to Predict New Lesions among Stable Angina Patients with Strong Statins) . Journal of Atherosclerosis and Thrombosis29 ( 6 ) 894 - 905 2022年6月

記述言語：英語出版者・発行元：(一社)日本動脈硬化学会

ストロングスタチンを服用している安定狭心症患者537例(男性392例、女性145例)を対象に、non-HDLコレステロール(non-HDL-C)が経皮的冠動脈インターベンション(PCI)後の新たな冠動脈狭窄病変を予測するかどうかについて検討した。予測能をFridewald式およびMartin式で推算したLDLコレステロール(LDL-C)値と比較した。追跡期間は2年で、新たな狭窄病変(NL)は90例で検出された。患者をNL群90例(男性74%、年齢中央値66歳)と非NL群447例(男性73%、年齢中央値70歳)の2群に分類した。患者背景はNL群の方が若年で、糖尿病が有意に多かった。Fridewald(F)式およびMartin式による推算LDL-C値が70mg/dL以上、non-HDL-Cが100mg/dL以上の患者はNL群の方が多かった。単変量解析で糖尿病、F式とMartin式の推算LDL-C値が70mg/dL以上、non-HDL-Cが100mg/dL以上が新たな病変と有意に関連した。多変量解析では糖尿病、およびnon-HDL-Cが100mg/dL以上(OR:1.85、P=0.016)が新たな病変を予測する独立因子であった。

赤井田将真, 中井雄貴, 富岡一俊, 谷口善昭, 立石麻奈, 田平隆行, 竹中俊宏, 窪薗琢郎, 大石充, 牧迫飛雄馬 . 地域在住高齢者ドライバーにおける自動車事故歴と転倒歴の関係 . 日本老年療法学会誌1 1 - 6 2022年6月

記述言語：日本語出版者・発行元：(一社)日本老年療法学会

地域在住高齢者ドライバーにおける自動車事故歴と転倒歴の関連性について検討した。地域コホート研究(垂水研究2018または2019)に参加した地域在住高齢者1029名のうち、調査時点で自動車運転免許を保有しており自動車運転をしている602名(女性50.0%、平均72.8±5.6歳)を対象とした。過去2年間の自動車事故経験者(事故歴あり)は34名(女性55.9%、平均72.7±4.9歳)、事故歴なしは568名(女性49.6%、平均72.9±5.7歳)であった。過去1年間の転倒経験者は78名(13.0%)であった。事故歴あり群は事故歴なし群に比べ転倒歴を有する割合が有意に高かった。事故歴とその他の変数(年齢、性別、多剤併用、運転頻度、運転距離、GDS-15、身体機能低下、MCI)の関係については群間での有意な差は認められなかった。二項ロジスティック回帰分析では、転倒歴を有することは事故歴を有することと有意な関連を認めた。

Hamamoto Yuki, Tokushige Akihiro, Yuasa Toshinori, Ikeda Yoshiyuki, Horizoe Yoshihisa, Yasuda Hisayo, Kubozono Takuro, Ohishi Mitsuru . 術前患者の深部静脈血栓症診断のための新たな検査前確率スコア(A new pre-test probability score for diagnosis of deep vein thrombosis in patients before surgery) . Journal of Cardiology79 ( 5-6 ) 664 - 670 2022年6月

記述言語：英語出版者・発行元：(一社)日本心臓病学会

深部静脈血栓症(DVT)が疑われる外来および入院患者973例(男性490例、女性483例)を対象に、術前にDVTを予測する検査前確率スコアを作成し、その妥当性を検証した。全例で超音波検査(全下肢静脈エコー)を実施した。いずれの症例も術前のDダイマー値は1μg/mL以上であった。患者を、予測スコアを作成するための導出群651例(女性51%、平均67.6±13.9歳)と妥当性を検証するための検証群322例(女性49%、平均67.6±13.9歳)に分類した。検査前確率スコアはDダイマー値が1.5μg/mL以上に2点、60歳以上、女性、糖質コルチコイドの使用、長期の運動制限、DVTリスクの高い悪性腫瘍にそれぞれ1点を加算して、0～2点を低リスク、3～4点を中等度リスク、5点以上を高リスクとした。検査前確率スコアのROC曲線下面積(AUC)は導出群で0.72、検証群で0.70であった。導出群でDVTの診断率は低リスク群(7%)、中等度リスク群(23%)に比べて高リスク群(47%)で有意に高かった。同様に検証群もそれぞれ6%、22%、50%と高リスク群で有意に高かった(いずれもP<0.0001)。

記述言語：日本語出版者・発行元：(一社)日本老年療法学会

Shidou R, Kohjitani A, Miyata M, Yamashita K, Ohno S, Ohishi M, Sugimura M . Estimation of the Risk of Postoperative Hypertension Following Minor to Moderate Surgery Using an Echocardiogram and Biomarkers . Int Heart J.63 ( 3 ) 558 - 565 2022年5月査読

出版者・発行元：一般社団法人インターナショナル・ハート・ジャーナル刊行会

This study aimed to determine independent factors for developing postoperative hypertension using 4 biomarkers in patients receiving oral and maxillofacial surgery under general anesthesia. Brain natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity myocardial troponin T (hs-TnT), and high-sensitivity myocardial troponin I (hs-TnI) were measured and preoperative echocardiograms were examined. Episodes of systolic blood pressure (SBP) ≥170 mmHg or diastolic blood pressure ≥100 mmHg within 1 week after surgery were considered postoperative hypertension. We analyzed 213 (130 men; 83 women) patients, who were divided into a postoperative hypertension group (HT group, n = 32) and a normal group (N group, n = 181). The HT group showed a higher LVMI (113.5 versus 100.1), higher E/e’ of the lat-eral wall (9.1 versus 7.7), and higher BNP (39.2 versus 22.9 pg/mL), NT-proBNP (400.1 versus 143.9 pg/mL), and hs-TnT (15.6 versus 10.3 ng/L) concentrations compared to the N group. NT-proBNP and hs-TnT concentrations positively associated with E/e’, but BNP and hs-TnI did not. NT-proBNP (AUC = 0.64, cutoff value: 117.0 pg/mL) and hs-TnT (AUC = 0.61, cutoff value: 11.0 ng/L) concentrations were effective for discriminat-ing E/e’ ≥12. Multivariate logistic regression analyses showed that risk factors responsible for developing postoperative hypertension were NT-proBNP and hs-TnT using biomarkers and E/e’ as independent variables, and NT-proBNP and SBP at admission using biomarkers and SBP at admission as independent variables. These findings suggest that NT-proBNP and hs-TnT concentrations, and SBP at admission, are useful to predict postoperative hypertension after minor to moderate surgery, and that left ventricular filling pressure is a primary factor associated with postoperative hypertension.

DOI： 10.1536/ihj.22-074

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Uchikado Y., Ikeda Y., Ohishi M. . Current Understanding of the Pivotal Role of Mitochondrial Dynamics in Cardiovascular Diseases and Senescence . Frontiers in Cardiovascular Medicine9 905072 2022年5月

記述言語：日本語出版者・発行元：Frontiers in Cardiovascular Medicine

The heart is dependent on ATP production in mitochondria, which is closely associated with cardiovascular disease because of the oxidative stress produced by mitochondria. Mitochondria are highly dynamic organelles that constantly change their morphology to elongated (fusion) or small and spherical (fission). These mitochondrial dynamics are regulated by various small GTPases, Drp1, Fis1, Mitofusin, and Opa1. Mitochondrial fission and fusion are essential to maintain a balance between mitochondrial biogenesis and mitochondrial turnover. Recent studies have demonstrated that mitochondrial dynamics play a crucial role in the development of cardiovascular diseases and senescence. Disruptions in mitochondrial dynamics affect mitochondrial dysfunction and cardiomyocyte survival leading to cardiac ischemia/reperfusion injury, cardiomyopathy, and heart failure. Mitochondrial dynamics and reactive oxygen species production have been associated with endothelial dysfunction, which in turn causes the development of atherosclerosis, hypertension, and even pulmonary hypertension, including pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Here, we review the association between cardiovascular diseases and mitochondrial dynamics, which may represent a potential therapeutic target.

DOI： 10.3389/fcvm.2022.905072

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Miyata H., Maruta M., Makizako H., Han G., Ikeda Y., Nakamura A., Tokuda K., Shimokihara S., Akaida S., Hidaka Y., Akasaki Y., Kubozono T., Ohishi M., Tabira T. . Association between satisfaction with meaningful activities and social frailty in community-dwelling Japanese older adults . Archives of Gerontology and Geriatrics100 104665 - 104665 2022年5月査読国際誌

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Archives of Gerontology and Geriatrics

Objectives: This cross-sectional study investigates the associations among satisfaction with meaningful activities, and social frailty in community-dwelling Japanese older adults. Methods: We analyzed data from 596 older adults (mean age 74.2 ± 6.4 years, female 63.6%) who participated in the Tarumizu Study 2019, a community-based health survey. Participants selected meaningful activities from 95 activities using the Aid for Decision-Making in Occupation Choice (ADOC) tool. Satisfaction was evaluated from 1 to 5, and those who were assigned a rating of 4 or 5 were operationally classified as the high satisfaction group (n = 487), with others occupying the low satisfaction group (n = 109). Both groups were evaluated based on the ADOC, social frailty (Makizako's five items), physical function, depressive symptoms, cognitive function, and higher-level competence. Results: Of the 596 participants, 18.7% showed prevalence of social frailty. The low satisfaction group had a significantly higher prevalence of social frailty (low satisfaction 28.4% vs. high satisfaction 16.4%, P = 0.004) and depressive symptoms (low satisfaction 30.3% vs. high satisfaction 17.9%, P<0.01), and poor higher-level competence (P = 0.026) than the high satisfaction group. Logistic regression analysis showed that social frailty (Odds Ratio 1.78, 95% Confidence Interval 1.068–2.990, P = 0.027) was significantly associated with satisfaction with meaningful activity after adjusting for covariates. We found no significant differences in categories of meaningful activities between the low and high satisfaction groups (P = 0.549). Conclusions: This study suggested that social frailty was associated with satisfaction with meaningful activities, regardless of the degree or category of satisfaction.

DOI： 10.1016/j.archger.2022.104665

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Hamamoto Y, Tokushige A, Toshinori Y, Ikeda Y, Horizoe Y, Yasuda H, Kubozono T, Ohishi M . A new pre-test probability score for diagnosis of deep vein thrombosis in patients before surgery . Journal of Cardiology79 ( 5 ) 664 - 670 2022年5月査読国際誌

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: Venous thromboembolism is a serious perioperative complication. We developed a new pre-test probability score for predicting deep vein thrombosis (DVT) before surgery. Methods: Whole leg ultrasonography was performed on 973 inpatients and outpatients with suspected DVT based on a preoperative D-dimer cut-off value of ≥ 1 μg/ml. We allocated two-thirds (n = 651) of the study participants to a derivation cohort and one-third (n = 322) to a validation cohort. The pre-test probability model was developed from the derivation cohort data. Results: The pre-test probability model for DVT assigned 2 points to D-dimer ≥ 1.5 μg/mL and 1 point each to age ≥ 60 years, female sex, ongoing glucocorticoid therapy, prolonged immobility, and cancer with high risk of DVT. The area under the curve of the pre-test probability score was 0.72 and 0.70 in the derivation and validation cohorts, respectively. The rates of DVT according to pre-test probability scores in the derivation and validation cohorts were 7% and 6% in the low (score = 0-2), 23% and 22% in the intermediate (score = 3-4), and 47% and 50% in the high probability group (score ≥ 5), respectively (p < 0.0001). Conclusions: The pre-test probability score (Kagoshima-DVT score) was helpful in detecting preoperative DVT in both inpatients and outpatients. We identified low probability group to reduce whole-leg ultrasonography and high probability group to detect more DVT before surgery.

DOI： 10.1016/j.jjcc.2021.11.025

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Shibata K., Tokushige A., Imamura M., Ikeda Y., Ohishi M. . Evaluating the Khorana risk score of gastrointestinal cancer patients during initial chemotherapy as a predictor of patient mortality: A retrospective study . Journal of Cardiology79 ( 5 ) 655 - 663 2022年5月査読国際誌

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: The Khorana risk score (KRS) has been recommended for predicting the incidence of cancer-associated thrombosis (CAT). However, it has been reported KRS was not useful in predicting CAT, but rather in predicting death by setting high scores for the primary tumor site or a low prevalence of severe obesity. Methods: A total of 260 consecutive patients with no history of thrombosis and who started initial chemotherapy for gastrointestinal cancer from January 2017 to December 2018 at our hospital were divided into three groups according to KRS; they were observed until December 2019 [122 patients (46.9%) in the low-risk group, 114 patients (43.8%) in the intermediate-risk group, and 24 patients (9.2%) in the high-risk group]. The incidence of CAT and all-cause death were compared among the three groups. Results: The median age of the patients was 67 years; 63.5% were men. CAT was observed in 61 patients (26.1%); 84 patients (37.9%) died during the observation period. The incidence rate of CAT was similar among the three groups (log-rank p = 0.4); but all-cause death showed a significant difference among the three groups (high-risk group: 58.2%, intermediate-risk group: 44.6%, low-risk group: 27.5%, log-rank p = 0.002). In the multivariate analysis, the high-risk KRS group remained at increased risk for all-cause death (HR, 2.83; 95% CI, 1.37–5.83; p = 0.005), but not with CAT. Conclusions: The KRS at the start of chemotherapy for gastrointestinal cancer is not effective in predicting CAT, but it is effective in predicting prognosis in patients with gastrointestinal cancer.

DOI： 10.1016/j.jjcc.2021.11.024

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Kanouchi H, Yamashita M, Kaimoto K, Kuwabara A, Kawakami Y, Takenaka S, Koriyama C, Kuwahata S, Takenaka T, Akasaki Y, Kubozono T, Miyata M, Ohishi M . Association of blood pressure and dietary intake of Sunomono, Japanese vinegared side dishes, in community-dwelling Japanese: A cross-sectional study . Heliyon8 ( 5 ) e09505 2022年5月査読国際誌

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Heliyon

Objective: Vinegar has been reported to have a hypotensive effect. We aimed to investigate the relationship between the consumption of vinegar-based side dishes and blood pressure. Research methods & procedures: This cross-sectional study included 746 individuals (257 men and 489 women) aged ≥40 years from Tarumizu, Kagoshima, Japan. Nutrient intake was estimated based on the brief-type self-administered diet history questionnaire. The intake frequency of vinegar-based side dishes (Sunomono and pickles) was determined using a self-administered diet history questionnaire. Participants who did not consume vinegar-based side dishes for a month were defined as having no Sunomono or pickle eating habit. Blood pressure was categorized into four groups according to the Japanese Society of Hypertension Guidelines for the Management of Hypertension. The association between the intake of vinegar-based side dishes and blood pressure categories was analyzed using ordinal logistic regression analysis adjusted for age, body mass index, smoking history, excessive alcohol intake, living situation, energy intake, protein intake, sodium intake, potassium intake, and seaweed intake. Results: Approximately 13.6% men and 6.1% women had no Sunomono eating habits. In men, eating Sunomono, but not pickles, was significantly related to blood pressure categories (estimate, −0.702; 95% CI, −1.122 to −0.310), whereas more frequent consumption of Sunomono did not show an improvement in the blood pressure category. The relationship between eating Sunomono and blood pressure categories was not recognized in women. Conclusion: This was the first study assessing the association between consumption of vinegar-based side dishes and blood pressure categories. We highlighted the effect of Sunomono consumption on blood pressure categories in men. Consumption of Sunomono may improve blood pressure in men.

DOI： 10.1016/j.heliyon.2022.e09505

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Shidou Rumi, Kohjitani Atsushi, Miyata Masaaki, Yamashita Kaoru, Ohno Sachi, Ohishi Mitsuru, Sugimura Mitsutaka . 心エコー所見およびバイオマーカーを用いた軽度から中等度の手術後の高血圧発症リスクの推定(Estimation of the Risk of Postoperative Hypertension Following Minor to Moderate Surgery Using an Echocardiogram and Biomarkers) . International Heart Journal63 ( 3 ) 558 - 565 2022年5月

記述言語：英語出版者・発行元：(一社)インターナショナルハートジャーナル刊行会

全身麻酔による歯科口腔外科手術を施行した患者213例を対象に、術後高血圧症の関連因子について検討した。術後1週間以内に収縮期血圧が170mmHg以上または拡張期血圧が100mmHg以上を呈した症例を術後高血圧と定義した。術後高血圧は32例で認めた。患者を術後高血圧の陽性群32例(男性19例、女性13例、平均74.6±10.6歳)と陰性群181例(男性111例、女性70例、平均70.9±11.4歳)に分類した。左室心筋重量係数は術後高血圧群(113.5±31.3)の方が陰性群(100.1±24.6)より有意に高く(P=0.0072)、E/e'も術後高血圧群の方が有意に高かった。脳性ナトリウム利尿ペプチド(BNP)、NT-proBNP、高感度心筋トロポニンT(hs-TnT)は術後高血圧群の方が有意に高く、NT-proBNPおよびhs-TnTはE/e'と正に相関した。多重ロジスティック回帰分析でNT-proBNP(OR:1.0020、P=0.0496)、hs-TnT(OR:1.0658、P=0.0472)、入院時の収縮期血圧(OR:1.0348、P=0.0026)が術後高血圧の有意な関連因子であった。

Yamamoto K, Akasaka H, Yasunobe Y, Shimizu A, Nomoto K, Nagai K, Umegaki H, Akasaki Y, Kojima T, Kozaki K, Kuzuya M, Ohishi M, Akishita M, Takami Y, Rakugi H . Clinical characteristics of older adults with hypertension and unrecognized cognitive impairment . Hypertens Res.45 ( 4 ) 612 - 619 2022年4月査読国際誌

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Hypertension Research

To treat older patients with hypertension, it is important to detect cognitive impairment at an early stage because of its potential influence on treatment efficacy and functional prognosis. In this study, we aimed to identify the incidence and determinants of cognitive impairment in hypertensive patients aged 65 years and above who visited our outpatient clinic and were not previously diagnosed with cognitive impairment. Among 312 patients with hypertension, we found that 35% (n = 109) and 7.7% (n = 24) had cognitive impairment and dementia, respectively, as defined by the Mini-Mental State Examination (≤27 or ≤23, respectively). Patients with cognitive impairment were older, had lower levels of education, and had lower instrumental activities of daily living (IADL) scores than those without cognitive impairment. Multiple regression analysis revealed that age and IADL were associated with cognitive impairment in patients with hypertension. Regarding the treatment of hypertension, the office and home blood pressure levels, number of antihypertensive medications prescribed, and proportion of the use of each antihypertensive drug was equivalent between patients with and without cognitive impairment. Finally, patients with unrecognized cognitive impairment showed distinct clinical characteristics, including high antihypertensive medication burden and preserved IADL, when compared to hypertensive patients in the different cohorts of definitive mild cognitive impairment of a similar age. These findings suggest that older hypertensive patients are at a high risk of masked cognitive decline, even if they are functionally independent.

DOI： 10.1038/s41440-022-00861-z

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Shiina K., Tomiyama H., Tanaka A., Yoshida H., Eguchi K., Kario K., Kato T., Teragawa H., Toyoda S., Ohishi M., Fukumoto Y., Takase B., Ishizu T., Node K. . Differential effect of a xanthine oxidase inhibitor on arterial stiffness and carotid atherosclerosis: a subanalysis of the PRIZE study . Hypertension Research45 ( 4 ) 602 - 611 2022年4月査読国際誌

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Hypertension Research

Atherosclerosis and arterial stiffness are phenotypes of atherosclerotic vascular damage. Atherosclerosis originates from endothelial vascular damage and forms focal morphological lesions; arterial stiffness originates from diffuse medial-layer damage in the arterial tree. Thus, the two phenomena reflect different facets of atherosclerotic vascular damage, and they both gradually progress. We conducted a subanalysis to compare the long-term effects of febuxostat on atherosclerosis and arterial stiffness in the PRIZE study (a multicenter, prospective, randomized, open-label, blinded-endpoint clinical trial to examine the effect of febuxostat on carotid atherosclerosis). Among 514 study participants, arterial stiffness parameters (brachial-ankle pulse wave velocity or cardio-ankle vascular index) were obtained at baseline, 12 months, and 24 months in 100 subjects. Among them, 48 subjects were allocated to the control group (i.e., nonpharmacological lifestyle modification for hyperuricemia), and 52 subjects were allocated to the febuxostat treatment group. While the decrease in serum uric acid was greater in the febuxostat group than in the control group, the adjusted percentage decrease in arterial stiffness parameters at month 24 was greater in the febuxostat group than in the control group, with a mean between-group difference (febuxostat − control) of −5.099% (95% confidence interval (CI) −10.009% to −0.188%, p = 0.042). Thus, long-term treatment with febuxostat may exert beneficial effects on arterial stiffness without improving carotid atherosclerosis. A long-term study to examine the effect of febuxostat on cardiovascular outcomes related to increased arterial stiffness is warranted.

DOI： 10.1038/s41440-022-00857-9

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Shiina Kazuki, Tomiyama Hirofumi, Tanaka Atsushi, Yoshida Hisako, Eguchi Kazuo, Kario Kazuomi, Kato Toru, Teragawa Hiroki, Toyoda Shigeru, Ohishi Mitsuru, Fukumoto Yoshihiro, Takase Bonpei, Ishizu Tomoko, Node Koichi, the PRIZE Study Investigators . 【アジアにおける高血圧管理の現在のエビデンスと展望】動脈壁硬化および頸動脈アテローム硬化に対するキサンチンオキシダーゼ阻害剤の効果の違い　PRIZE試験のサブ解析(【Current evidence and perspectives for hypertension management in Asia】Differential effect of a xanthine oxidase inhibitor on arterial stiffness and carotid atherosclerosis: a subanalysis of the PRIZE study) . Hypertension Research45 ( 4 ) 602 - 611 2022年4月

記述言語：英語出版者・発行元：Nature Publishing Group

PRIZE試験は、頸動脈アテローム硬化に対するフェブキソスタット(Feb)の効果について検討した多施設共同前向き無作為化非盲検エンドポイント臨床試験である。今回、PRIZE試験のサブ解析を実施し、アテローム硬化および動脈壁硬化に対するFebの長期効果を比較した。Feb群52例(中央値66.55歳)と対照群48例(中央値71.00歳)を対象とした。評価項目は、ベースライン時、12ヵ月時、24ヵ月時の動脈壁硬化パラメータ(上腕・足首間脈波伝播速度または心臓足首血管指数)、総頸動脈中膜内膜複合体厚などとした。その結果、Feb群では対照群と比較して血清尿酸値の減少が大きかった。しかし、24ヵ月時点での動脈壁硬化パラメータの調整済み減少率は、対照群と比較してFeb群で大きかった(平均群間差、Feb-対照、p=0.042)。平均総頸動脈中膜内膜複合体厚のベースラインから24ヵ月までの変化率に両群間で差は認められなかった。以上から、Feb長期投与は頸動脈アテローム硬化を改善することなく、動脈壁硬化に有益な効果を発揮する可能性が示された。

Yamamoto Koichi, Akasaka Hiroshi, Yasunobe Yukiko, Shimizu Atsuya, Nomoto Kenichiro, Nagai Kumiko, Umegaki Hiroyuki, Akasaki Yuichi, Kojima Taro, Kozaki Koichi, Kuzuya Masafumi, Ohishi Mitsuru, Akishita Masahiro, Takami Yoichi, Rakugi Hiromi, Cherry Study Group . 【アジアにおける高血圧管理の現在のエビデンスと展望】認知機能障害が認められない高血圧症高齢者の臨床的特徴(【Current evidence and perspectives for hypertension management in Asia】Clinical characteristics of older adults with hypertension and unrecognized cognitive impairment) . Hypertension Research45 ( 4 ) 612 - 619 2022年4月

記述言語：英語出版者・発行元：Nature Publishing Group

当院外来を受診した65歳以上の高血圧症患者のうち、過去に認知障害と診断されていない患者312例を対象に、認知機能障害の発生率とその決定要因について検討した。評価項目は患者背景、ミニメンタルステート検査、手段的日常生活動作(IADL)などとした。認知機能障害の高血圧患者109例(男性54例、平均79.0±6.5歳)、非認知機能障害の高血圧患者203例(男性95例、平均75.0±5.4歳)を対象とした。その結果、認知機能障害の高血圧患者は、非認知機能障害の高血圧患者と比較して、高齢で、教育水準が低く、IADLスコアが低かった。重回帰分析の結果、年齢およびIADLが高血圧患者の認知障害と関連していることが示された。両群間で診察室血圧および家庭血圧、降圧剤処方数、各降圧剤の使用割合は同程度であった。また、本試験に参加した認知機能障害の高血圧患者とORANGEレジストリに登録されたMCIを有する高血圧患者を比較した。その結果、本試験に参加した認知機能障害の高血圧患者はORANGEレジストリ患者と比較して降圧剤処方数が多く、重度の高血圧であることが示された。ORANGEレジストリ患者では本試験の患者と比較してIADL障害を有していることが示された。以上から、高血圧高齢患者は、たとえ機能的に自立していたとしても、隠れた認知機能低下リスクが高いことが示唆された。

Kawasoe M., Kawasoe S., Kubozono T., Ojima S., Kawabata T., Ikeda Y., Oketani N., Miyahara H., Tokushige K., Miyata M., Ohishi M. . Development of a risk prediction score for hypertension incidence using Japanese health checkup data . Hypertension Research45 ( 4 ) 730 - 740 2022年4月査読

記述言語：日本語出版者・発行元：Hypertension Research

Hypertension is a risk factor for cardiovascular disease. We developed a simple scoring method for predicting future hypertension using health checkup data. A total of 41,902 participants aged 30–69 years without baseline hypertension who underwent annual health checkups (mean age, 52.3 ± 10.2 years; male, 47.7%) were included. They were randomly assigned to derivation (n = 27,935) and validation cohorts (n = 13,967) at a ratio of 2:1. In the derivation cohort, we performed multivariable logistic regression analysis and assigned scores to each factor significantly associated with 5-year hypertension. We evaluated the predictive ability of the scores using area under the curve (AUC) analysis and then applied them to the validation cohort to assess their validity. The score including items requiring blood sampling ranged from 0 to 14 and included seven indicators (age, body mass index, blood pressure, current smoking, family history of hypertension, diabetes, and hyperuricemia). The score not including items requiring blood sampling ranged from 0 to 12 and included five indicators (the above indicators, except diabetes and hyperuricemia). The score not including items requiring blood sampling was better; blood sampling did not improve diagnostic ability. The AUC of the score not including items requiring blood sampling was 0.76, with a sensitivity and specificity of 0.82 and 0.60, respectively, for scores ≥6 points. The incidence of hypertension gradually and constantly increased (from 0.9 to 49.6%) as the score increased from 0 to ≥10. Analysis in the validation cohort yielded similar results. We developed a simple and useful clinical prediction model to predict the 5-year incidence of hypertension among a general Japanese population. The model had reasonably high predictive ability and reproducibility.

DOI： 10.1038/s41440-021-00831-x

Scopus

PubMed

Kawasoe Mariko, Kawasoe Shin, Kubozono Takuro, Ojima Satoko, Kawabata Takeko, Ikeda Yoshiyuki, Oketani Naoya, Miyahara Hironori, Tokushige Koichi, Miyata Masaaki, Ohishi Mitsuru . 日本の健康診断データを用いた高血圧発症リスク予測スコアの開発(Development of a risk prediction score for hypertension incidence using Japanese health checkup data) . Hypertension Research45 ( 4 ) 730 - 740 2022年4月

記述言語：英語出版者・発行元：Nature Publishing Group

大規模健康診断データを用いて、5年高血圧発症リスクを予測するためスコアリング法の開発を試みた。ベースライン時点で高血圧を有さなかった年次健康診断受診者41902例(男性47.7%、平均52.3±10.2歳)を対象とした。受診者をderivationコホート27935例、validationコホート13967例に無作為にわけて検討した。採血を要するリスクスコア(0～14点;年齢、BMI、血圧、現在の喫煙状況、高血圧の家族歴、糖尿病、高尿酸血症の有無)、採血不要のリスクスコア(0～12点;糖尿病および高尿酸血症を除く上記因子)を作成した。その結果、採血不要スコアのAUCは0.76であり、6点以上では感度、特異度はそれぞれ0.82、0.60であり、採血を要するスコアとほぼ同じであった。高血圧発症率はスコアが高くなるにつれて上昇していた(0～10点以上)。validationコホートでの解析でも同様の結果が得られた。以上から、本モデルの高い予測能および再現性が示された。

谷口善昭, 牧迫飛雄馬, 中井雄貴, 富岡一俊, 窪薗琢郎, 竹中俊宏, 大石充 . 地域在住高齢者における骨量および筋量の低下と身体活動との関連性 . 理学療法学49 ( 2 ) 131 - 138 2022年4月

記述言語：日本語出版者・発行元：(一社)日本理学療法学会連合

【目的】地域在住高齢者における骨量・筋量低下と身体活動との関連性を明らかにすることを目的とした。【方法】地域コホート研究(垂水研究2018)に参加した地域在住高齢者173名を分析対象とした。骨量低下は%YAMが70%以下とし,筋量低下は四肢骨格筋指数がサルコペニアの基準より低いものとした。身体活動量は3軸加速度計を用いて,座位行動時間延長,中高強度身体活動時間低下,歩数低下の有無に分類した。骨量・筋量をもとに正常群,骨量低下群,筋量低下群,骨量・筋量低下群の4群に分類し,基本情報および身体活動を比較した。【結果】骨量・筋量低下群は正常群と比べて中高強度身体活動時間が有意に減少していた(オッズ比3.29,p<0.05,共変量:年齢(5歳階級),性別,歩行速度低下,うつ傾向)。【結論】骨量・筋量低下を併存している高齢者は,中高強度身体活動時間が減少していることが示唆された。(著者抄録)

記述言語：英語出版者・発行元：Nature Publishing Group

牧迫飛雄馬, 白土大成, 椎葉竜平, 谷口善昭, 窪薗琢郎, 大石充 . 地域在住高齢者における運動器疾患，転倒歴および多剤併用とサルコペニアとの関連 . 日本予防理学療法学会雑誌1 ( 0 ) 19 - 24 2022年3月査読

記述言語：日本語出版者・発行元：一般社団法人日本予防理学療法学会

<p>【目的】地域在住高齢者における運動器疾患，転倒歴および多剤併用とサルコペニアとの関連性を調べることを目的とした。【方法】地域コホート研究に参加した高齢者905 名を対象とし，運動器疾患の有無，1 日の服薬数，過去1 年間での転倒歴を聴取した。サルコペニアはAWGS2019 の基準で判定した。【結果】全対象者のうちの166 名（18.3 ％）がサルコペニアに該当した。骨粗鬆症を有する者ではサルコペニアの該当者が有意に多かったが，脊椎疾患および変形性関節症とサルコペニアとの関連は認められなかった。ロジスティック回帰分析の結果，運動器疾患とサルコペニアの関連は確認されず，多剤併用（6 剤以上）（オッズ比1.56）および転倒歴（オッズ比1.65）がサルコペニアと有意に関連していた。【結論】骨粗鬆症を有する高齢者ではサルコペニアに該当する者の割合が高かったものの，多変量解析においてはサルコペニアと運動器疾患との関連性は認められず，多剤併用および転倒歴がサルコペニアと関連する要因として抽出された。</p>

DOI： 10.57304/jptp.1.0_19

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