健康診断受診者の心・脳血管障害発症の季節性とリスク因子関与の差異
目的：心筋梗塞や脳卒中の発症は季節との関連性が報告されている．多くの研究は病院に入院した患者の統計である．そこで，一般企業の健康診断診受診者を対象に，心筋梗塞・脳卒中を発症した季節およびリスク因子を調べ，疾患の特徴と差異を検討した．また，心・脳血管障害発症例と非発症例の危険因子の差も検討した． 対象と方法：A社（健康診断受診者10,450名）における1年間の心・脳血管障害発症月およびリスク因子を調査した．非発症例のリスク因子との比較も行った． 結果：心・脳血管障害は12例（心筋梗塞5例，脳出血2例，くも膜下出血3例，脳梗塞2例）に発症した．全例男性，発症平均年齢は50.7歳で心筋梗塞は全例40...
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| Published in | 人間ドック (Ningen Dock) Vol. 31; no. 5; pp. 668 - 674 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
公益社団法人 日本人間ドック学会
2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1880-1021 2186-5027 |
| DOI | 10.11320/ningendock.31.668 |
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| Abstract | 目的：心筋梗塞や脳卒中の発症は季節との関連性が報告されている．多くの研究は病院に入院した患者の統計である．そこで，一般企業の健康診断診受診者を対象に，心筋梗塞・脳卒中を発症した季節およびリスク因子を調べ，疾患の特徴と差異を検討した．また，心・脳血管障害発症例と非発症例の危険因子の差も検討した． 対象と方法：A社（健康診断受診者10,450名）における1年間の心・脳血管障害発症月およびリスク因子を調査した．非発症例のリスク因子との比較も行った． 結果：心・脳血管障害は12例（心筋梗塞5例，脳出血2例，くも膜下出血3例，脳梗塞2例）に発症した．全例男性，発症平均年齢は50.7歳で心筋梗塞は全例40歳代に発症していた．発症を月別に検討すると夏と冬の2峰性のピークを有していた．特に，心筋梗塞では8月と冬に発症が多かった．一方，脳卒中は季節に関らず通年発症していた．リスク因子にも特徴があり，心筋梗塞者は脳卒中に比べ内臓肥満が多かった．血圧高値は脳卒中例で86%と高頻度に認められた．特に脳出血（脳出血＋くも膜下出血）例では全例血圧高値であった．高LDL-C血症は心筋梗塞全例に認められた．喫煙中であったものは心筋梗塞例が60%で脳卒中に比べ多かった．非発症例との比較では，心・脳血管障害発症者は非発症者と比べ，血圧，血糖，LDLコレステロール，中性脂肪が高く，肥満傾向であった． 結論：心筋梗塞と脳卒中は血管障害を共通の病因として発症するが，心筋梗塞と脳卒中の発症の季節性とリスク因子は多少異なる．心筋梗塞は夏と冬に多く発症の季節性が示唆された．一方，脳卒中では1年を通じ発症していた．リスク因子に関して，心筋梗塞発症例は脳卒中に比べ肥満が多く，特に，内臓肥満が多く認められた． |
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| AbstractList | 目的：心筋梗塞や脳卒中の発症は季節との関連性が報告されている．多くの研究は病院に入院した患者の統計である．そこで，一般企業の健康診断診受診者を対象に，心筋梗塞・脳卒中を発症した季節およびリスク因子を調べ，疾患の特徴と差異を検討した．また，心・脳血管障害発症例と非発症例の危険因子の差も検討した． 対象と方法：A社（健康診断受診者10,450名）における1年間の心・脳血管障害発症月およびリスク因子を調査した．非発症例のリスク因子との比較も行った． 結果：心・脳血管障害は12例（心筋梗塞5例，脳出血2例，くも膜下出血3例，脳梗塞2例）に発症した．全例男性，発症平均年齢は50.7歳で心筋梗塞は全例40歳代に発症していた．発症を月別に検討すると夏と冬の2峰性のピークを有していた．特に，心筋梗塞では8月と冬に発症が多かった．一方，脳卒中は季節に関らず通年発症していた．リスク因子にも特徴があり，心筋梗塞者は脳卒中に比べ内臓肥満が多かった．血圧高値は脳卒中例で86%と高頻度に認められた．特に脳出血（脳出血＋くも膜下出血）例では全例血圧高値であった．高LDL-C血症は心筋梗塞全例に認められた．喫煙中であったものは心筋梗塞例が60%で脳卒中に比べ多かった．非発症例との比較では，心・脳血管障害発症者は非発症者と比べ，血圧，血糖，LDLコレステロール，中性脂肪が高く，肥満傾向であった． 結論：心筋梗塞と脳卒中は血管障害を共通の病因として発症するが，心筋梗塞と脳卒中の発症の季節性とリスク因子は多少異なる．心筋梗塞は夏と冬に多く発症の季節性が示唆された．一方，脳卒中では1年を通じ発症していた．リスク因子に関して，心筋梗塞発症例は脳卒中に比べ肥満が多く，特に，内臓肥満が多く認められた． |
| Author | 船津, 和夫 小原, 啓子 山下, 毅 近藤, 修二 中村, 治雄 水野, 杏一 横山, 雅子 影山, 洋子 本間, 優 |
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| References_xml | – reference: 24）Cantin B, Després JP, Lamarche B, et al: Association of fibrinogen and lipoprotein(a) as coronary heart disease risk factor in men (The Quebec Cardiovascular Study). Am J Cardiol 2002; 89: 662-666. – reference: 49）Adamsson Eryd S, Gudbjörnsdottir S, Manhem K, et al: Blood pressure and complications in individuals with type 2 diabetes and no previous cardiovascular disease: national population based cohort study. BMJ 2016; 354: i4070. – reference: 16）沢登貴雄，小森貞嘉：季節の心疾患，特に急性心筋梗塞症への影響．地球環境 2003；8：193-200． – reference: 41）Esteban MR, Montero SM, Sánchez JJ, et al: Acute coronary syndrome in the young: clinical characteristics, risk factors and prognosis. Open Cardiovasc Med J 2014; 8: 61-67. – reference: 9）Shigematsu K, Watanabe Y, Nakano H, et al: Higher ratio of ischemic stroke to hemorrhagic stroke in summer. Acta Neurol Scand 2015; 132: 423-429. – reference: 45）O'Donnell MJ, Chin SL, Rangarajan S, et al; INTERSTROKE investigators: Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet 2016; 388: 761-775. – reference: 37）Harmsen P, Rosengren A, Tsipogianni A, et al: Risk factors for stroke in middle-aged men in Göteborg, Sweden. Stroke 1990; 21: 223-229. – reference: 48）Ettehad D, Emdin CA, Kiran A, et al: Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016; 387: 957-967. – reference: 2）Honda T, Fujimoto K, Miyao Y: Influence of weather conditions on the frequent onset of acute myocardial infarction. J Cardiol. 2016; 67: 42-50. – reference: 20）Marchant B, Ranjadayalan K, Stevenson R, et al: Circadian and seasonal factors in the pathogenesis of acute myocardial infarction: the influence of environmental temperature. Br Heart J 1993; 69: 385-387. – reference: 1）Moschos N, Christoforaki M, Antonatos P: Seasonal distribution of acute myocardial infarction and its relation to acute infections in mild climate. Int J Cardiol 2004; 93: 39-44. – reference: 30）瀧澤俊也，柴田健雄，小林祥泰：脳血栓と脳出血の季節別，月別にみた発症頻度．小林祥泰編，脳卒中データバンク 2009，中山書店，東京，2009，24-25． – reference: 34）Rué M, Camiade E, Jecko V, et al: The relationship between aneurysmal subarachnoid hemorrhage and meteorological parameters based on a series of 236 French patients. Neurochirurgie 2014; 60: 222-226. – reference: 47）SPRINT Research Group, Wright JT Jr, Williamson JD, Whelton PK, et al: A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med 2015; 373: 2103-2116. – reference: 7）林田純人：循環器疾患傷病者の救急搬送：大阪市消防局の経験から．日冠疾会誌 2014；20：42-45． – reference: 5）Field TS, Hill MD: Weather, Chinock, and stroke occurrence. 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Circulation 2003; 107: 346-354. – reference: 35）Chyatte D, Chen TL, Bronstein K, et al: Seasonal fluctuation in the incidence of intracranial aneurysm rupture and its relationship to changing climatic conditions. J Neurosurg 1994; 81: 525-530. – reference: 31）Jakovljevi D, Salomaa V, Sivenius J, et al: Seasonal variation in the occurrence of stroke in a Finnish adult population. The FINMONICA Stroke Register. Finnish Monitoring Trends and Determinants in Cardiovascular Disease. Stroke 1996; 27: 1774-1779. – reference: 25）Azegami M, Hongo M, Yazaki Y, et al: Seasonal difference in onset of coronary heart disease in young Japanese patients: a comparison with older patients. Cir J 2005; 69: 1176-1179. – reference: 27）Cantin B, Després JP, Lamarche B, et al: Association of fibrinogen and lipoprotein(a) as coronary heart disease risk factor in men. Am J Cardiol 2002; 89: 662-666. – reference: 32）Shinkawa A, Ueda K, Hasuo Y, et al: Seasonal variation in stroke incidence in Hisayama, Japan. 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| Snippet | 目的：心筋梗塞や脳卒中の発症は季節との関連性が報告されている．多くの研究は病院に入院した患者の統計である．そこで，一般企業の健康診断診受診者を対象に，心筋梗塞・脳卒中を発症した季節およびリスク因子を調べ，疾患の特徴と差異を検討した．また，心・脳血管障害発症例と非発症例の危険因子の差も検討した．... |
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| SubjectTerms | リスク因子 心筋梗塞 発症季節性 脳卒中 |
| Title | 健康診断受診者の心・脳血管障害発症の季節性とリスク因子関与の差異 |
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