虚血性心電図異常を見出す新しい体格指数の開発
【目的】IHD（虚血性心疾患）関連の心電図異常を見出す能力が高い，侵襲性のない新しい体格指数を作成することを目的とした。【方法】2004～2010年に人間ドックでCT検査を受けた12,628名を対象とした。IHD関連の心電図異常（心電図異常もしくは心筋梗塞現在治療中）を従属変数，身長，体重，ウエスト周囲長CT（WCCT）を独立変数にした回帰分析に基づき，新たな体格指数（BSI）を作成した。ROC曲線を描き，IHD関連の心電図異常を，BSI，内臓脂肪面積（VFA），内臓脂肪面積と皮下脂肪面積の和，WCCT，BMIで比較した。【結果】男性においてIHD関連の心電図異常を見出すためのBSIのROCの...
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| Published in | 栄養学雑誌 Vol. 77; no. 2; pp. 39 - 45 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本栄養改善学会
01.04.2019
日本栄養改善学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5147 1883-7921 |
| DOI | 10.5264/eiyogakuzashi.77.39 |
Cover
| Abstract | 【目的】IHD（虚血性心疾患）関連の心電図異常を見出す能力が高い，侵襲性のない新しい体格指数を作成することを目的とした。【方法】2004～2010年に人間ドックでCT検査を受けた12,628名を対象とした。IHD関連の心電図異常（心電図異常もしくは心筋梗塞現在治療中）を従属変数，身長，体重，ウエスト周囲長CT（WCCT）を独立変数にした回帰分析に基づき，新たな体格指数（BSI）を作成した。ROC曲線を描き，IHD関連の心電図異常を，BSI，内臓脂肪面積（VFA），内臓脂肪面積と皮下脂肪面積の和，WCCT，BMIで比較した。【結果】男性においてIHD関連の心電図異常を見出すためのBSIのROCの曲線下面積（AUC）は，VFA，WCCT，BMIに比べて有意に大きくなっていた（p＜0.01）。女性においてAUCは，WCCTとBMIより有意に大きくなっており（p＜0.05），VFAとはほぼ同等であった。IHD関連の心電図異常を感度80％で見出すことのできるBSIは，男性で－1.2，女性で－2.4であった。【考察】BSIは，IHD関連の心電図異常を見出す能力は，男性ではVFAより大きく，女性ではほぼ同等であることから，医療現場で使う指標としては有用である可能性が示唆された。今後は，IHDリスク評価について縦断的にみていく必要があると考えられる。 |
|---|---|
| AbstractList | 【目的】IHD（虚血性心疾患）関連の心電図異常を見出す能力が高い，侵襲性のない新しい体格指数を作成することを目的とした。【方法】2004～2010年に人間ドックでCT検査を受けた12,628名を対象とした。IHD関連の心電図異常（心電図異常もしくは心筋梗塞現在治療中）を従属変数，身長，体重，ウエスト周囲長CT（WCCT）を独立変数にした回帰分析に基づき，新たな体格指数（BSI）を作成した。ROC曲線を描き，IHD関連の心電図異常を，BSI，内臓脂肪面積（VFA），内臓脂肪面積と皮下脂肪面積の和，WCCT，BMIで比較した。【結果】男性においてIHD関連の心電図異常を見出すためのBSIのROCの曲線下面積（AUC）は，VFA，WCCT，BMIに比べて有意に大きくなっていた（p＜0.01）。女性においてAUCは，WCCTとBMIより有意に大きくなっており（p＜0.05），VFAとはほぼ同等であった。IHD関連の心電図異常を感度80％で見出すことのできるBSIは，男性で－1.2，女性で－2.4であった。【考察】BSIは，IHD関連の心電図異常を見出す能力は，男性ではVFAより大きく，女性ではほぼ同等であることから，医療現場で使う指標としては有用である可能性が示唆された。今後は，IHDリスク評価について縦断的にみていく必要があると考えられる。 【目的】IHD(虚血性心疾患)関連の心電図異常を見出す能力が高い, 侵襲性のない新しい体格指数を作成することを目的とした. 【方法】2004～2010年に人間ドックでCT検査を受けた12,628名を対象とした. IHD関連の心電図異常(心電図異常もしくは心筋梗塞現在治療中)を従属変数, 身長, 体重, ウエスト周囲長CT(WCCT)を独立変数にした回帰分析に基づき, 新たな体格指数(BSI)を作成した. ROC曲線を描き, IHD関連の心電図異常を, BSI, 内臓脂肪面積(VFA), 内臓脂肪面積と皮下脂肪面積の和, WCCT, BMIで比較した. 【結果】男性においてIHD関連の心電図異常を見出すためのBSIのROCの曲線下面積(AUC)は, VFA, WCCT, BMIに比べて有意に大きくなっていた(p<0.01). 女性においてAUCは, WCCTとBMIより有意に大きくなっており(p<0.05), VFAとはほぼ同等であった. IHD関連の心電図異常を感度80%で見出すことのできるBSIは, 男性で-1.2, 女性で-2.4であった. 【考察】BSIは, IHD関連の心電図異常を見出す能力は, 男性ではVFAより大きく, 女性ではほぼ同等であることから, 医療現場で使う指標としては有用である可能性が示唆された. 今後は, IHDリスク評価について縦断的にみていく必要があると考えられる. |
| Author | 横山, 徹爾 松下, 由実 |
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| Copyright | 2019 特定非営利活動法人 日本栄養改善学会 |
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| DOI | 10.5264/eiyogakuzashi.77.39 |
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| References | 20) Prineas, R.J., Crow, R.S., Blackburn, H.: The Minnesota Code Manual of Electrocardiographic Findings: Standards and Procedures for Measurement and Classification (1982) John Wright, London 16) Lemieux, S., Prud'homme, D., Moorjani, S., et al.: Do elevated levels of abdominal visceral adipose tissue contribute to age-related differences in plasma lipoprotein concentrations in men?, Atherosclerosis, 118, 155-164 (1995 8) Wagenknecht, L.E., Langefeld, C.D., Scherzinger, A.L., et al.: Insulin sensitivity, insulin secretion, and abdominal fat: the Insulin Resistance Atherosclerosis Study (IRAS) Family Study, Diabetes, 52, 2490-2496 (2003 11) Sironi, A.M., Gastaldelli, A., Mari, A., et al.: Visceral fat in hypertension: influence on insulin resistance and beta-cell function, Hypertension, 44, 127-133 (2004 17) Kobayashi, H., Nakamura, T., Miyaoka, K., et al.: Visceral fat accumulation contributes to insulin resistance, small-sized low-density lipoprotein, and progression of coronary artery disease in middle-aged non-obese Japanese men, Jpn. Circ. J., 65, 193-199 (2001 6) Boyko, E.J., Fujimoto, W.Y., Leonetti, D.L., et al.: Visceral adiposity and risk of type 2 diabetes: a prospective study among Japanese Americans, Diabetes Care, 23, 465-471 (2000 21) Dobbelsteyn, C.J., Joffres, M.R., MacLean, D.R., et al.: A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys, Int. J. Obes. Relat. Metab. Disord., 25, 652-661 (2001 18) Matsushita, Y., Nakagawa, T., Yamamoto, S., et al.: Associations of visceral and subcutaneous fat areas with the prevalence of metabolic risk factor clustering in 6, 292 Japanese individuals: the Hitachi Health Study, Diabetes Care, 33, 2117-2119 (2010 7) Tulloch-Reid, M.K., Hanson, R.L., Sebring, N.G., et al.: Both subcutaneous and visceral adipose tissue correlate highly with insulin resistance in African Americans, Obes. Res., 12, 1352-1359 (2004 5) Kanaya, A.M., Harris, T., Goodpaster, B.H., et al.: Adipocytokines attenuate the association between visceral adiposity and diabetes in older adults, Diabetes Care, 27, 1375-1380 (2004 3) Goodpaster, B.H., Krishnaswami, S., Resnick, H., et al.: Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women, Diabetes Care, 26, 372-379 (2003 27) Huxley, R., Mendis, S., Zheleznyakov, E., et al.: Body mass index, waist circumference and waist: hip ratio as predictors of cardiovascular risk—a review of the literature, Eur. J. Clin. Nutr., 64, 16-22 (2010 15) Nicklas, B.J., Penninx, B.W., Ryan, A.S., et al.: Visceral adipose tissue cutoffs associated with metabolic risk factors for coronary heart disease in women, Diabetes Care, 26, 1413-1420 (2003 23) Lee, C.M., Huxley, R.R., Wildman, R.P., et al.: Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis, J. Clin. Epidemiol., 61, 646-653 (2008 1) Ignarro, L.J., Balestrieri, M.L., Napoli, C.: Nutrition, physical activity, and cardiovascular disease: an update, Cardiovasc. Res., 73, 326-340 (2007 28) Ehrlich, A.C., Smith, D.A.: Abdominal diameter index and 12-year cardiovascular disease incidence in male bridge and tunnel workers, Int. J. Obes. (Lond.), 35, 409-415 (2011 13) Pascot, A., Lemieux, S., Lemieux, I., et al.: Age-related increase in visceral adipose tissue and body fat and the metabolic risk profile of premenopausal women, Diabetes Care, 22, 1471-1478 (1999 14) Nagaretani, H., Nakamura, T., Funahashi, T., et al.: Visceral fat is a major contributor for multiple risk factor clustering in Japanese men with impaired glucose tolerance, Diabetes Care, 24, 2127-2133 (2001 19) Yamamoto, S., Nakagawa, T., Matsushita, Y., et al.: Visceral fat area and markers of insulin resistance in relation to colorectal neoplasia, Diabetes Care, 33, 184-189 (2010 10) Hayashi, T., Boyko, E.J., Leonetti, D.L., et al.: Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans, Ann. Intern. Med., 140, 992-1000 (2004 24) Ashwell, M., Gunn, P., Gibson, S.: Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis, Obes. Rev., 13, 275-286 (2012 22) Schneider, H.J., Glaesmer, H., Klotsche, J., et al.: DETECT Study Group. Accuracy of anthropometric indicators of obesity to predict cardiovascular risk, J. Clin. Endocrinol. Metab., 92, 589-594 (2007 25) Haun, D.R., Pitanga, F.J., Lessa, I.: Waist-height ratio compared to other anthropometric indicators of obesity as predictors of high coronary risk, Rev. Assoc. Med. Bras., 55, 705-711 (2009 2) Fox, C.S., Massaro, J.M., Hoffmann, U., et al.: Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study, Circulation, 116, 39-48 (2007 12) Ding, J., Visser, M., Kritchevsky, S.B., et al.: The association of regional fat depots with hypertension in older persons of white and African American ethnicity, Am. J. Hypertens., 17, 971-976 (2004 4) Hayashi, T., Boyko, E.J., Leonetti, D.L., et al.: Visceral adiposity and the risk of impaired glucose tolerance: a prospective study among Japanese Americans, Diabetes Care, 26, 650-655 (2003 9) Hayashi, T., Boyko, E.J., McNeely, M.J., et al.: Visceral adiposity, not abdominal subcutaneous fat area, is associated with an increase in future insulin resistance in Japanese Americans, Diabetes, 57, 1269-1275 (2008 26) Zimmet, P., Magliano, D., Matsuzawa, Y., et al.: The metabolic syndrome: a global public health problem and a new definition, J. Atheroscler. Thromb., 12, 295-300 (2005 |
| References_xml | – reference: 19) Yamamoto, S., Nakagawa, T., Matsushita, Y., et al.: Visceral fat area and markers of insulin resistance in relation to colorectal neoplasia, Diabetes Care, 33, 184-189 (2010) – reference: 21) Dobbelsteyn, C.J., Joffres, M.R., MacLean, D.R., et al.: A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys, Int. J. Obes. Relat. Metab. Disord., 25, 652-661 (2001) – reference: 28) Ehrlich, A.C., Smith, D.A.: Abdominal diameter index and 12-year cardiovascular disease incidence in male bridge and tunnel workers, Int. J. Obes. (Lond.), 35, 409-415 (2011) – reference: 2) Fox, C.S., Massaro, J.M., Hoffmann, U., et al.: Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study, Circulation, 116, 39-48 (2007) – reference: 14) Nagaretani, H., Nakamura, T., Funahashi, T., et al.: Visceral fat is a major contributor for multiple risk factor clustering in Japanese men with impaired glucose tolerance, Diabetes Care, 24, 2127-2133 (2001) – reference: 1) Ignarro, L.J., Balestrieri, M.L., Napoli, C.: Nutrition, physical activity, and cardiovascular disease: an update, Cardiovasc. Res., 73, 326-340 (2007) – reference: 24) Ashwell, M., Gunn, P., Gibson, S.: Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis, Obes. Rev., 13, 275-286 (2012) – reference: 25) Haun, D.R., Pitanga, F.J., Lessa, I.: Waist-height ratio compared to other anthropometric indicators of obesity as predictors of high coronary risk, Rev. Assoc. Med. Bras., 55, 705-711 (2009) – reference: 6) Boyko, E.J., Fujimoto, W.Y., Leonetti, D.L., et al.: Visceral adiposity and risk of type 2 diabetes: a prospective study among Japanese Americans, Diabetes Care, 23, 465-471 (2000) – reference: 4) Hayashi, T., Boyko, E.J., Leonetti, D.L., et al.: Visceral adiposity and the risk of impaired glucose tolerance: a prospective study among Japanese Americans, Diabetes Care, 26, 650-655 (2003) – reference: 5) Kanaya, A.M., Harris, T., Goodpaster, B.H., et al.: Adipocytokines attenuate the association between visceral adiposity and diabetes in older adults, Diabetes Care, 27, 1375-1380 (2004) – reference: 9) Hayashi, T., Boyko, E.J., McNeely, M.J., et al.: Visceral adiposity, not abdominal subcutaneous fat area, is associated with an increase in future insulin resistance in Japanese Americans, Diabetes, 57, 1269-1275 (2008) – reference: 13) Pascot, A., Lemieux, S., Lemieux, I., et al.: Age-related increase in visceral adipose tissue and body fat and the metabolic risk profile of premenopausal women, Diabetes Care, 22, 1471-1478 (1999) – reference: 18) Matsushita, Y., Nakagawa, T., Yamamoto, S., et al.: Associations of visceral and subcutaneous fat areas with the prevalence of metabolic risk factor clustering in 6, 292 Japanese individuals: the Hitachi Health Study, Diabetes Care, 33, 2117-2119 (2010) – reference: 17) Kobayashi, H., Nakamura, T., Miyaoka, K., et al.: Visceral fat accumulation contributes to insulin resistance, small-sized low-density lipoprotein, and progression of coronary artery disease in middle-aged non-obese Japanese men, Jpn. Circ. J., 65, 193-199 (2001) – reference: 23) Lee, C.M., Huxley, R.R., Wildman, R.P., et al.: Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis, J. Clin. Epidemiol., 61, 646-653 (2008) – reference: 10) Hayashi, T., Boyko, E.J., Leonetti, D.L., et al.: Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans, Ann. Intern. Med., 140, 992-1000 (2004) – reference: 20) Prineas, R.J., Crow, R.S., Blackburn, H.: The Minnesota Code Manual of Electrocardiographic Findings: Standards and Procedures for Measurement and Classification (1982) John Wright, London – reference: 15) Nicklas, B.J., Penninx, B.W., Ryan, A.S., et al.: Visceral adipose tissue cutoffs associated with metabolic risk factors for coronary heart disease in women, Diabetes Care, 26, 1413-1420 (2003) – reference: 3) Goodpaster, B.H., Krishnaswami, S., Resnick, H., et al.: Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women, Diabetes Care, 26, 372-379 (2003) – reference: 16) Lemieux, S., Prud'homme, D., Moorjani, S., et al.: Do elevated levels of abdominal visceral adipose tissue contribute to age-related differences in plasma lipoprotein concentrations in men?, Atherosclerosis, 118, 155-164 (1995) – reference: 12) Ding, J., Visser, M., Kritchevsky, S.B., et al.: The association of regional fat depots with hypertension in older persons of white and African American ethnicity, Am. J. Hypertens., 17, 971-976 (2004) – reference: 22) Schneider, H.J., Glaesmer, H., Klotsche, J., et al.: DETECT Study Group. Accuracy of anthropometric indicators of obesity to predict cardiovascular risk, J. Clin. Endocrinol. Metab., 92, 589-594 (2007) – reference: 7) Tulloch-Reid, M.K., Hanson, R.L., Sebring, N.G., et al.: Both subcutaneous and visceral adipose tissue correlate highly with insulin resistance in African Americans, Obes. Res., 12, 1352-1359 (2004) – reference: 26) Zimmet, P., Magliano, D., Matsuzawa, Y., et al.: The metabolic syndrome: a global public health problem and a new definition, J. Atheroscler. Thromb., 12, 295-300 (2005) – reference: 27) Huxley, R., Mendis, S., Zheleznyakov, E., et al.: Body mass index, waist circumference and waist: hip ratio as predictors of cardiovascular risk—a review of the literature, Eur. J. Clin. Nutr., 64, 16-22 (2010) – reference: 11) Sironi, A.M., Gastaldelli, A., Mari, A., et al.: Visceral fat in hypertension: influence on insulin resistance and beta-cell function, Hypertension, 44, 127-133 (2004) – reference: 8) Wagenknecht, L.E., Langefeld, C.D., Scherzinger, A.L., et al.: Insulin sensitivity, insulin secretion, and abdominal fat: the Insulin Resistance Atherosclerosis Study (IRAS) Family Study, Diabetes, 52, 2490-2496 (2003) |
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| Snippet | ... 【目的】IHD(虚血性心疾患)関連の心電図異常を見出す能力が高い, 侵襲性のない新しい体格指数を作成することを目的とした. 【方法】2004～2010年に人間ドックでCT検査を受けた12,628名を対象とした. IHD関連の心電図異常(心電図異常もしくは心筋梗塞現在治療中)を従属変数, 身長, 体重,... |
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| SubjectTerms | BMI 体格指数 循環器疾患 肥満 |
| Title | 虚血性心電図異常を見出す新しい体格指数の開発 |
| URI | https://www.jstage.jst.go.jp/article/eiyogakuzashi/77/2/77_39/_article/-char/ja http://mol.medicalonline.jp/library/journal/download?GoodsID=cr6nutri/2019/007702/001&name=0039-0045j |
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| ispartofPNX | 栄養学雑誌, 2019/04/01, Vol.77(2), pp.39-45 |
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