http://hdl.handle.net/10564/1561 2007-12 2026-04-10T15:40:39Z http://hdl.handle.net/10564/325 タイトル: 第127回奈良医学会 : 学会記事 2007-12-30T15:00:00Z http://hdl.handle.net/10564/324 タイトル: 神経疾患とメタボリックシンドローム : 通院患者における合併頻度 著者: 上野, 聡; 降矢, 芳子; 杉江, 和馬; 川原, 誠; 形岡, 博史; 斉藤, こずえ; 桐山, 敬生; 木下, 聡子; 平野, 牧人 抄録: Background and Objective: Metabolic syndrome (MetS) is highly prevalent in Japan; however, most previous surveys have studied only adults able to engage fully in normal daily activities, after excluding persons with diseases or disabilities. Recently, lifestyle-related risk factors have been strongly linked to a number of major diseases. In particular, the incidence of atherosclerotic vascular diseases associated with MetS has increased markedly, and this trend is projected to continue. We focused on the prevalence of MetS among out-patients with neurological diseases. Patients and methods: The subjects for this hospital-based study were 713 out-patients with various neurological diseases (329 men, mean age 65.2 ± 14.5 yr, age range 40-78 yr, and 384 women, mean age 64.6 ± 15.3 yr, age range 40-88 yr) who presented at the Department of Neurology, Nara Medical University Hospital. A total of 120 patients had cerebral infarction, 102 Parkinson's disease, 32 spinal spondylosis, 30 headache, 32 myositis, and the rest various other neurological diseases. MetS was diagnosed according to the criteria proposed by The Japanese Society of Internal Medicine in 2005. The cutoff values for waist circumference (WC) were greater than 85 cm in men and 90 cm in women. A diagnosis of MetS additionally required two or more of the following: a serum triglyceride level (TG) of at least 150 mg/dl and/or a high-density lipoprotein cholesterol level (HDLC) of less than 40 mg/dl; a blood pressure (BP) of greater than 130/85; or a fasting plasma glucose level (FPG) of greater than 110 mg/dl. Visceral fat accumulation was measured by abdominal CT scanning (N2systern, K.K., Japan). Results: WC positively correlated with visceral fat area as determined by CT scanning. WC also positively correlated with TG in both sexes and FBS in women, but negatively correlated with HDL-C in both sexes. The mean prevalence of MetS among subjects 40 to 70 years of age was 25.1% in men and 12.6% in women. To assess the incidence of MetS in the absence of cerebrovascular disease (CVD), we performed a subgroup analysis of patients with and without CVD. The risk of MetS was similar in out- patients without CVD and those with CVD. The prevalence of Pre MetS (defined as WC plus one risk factor) plus MetS was 50% in men and 20% in women. The prevalence of MetS in outpatients with neurological diseases was similar to that in the general population. Conclusion: The risk of atherosclerotic diseases in out-patients with neurological diseases is similar to that in the general population, potentially increasing the risk of unfavorable outcomes. The recognition and management of MetS represents an important challenge for physicians and other healthcare professionals. Strategies aimed at reducing risk factors for MetS are urgently required. 2007-12-30T15:00:00Z http://hdl.handle.net/10564/323 タイトル: 健康関連QOLをアウトカムとした地域高齢者のコホート研究－藤原京スタディ－ : 予備調査:健常高齢者の認知機能と抑うつ 著者: 森川, 将行; 木内, 邦明; 橋本, 和典; 長内, 清行; 岸本, 年史; 岡本, 希; 車谷, 典男 抄録: This feasibility investigation for the Fujiwarakyo study, a cohort study focusing on health-related quality of life among the healthy elderly was performed for 5 days in February, 2007. Mental status, one of the investigative components, was evaluated by Mini-Mental State Examination (MMSE), word recall test (one of the subtests of Alzheimer's Disease Assessment Scale-cognitive component-Japanese version: ADAS- Jco9.), and Geriatric Depression Scale, short form (GDS15). Participants consisted of 74 males (mean age: 75.2 y.o.) and 67 females (74.3 y.o.). MMSE scores were distributed from 19 to 30 ; 20 cases (14.2%) were lower than 24 points (dementia range). Mild cognitive impairment (MCI) was found in 9 cases (6.4%), in whom MMSE scores were more than 24 points and less than 1.5 standard deviation (SD) in the word recall test. The mean number of correct answers in the word recall test was 6.0, and they were positively correlated with MMSE scores (R=0.41, P<0.001). GDS15 scores were 2.4 ± 2.0 (mean ± SD) and the healthy elderly with depressive sylnptoms (≧6 points) were 18 cases (12.8%). Scores of MMSE and GDS15 are reported to be affected by gender or education. To exclude these effects, the Fuji'warakyo study to be performed in future is going to consider factors such as gender and education for evaluation dementia, MCI and depressive symptoms. 2007-12-30T15:00:00Z http://hdl.handle.net/10564/322 タイトル: 食事調査の精度向上に関する疫学研究 : 3日間食事記録法と写真および面接を併用する修正法との比較 著者: 天野, 信子 抄録: To evaluate the accuracy improvement of a dietary survey focused on estimation of dietary intake, the author compared data from the 3-day diet record method (3DR method) with data from a modification of the method supplemented with photography and interviews (modified 3DR method). A dietary survey using the 3DR method was performed on 210 first or second grade students of a women's university during April 2001 to January 2003 using the 3DR question/answer form at each season. As the modified 3DR method, each of the students was also required to take photographs of her meals before and after comsumption, and participate in an interview with a registered nutritionist. Eighty-five completed answer forms were finally collected, and the data of 1020 days in total were analyzed. The results were as follows. 1. Both energy and nutrient intakes were estimated as significantly higher in 18 of the 37 items by the 3DR method compared with the modified 3DR method. However, differences between the values estimated by these two methods were within at most 4%. 2.The proportion of discrepancy between the data obtained by the two methods, analyzed by quartiles, was highest for carbohydrates at 24.2% (weighted kappa = 0.68) and lowest for calcium at 6.5% (weighted kappa = 0.91). 3.Seasonal fluctUation in the energy intake-adjusted nutrients intakes was observed for only 6 out of 36 items by the 3DR method, but for 10 items by the modified 3DR method. These results suggest that the modified 3DR method is not necessarily superior to the simple 3DR method in a mass epidemiological study. 2007-12-30T15:00:00Z