臨牀消化器内科 Vol.28 No.4(6-2)


特集名 NASH ― 病態と治療
題名 NASHの成因と病態 (2) NAFLD／NASHと生活習慣病
発刊年月 2013年 04月
著者 荒瀬 康司 虎の門病院健康管理センター・画像センター，肝臓センター兼任
【 要旨 】 NAFLDでの生活習慣病の頻度および発生率を検討した．当院健診初回受診者39,851例でのNAFLDの頻度は，男性20％強，女性10％強であった．NAFLDでのメタボリックシンドロームの合併は，男性で30％強，女性で10％強にみられた．NAFLDでの新規糖尿病発症率は5年6.8％，10年17.7％，新規慢性腎臓病発症率は5年3.1％，10年12.2％であった．心・脳血管系病変の発症率は60歳以上では10年で11.7％であった．NAFLD症例の診療に際しては，肝臓以外に脂質異常，糖尿病，高血圧，心・脳血管病変，慢性腎障害なども念頭に入れ診療する必要性がある．
Theme NASH -- Pathogenesis and Treatment
Title Relationship between Non-alcoholic Fatty Liver Disease and Lifestyle Related Disease
Author Yasuji Arase Department of Health Management Center, Department of Radiology, Department of Hepatology, Toranomon Hospital
[ Summary ] Nonalcoholic fatty liver disease (NAFLD) is often present in patients with lifestyle related disease, such as hyperlipidemia, type 2 diabetes mellitus, hypertension, or metabolic syndrome. The aim of this retrospective cohort study was to assess the prevalence of and new developments in treating lifestyle related diseases. A total of 39,851 individuals (males 27,661, females 12,190) underwent the first round of multiphasic health screening examinations at the Toranomon Hospital. The prevalence of NAFLD was 20.8 % in males and 12.8 % in females. The prevalence of metabolic syndrome in patients with NAFLD was 32.4 % in males and 10.6 % in females. Development rate of type 2 diabetes mellitus in a group of 6,003 patients with NAFLD was 6.8 % in the 5th year and 17.7 % in the 10th year. The development rate for chronic kidney disease in a group of 5,561 patients with NAFLD was 3.1 % by the 5th year and 12.2 % by the 10th year. The 10 year cumulative development rate for coronary heart disease or cerebral stroke was 11.7 % out of 1,798 patients with NAFLD at the age of ≥ 60. Thus, our results show that physicians in charge of NAFLD patients should pay attention to the development and prevention of lifestyle related diseases.
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