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血清LBP値とメタボリックシンドローム発症との関連 : 久山町研究

友岡, 祥子 TOMOOKA, Shoko トモオカ, ショウコ 九州大学

2023.03.20

概要

九州大学学術情報リポジトリ
Kyushu University Institutional Repository

Serum lipopolysaccharide-binding protein levels
and the incidence of metabolic syndrome in a
general Japanese population: the Hisayama Study
友岡, 祥子

https://hdl.handle.net/2324/6787528
出版情報:Kyushu University, 2022, 博士(歯学), 課程博士
バージョン:
権利関係:Copyright © 2022 Shoko Tomooka et al. This is an open access article distributed
under the terms of Creative Commons Attribution License.

(様式3)





:友岡祥子

論 文 名 :Serum lipopolysaccharide-binding protein levels and the
incidence of metabolic syndrome in a general Japanese
population: the Hisayama Study
( 血清LBP値とメタボリックシンドローム発症との関連:久山町研究)




:甲















背景:慢性的な低濃度のリポ多糖がメタボリックシンドローム(MetS)発症に及
ぼす影響は未だ明らかとなっていない。本研究では、日本人の地域住民において、
リポ多糖の指標である血清リポ多糖結合蛋白(LBP)濃度とMetS発症との関連を
検討した。
方法:2002-2003年の久山町健診を受診した40歳以上の住民のうち、MetSを有す
る者を除外した1,869人を対象とし、2007-2008年に再調査を行った。MetSの診断
には、日本の診断基準を用いた。血清LBPレベルは4分位に分類した(Q1群2.209.56, Q2群9.57-10.78, Q3群10.79-12.18, Q4群12.19-24.34 μg/mL)。MetS発
症のオッズ比は、ロジスティック回帰モデルを用いて算出した。
結果:2007-2008年の調査時に159例のMetS発症を認めた。血清LBPレベル別にみ
たMetS発症のオッズ比は、年齢、性別、喫煙、飲酒、運動習慣の多変量調整後、
血清LBPレベルの増加に伴いMetS発症リスクは有意に上昇した(Q1群に対するオ
ッズ比[95%信頼区間]:Q2群2.92[1.59-5.37]、Q3群3.48[1.91-6.35]、Q4
群3.86[2.12-7.03]、傾向性P<0.001])。この関連は、インスリン抵抗性の指
標であるHOMA-IRを追加し調整したモデルではオッズ比の減衰を認めたが、有意
な関連は残存した(傾向性P=0.007)。一方、血清高感度CRPを追加し調整したモ
デルでは有意な関連性は消失した(傾向性P=0.07)。
結論:わが国の地域住民において、血清LBP値の上昇に伴いMetS発症リスクは有
意に上昇した。以上の成績より、低濃度のエンドトキシン血症は、全身性の慢性
炎症とインスリン抵抗性を介してMetS発症の病態に関与することが示唆された。

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