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日本成年人血脂异常治疗现状:基于2009年日本国民健康体检协会数据库的分析

Status of dyslipidemia treatment in Japanese adults: an analysis of the 2009 Japan Society of Ningen Dock database.

作者信息

Takahashi Eiko, Moriyama Kengo, Yamakado Minoru

机构信息

Japan Society of Ningen Dock, Academic Committee, Japan.

出版信息

Intern Med. 2013;52(3):295-301. doi: 10.2169/internalmedicine.52.9054. Epub 2013 Feb 1.

Abstract

OBJECTIVE

The Japan Atherosclerosis Society (JAS) has recommended serum lipid management goals (SLMGs) based on the coronary heart disease (CHD) risk classification included in its 2007 guidelines for the diagnosis and prevention of atherosclerotic cardiovascular disease in the Japanese population (JAS GL 2007). The Japan Society of Ningen Dock created a database of subjects receiving annual health examinations at 21 institutes nationwide. Using this database, we evaluated the efficacy of current treatment for patients with dyslipidemia by identifying risk factors for CHD development, based on the JAS recommendations.

METHODS

This multicenter, retrospective study was conducted using data obtained from 21 institutions across Japan. 17,991 adults taking dyslipidemia medications were enrolled. The JAS GL 2007 was used for evaluation. Since the guideline indicated separate goals (secondary prevention for subjects with a prior history of CHD and primary prevention for those with other CHD risk factors), we evaluated the percentages of goals met. The serum low-density lipoprotein cholesterol (LDL-C) levels were calculated using the Friedewald formula. The LDL-C level was measured using a direct homogeneous assay if the triglycerides (TG) level was 400 mg/dL or higher.

RESULTS

The achievement rates of the SLMGs were as follows: LDL-C, 72.3%; high-density lipoprotein cholesterol (HDL-C), 94.6%; and TG, 69.7%.

CONCLUSION

Our results regarding Japanese patients receiving dyslipidemia treatment for CHD prevention identified insufficient reductions in the levels of LDL-C and TG in those at high risk for CHD and suggest the need for more aggressive lipid-lowering therapy.

摘要

目的

日本动脉粥样硬化协会(JAS)根据其2007年日本人群动脉粥样硬化性心血管疾病诊断和预防指南(JAS GL 2007)中包含的冠心病(CHD)风险分类,推荐了血清脂质管理目标(SLMGs)。日本国民健康体检协会创建了一个全国21家机构接受年度健康检查的受试者数据库。利用该数据库,我们根据JAS的建议,通过识别冠心病发生的风险因素,评估了当前对血脂异常患者的治疗效果。

方法

本多中心回顾性研究使用了从日本各地21家机构获得的数据。纳入了17991名服用血脂异常药物的成年人。采用JAS GL 2007进行评估。由于该指南指出了不同的目标(对有冠心病病史的受试者进行二级预防,对有其他冠心病风险因素的受试者进行一级预防),我们评估了目标达成率。血清低密度脂蛋白胆固醇(LDL-C)水平采用Friedewald公式计算。如果甘油三酯(TG)水平为400mg/dL或更高,则使用直接匀相测定法测量LDL-C水平。

结果

SLMGs的达成率如下:LDL-C为72.3%;高密度脂蛋白胆固醇(HDL-C)为94.6%;TG为69.7%。

结论

我们关于日本接受血脂异常治疗以预防冠心病患者的研究结果表明,冠心病高危患者的LDL-C和TG水平降低不足,提示需要更积极的降脂治疗。

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