Wanezaki Masahiro, Watanabe Tetsu, Nishiyama Satoshi, Hirayama Atsushi, Arimoto Takanori, Takahashi Hiroki, Shishido Tetsuro, Miyamoto Takuya, Kawasaki Ryo, Fukao Akira, Kubota Isao
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
J Cardiol. 2016 Aug;68(2):117-24. doi: 10.1016/j.jjcc.2015.08.015. Epub 2015 Sep 26.
It has been reported that there are regional differences in the incidence of acute myocardial infarction (AMI) in Japan. The purpose of this study was to investigate trends in regional differences in AMI incidence and dyslipidemia between coastal and inland areas.
We investigated trends in AMI incidence and risk factors in 5325 first-ever AMI patients residing in a coastal area (n=1817), a rural inland area (n=1959), or an urban inland area (n=1549) for the periods 1994-2002, and 2003-2010, using data from the Yamagata AMI Registry.
Patients in the coastal area were significantly older than those in rural and urban inland areas and had a lower prevalence of dyslipidemia. The age-adjusted incidence rate of AMI was significantly lower in coastal and rural inland areas patients than those from urban inland area (males: 43.3, 42.2, and 51.3/10(5) person-years; females: 17.4, 20.0, and 23.7/10(5) person-years, respectively) during 2 observation periods. Due to a large increase in AMI incidence in younger males of the coastal area and a decrease in AMI incidence in late elderly females of the urban inland area, no significant regional differences in the age-adjusted incidence rates of AMI were observed during the 2003-2010 period in both genders. The increase in AMI incidence in males in the coastal area was associated with an increasing prevalence of dyslipidemia.
There were no longer any regional differences observed in AMI incidence, which was considered to be associated with increased dyslipidemia especially in the coastal area.
据报道，日本急性心肌梗死（AMI）的发病率存在地区差异。本研究的目的是调查沿海和内陆地区AMI发病率及血脂异常的地区差异趋势。
我们利用山形AMI登记处的数据，调查了1994 - 2002年以及2003 - 2010年期间居住在沿海地区（n = 1817）、农村内陆地区（n = 1959）或城市内陆地区（n = 1549）的5325例首次发生AMI的患者的AMI发病率及危险因素趋势。
沿海地区的患者比农村和城市内陆地区的患者年龄显著更大，血脂异常的患病率更低。在两个观察期内，沿海和农村内陆地区患者的年龄调整后AMI发病率显著低于城市内陆地区患者（男性：分别为43.3、42.2和51.3/10⁵人年；女性：分别为17.4、20.0和23.7/10⁵人年）。由于沿海地区年轻男性的AMI发病率大幅上升以及城市内陆地区老年女性的AMI发病率下降，在2003 - 2010年期间，两性的年龄调整后AMI发病率均未观察到显著的地区差异。沿海地区男性AMI发病率的增加与血脂异常患病率的上升有关。
未再观察到AMI发病率的地区差异，这被认为与血脂异常增加有关，尤其是在沿海地区。
