Satoh Hiroaki, Ohira Tetsuya, Nagai Masato, Hosoya Mitsuaki, Sakai Akira, Watanabe Tsuyoshi, Ohtsuru Akira, Kawasaki Yukihiko, Suzuki Hitoshi, Takahashi Atsushi, Kobashi Gen, Ozasa Kotaro, Yasumura Seiji, Yamashita Shunichi, Kamiya Kenji, Abe Masafumi
Department of Nephrology, Hypertension, Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Japan.
Intern Med. 2016;55(15):1967-76. doi: 10.2169/internalmedicine.55.6030. Epub 2016 Aug 1.
Objective The Great East Japan Earthquake and the Fukushima Daiichi nuclear disaster forced the evacuation of residents and led to many changes in the lifestyle of the evacuees. A comprehensive health check was implemented to support the prevention of lifestyle-related disease, and we analyzed changes in lipid metabolism before and after these disasters. Methods Subjects included Japanese men and women living near the Fukushima Daiichi nuclear power plant in Fukushima Prefecture. Annual health checkups, focusing on metabolic syndromes, were conducted for persons ≥40 years of age by the Heath Care Insures. Results A total of 27,486 subjects underwent a follow-up examination after the disaster, with a mean follow-up of 1.6 years. Following the disaster, the prevalence of hypo-high-density lipoprotein (HDL) cholesterolemia increased significantly from 6.0% to 7.2%. In the hypo-HDL cholesterolemia group, the body mass index (BMI), blood pressure, and LDL-C level increased significantly in men after the disaster. On the other hand, in the normal HDL-C level group, the BMI, blood pressure, glucose and lipid metabolism, and liver function were adversely affected. The decrease in HDL-C was significantly greater in evacuees than non-evacuees in the normal HDL-C level group. Furthermore, a multivariate logistic regression analysis showed that the evacuation was significantly associated with the incidence of hypo-HDL cholesterolemia. Conclusion This is the first study to evaluate how the evacuation affected the incidence of hypo-HDL cholesterolemia and led to an increase in cardiovascular disease. This information may be important in the follow-up and lifestyle change recommendations for evacuees.
目的 东日本大地震及福岛第一核电站核灾难迫使居民撤离，并导致撤离者的生活方式发生诸多变化。为支持预防生活方式相关疾病，实施了全面健康检查，我们分析了这些灾难前后脂质代谢的变化。方法 研究对象包括居住在福岛县福岛第一核电站附近的日本男性和女性。医疗保健机构对40岁及以上人群进行了以代谢综合征为重点的年度健康检查。结果 共有27486名受试者在灾难后接受了随访检查，平均随访时间为1.6年。灾难后，低高密度脂蛋白（HDL）胆固醇血症的患病率从6.0%显著增加到7.2%。在低HDL胆固醇血症组中，灾难后男性的体重指数（BMI）、血压和低密度脂蛋白胆固醇（LDL-C）水平显著升高。另一方面，在HDL-C水平正常组中，BMI、血压、糖脂代谢和肝功能受到不利影响。在HDL-C水平正常组中，撤离者的HDL-C下降幅度明显大于非撤离者。此外，多因素逻辑回归分析表明，撤离与低HDL胆固醇血症的发生率显著相关。结论 这是第一项评估撤离如何影响低HDL胆固醇血症的发生率并导致心血管疾病增加的研究。这些信息对于撤离者的随访和生活方式改变建议可能很重要。
