抄録
動脈硬化は循環器疾患の最大原因である.トノメトリー法(Sphygmo CorVxアットコアメディカル社製 オーストラリア)により求められる大動脈起始部Augmentation index(AGI)は全身の動脈硬化(動脈の硬さ)の指標である.今回某鉄鋼企業の従業員男性125名,女性32名に対して,AGIを測定し,健康診断結果と比較検討を行った. AGIは女性の方が男性に比較して有意に高かった.男女間で平均年齢,喫煙率,血圧などの背景に性差が大きく,かつその差によって結果の説明が困難であったため,分析は男女別々に行った.男性では喫煙習慣のある人で高い傾向が認められ,高血圧の従業員では正常血圧の人に比較して有意に高かった.また眼底検査で高血圧性変化の所見が認められた症例で有意に高値を示した.AGIと年齢や飲酒量,それに健康診断各項目の実測値(BMI,血圧,総コレステロール,中性脂肪,HDLコレステロール,空腹時血糖,体脂肪率)との相関関係を調べたところ,男女とも年齢と拡張期血圧とに有意な相関関係が認められた.男性従業員のAGI正常(23%以下)86例と,高値(24%以上)39例との比較を行ったところ,AGIの高い人で年齢が有意に高く,また拡張期血圧が有意に高かった.またAGI高値群では有意に血圧異常者の割合が高かった.重回帰分析の結果,年齢,喫煙の有無,拡張期血圧が独立予測因子であった.大動脈起始部Augmentation indexの測定は動脈硬化の指標として,また保健指導において有用と考えられた.
Arteriosclerosis is one of the major determinant of cardiovascular risks. The augmentation index (AGI) is a measure of systemic arterial stiffness derived from the ascending aortic pressure waveform. We examined the relationship between the AGI of the aorta measured by SphygmoCor (A + CorMedical Ltd. Australia) and the data from the health examination of 125 males and 31 females working for a steel company. In females the AGI was significantly higher than that in males. As the subjects were males and females significantly different in age, smoking habit, blood pressure, and other conditions, these data were analyzed separately for males and females. In males, smokers had a high AGI. Employees with hypertension had a significantly higher AGI than employees with normotension. The employees with hypertensive retinopathy had a higher AGI. The studies indicated that AGI was associated with age and diastolic blood pressure in both males and females. The items of age, volume of alcohol consumption per day and the health examination results such as BMI, total cholesterol, triglyceride, HDL-cholesterol, fasting plasma glucose, and the body fat ratio of employees in the high AGI group (AGI:24% or more) n=39 and low AGI group (AGI:23% or less) n=86 were compared. The results suggested that employees with high AGI were older and had higher diastolic blood pressure than employees with low AGI. In the high AGI group, the percentage of employees with hypertension was significantly higher than that in the low AGI group. These results of stepwise regression analysis indicated that age, smoking habit and diastolic blood pressure were significant and independent predictive factors for arteriosclerosis. AGI of the central artery is considered to be a useful parameter for assessing arteriosclerosis and for guiding health promotion.
