| 研究課題/領域番号 |
15K08760
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| 研究機関 | 国立研究開発法人国立国際医療研究センター |
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研究代表者 |
岡崎 修 国立研究開発法人国立国際医療研究センター, その他部局等, 第3循環器内科医長 (30203970)
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| 研究分担者 |
Jesmin Subrina 筑波大学, 体育系, 研究員 (60374261)
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| 研究期間 (年度) |
2015-04-01 – 2018-03-31
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| キーワード | 予防医学 / 心筋梗塞 / 日本 / バングラデシュ / HDL |
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| 研究実績の概要 |
We completed two years of this research project. Expected number of patient recruitment was possible in Ist and 2nd year of this project. More than 400 patients of acute coronary syndrome (ACS) and myocardial infarction were included in current study with age and sex adjusted control subjects. Most of the sample collection was done at Bogra Medical College and Hospital, Bogra, Bangladesh and partly at Rajshahi Medical College, Rajshahi, Bangladesh. Standard definitions were used to diagnose acute coronary syndrome (ACS) in patients who had acute myocardial infarction (MI) or unstable angina. We divided the ACS patients with normal HDL (average 50mg/dl and with low HDL (average 34mg/dl) groups. Mean triglyceride level was significantly higher in ACS+low HDL subjects (mean value 170mg/dl) than in ACS+normal HDL subjects (mean value 147mg/dl) (p<0.001). Diabetes prevalence is significantly higher in ACS patients having low HDL than the ACS patients with normal HDL (p<0.01). Remarkable difference was found in the level of waist circumference in ACS patients with normal and low HDL levels; 33% ACS+low HDL patients had elevated waist circumference. There was no significant difference in mean blood pressure level or in hypertension prevalence in ACS patients depending on HDL levels. The distribution pattern of STEMI, non-STEMI and unstable angina types did not differ in ACS patients when correlation analysis was done based on HDL levels. From a cross sectional study design, we found about 55% ACS patients had low HDL in Bangladesh.
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| 現在までの達成度 (区分) |
現在までの達成度 (区分)
2: おおむね順調に進展している
理由
The current research is on right track both from the contexts of time line and the amount of research activities scheduled to be done (100% done with target milestone achievement and implementation in both Ist and 2nd year). Trained hospital staffs and trained research staffs could overcome all the troubles during data collection in Bangladesh. An excellent supervision strategy has been also followed from Japan to progress this research in Bangladesh with efficiency and quality control manner. Last year twice one research assistant from Japan visited the sample collection activities of current project in Bangladesh. In addition, Dr. Arifur Rahman, Associate Professor, Bogra Medical College, Bogra, Bangladesh has visited Japan twice for the discussion of this project data with Japanese cardiologist (Professor Moroi, Dr. Okazaki and Dr. Shimojo). There was no big problem during data collection. With all the supports from Bangladeshi Institutes and also from Japanese Institutes, the current project will be completed in achieving 100% target planned during this project application.
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| 今後の研究の推進方策 |
We will continue a bit sample collection for the ongoing case control study using ACS patients in Bangladesh. We already completed the measurement of common biochemical factors in these study subjects sampled in current study. We are now on the way to analyze biomarkers in the current study subjects (already more than 70% advanced biomarkers measurement related to ACS already been done). Data analysis is being conducted in the perspective of case control study design. Additionally data analysis is being performed also in the cross sectional study design in ACS patients. A parallel project initiated by HDRCRP in Bangladesh has been focusing on the normalizing of the low HDL levels in Bangladesh with daily exercise program. The current study data will be compared with that project data. After completion of current project data analysis, the generated data will be compared with Japanese ACS patients data having low HDL. Advanced statistical analysis will be done this year. Scientific manuscript will be also prepared to submit to high impact factor journal. Finally, an active discussion will be held next year in Japan among the cardiologists from both Japan and Bangladesh on the possible strategy innovation for the prevention of ACS in Bangladesh targeting HDL levels.
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| 次年度使用額が生じた理由 |
Last year we did not employee some mobile based research assistants in Bangladesh.
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| 次年度使用額の使用計画 |
The unused money for that labor cost will be used this year.
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