| 研究課題/領域番号 |
24406026
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| 応募区分 | 海外学術 |
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| 研究機関 | 独立行政法人国立国際医療研究センター |
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研究代表者 |
諸井 雅男 独立行政法人国立国際医療研究センター, その他部局等, その他 (30256721)
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| 研究分担者 |
水谷 太郎 筑波大学, 医学医療系, 教授 (80181890)
JESMIN Subrina 筑波大学, 医学医療系, 助教 (60374261)
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| 研究期間 (年度) |
2012-04-01 – 2015-03-31
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| キーワード | 南アジア / 若年冠動脈疾患 / 危険因子 / 予防法 |
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| 研究概要 |
Through analysis of prospective observational study and case-control study, we found mean age of younger patients of acute coronary syndrome (ACS) in Bangladesh was 43.25 ± 0.27 years. Among our young study subjects having ACS, STEMI ACS was 54%, non-STEMI ACS was 6% and unstable angina was 28%. Mean age of male and female ACS patients was same. Prevalence of ACS was higher in male subjects compared to female subjects. There was no significant difference in rural and urban prevalence of ACS in Bangladesh. The prevalence of metabolic syndrome in male and female ACS patients was 26.56% vs. 45.71%. The prevalence of important cardio metabolic risk factors in young ACS patients in Bangladesh are: diabetes (29.89%); hypertension (39.27%); low HDL (51.77%); elevated triglyceride (44.29%). 16.3% young ACS patients in Bangladesh are overweight whereas 3.26% patients are obese. 26% of young ACS patients in Bangladesh have sedentary life style. 58.7% young ACS patients in Bangladesh are current smoker. No (0); one (1); two (2); three (3) or more than three metabolic abnormality is present in 11%; 28%; 30% as well as in 31% young ACS patients in Bangladesh, respectively. In young STEMI ACS patients in Bangladesh, diabetes is a highly prevalent risk factor compared to older ACS patients with STEMI. For non-STEMI myocardial infarction, hypertension appears to be the main risk factor in young Bangladeshi population. Appropriate strategies are needed for the early detection and treatment of cardio metabolic risk factors to prevent coronary artery disease progression 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)
1: 当初の計画以上に進展している
理由
This year we will continue the rest of the case control and cross sectional study that already started. In the case control study, we are determining cardiovascular risk factors in young patients with coronary heart disease (CHD) in Bangladesh. Successive consenting patients <45 yr with an acute coronary event or recent diagnosis of CHD are enrolled (cases, n=200) especially from the prospective observational study. Age- and gender-matched subjects with no clinical evidence of CHD are recruited as controls (n=200) especially from the people who come to hospital for general health checkup. Besides, we already performed a part of cross sectional study in last two years. This year also we will continue to conduct a cross sectional study design in population to find out the prevalence of conventional and emerging risk factors of CHD in rural Bangladeshi population in Dhaka and Rajshahi divisions. Consistent to our other studies on non-communicable diseases, we recruit the study population aged (15-75 years of age) so that our pilot data can be compared. A multi-stage random sampling method is used to recruit the study participants. This year we will continue socio demographic assessment, clinical, biochemical and functional assessment, advanced biomarkers measurement, environmental factors association determination, data analysis and interpretation, compare the data of Bangladesh with other South Asian countries, compare the data with Japanese population, planning the health policy reformulation for South Asian countries including Bangladesh.
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| 今後の研究の推進方策 |
This year we will continue the rest of the case control and cross sectional study that already started. In the case control study, we are determining cardiovascular risk factors in young patients with coronary heart disease (CHD) in Bangladesh. Successive consenting patients <45 yr with an acute coronary event or recent diagnosis of CHD are enrolled (cases, n=200) especially from the prospective observational study. Age- and gender-matched subjects with no clinical evidence of CHD are recruited as controls (n=200) especially from the people who come to hospital for general health checkup. Besides, we already performed a part of cross sectional study in last two years. This year also we will continue to conduct a cross sectional study design in population to find out the prevalence of conventional and emerging risk factors of CHD in rural Bangladeshi population in Dhaka and Rajshahi divisions. Consistent to our other studies on non-communicable diseases, we recruit the study population aged (15-75 years of age) so that our pilot data can be compared. A multi-stage random sampling method is used to recruit the study participants. This year we will continue socio demographic assessment, clinical, biochemical and functional assessment, advanced biomarkers measurement, environmental factors association determination, data analysis and interpretation, compare the data of Bangladesh with other South Asian countries, compare the data with Japanese population, planning the health policy reformulation for South Asian countries including Bangladesh.
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| 次年度の研究費の使用計画 |
Last year we did not measure the expensive biomarkers from this grant money, we had some donations from local Bangladesh to buy some expensive re-agents.
This year we will use the saved money from last year to measure more expensive biomarkers than planned originally.
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