日本における慢性閉塞性肺疾患の疫学：久山町研究の知見

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  • 松元 幸一郎
    九州大学大学院医学研究院臨床医学部門内科学講座呼吸器内科学分野

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  • Epidemiology of Chronic Obstructive Pulmonary Disease in Japan: Knowledge from Hisayama Study
  • ニホン ニ オケル マンセイ ヘイソクセイ ハイ シッカン ノ エキガク : ヒサヤママチ ケンキュウ ノ チケン

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Chronic obstructive pulmonary disease (COPD) is a chronic lung disease showing persistent airflow obstruction in spirometry. Despite its high social and economic burden and mortality worldwide, its epidemiologic knowledge in Japan remained unestablished until the end of 20th century. The Hisayama study is an ongoing population-based epidemiologic study for lifestyle-related diseases in the community of Hisayama, a town in the western part of Japan. Spirometry has been conducted in annual health checkup for the town residents aged 40 years and over since 2008. According to the spirometric data, the prevalence of COPD was 8.7％ and only 17.5％ of subjects with airflow obstruction had previous diagnosis of COPD. To improve early diagnosis, a five-item screening questionnaire to detect persistent airflow obstruction (COPD-Q) was developed. Subsequent analyses revealed that airflow obstruction is a significant risk factor for carotid atherosclerosis, especially in midlife, and deterioration of periodontal status could be a risk factor for rapid lung function decline. The accumulation of epidemiologic knowledge in Hisayama study may pave the way for primary prevention of COPD in Japan.

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