{"created":"2023-05-15T11:23:24.643575+00:00","id":3001,"links":{},"metadata":{"_buckets":{"deposit":"64132ef0-b241-4ef6-b5db-291253b17193"},"_deposit":{"created_by":1,"id":"3001","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"3001"},"status":"published"},"_oai":{"id":"oai:showa.repo.nii.ac.jp:00003001","sets":["1:6:244:245"]},"author_link":["10335","10339","10342","10341","10345","10340","10336","10337","10344","10338","10343","10334"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-02"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"34","bibliographicPageStart":"28","bibliographicVolumeNumber":"79","bibliographic_titles":[{"bibliographic_title":"昭和学士会雑誌"}]}]},"item_10002_description_6":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"骨粗鬆症診療において，栄養状態の評価は重要である．抗RANKLモノクローナル抗体（デノスマブ）は破骨細胞活性を強力に抑制し骨密度上昇作用を有する．しかし，栄養状態が治療成績に及ぼす影響は過去に報告されていない．本研究の目的は，栄養状態の評価であるCONUT変法（Controlling nutritional status）を用い，骨粗鬆症治療開始時の栄養状態がデノスマブの治療成績に及ぼす影響を検討することである．閉経後骨粗鬆症に対してデノスマブを用いて加療した145例のうち，12か月の経過観察が可能であった110例を対象とした．CONUT変法を用い，デノスマブ投与時の血液検査から正常群（CONUT 0–1点）と栄養不良群（CONUT 2点以上）の2群に分けた．評価項目は患者背景・血液検査・骨代謝マーカー（total-P1NP: total N-terminal propetide of type 1 procollagen，TRACP-5b: tartrate-resistant acid phosphatase 5b）・腰椎および大腿骨骨密度（DXA法：Dual-energy X-ray Absorptiometry）とし，治療開始時および12か月で比較検討した．正常群は77人（70％），栄養不良群は33人（30％）であった．両群間の比較（正常群vs.栄養不良群）では，年齢は栄養不良群で有意に高く（p＜0.01），血清Ca （calcium）値・全大腿骨近位部骨密度は正常群で有意に高かった（全てp＜0.01）．骨代謝マーカーはデノスマブ投与により有意に減少していた（全てp＜0.01）．骨密度は正常群では腰椎・大腿骨頸部・全大腿骨近位部骨密度はすべて有意に上昇していた（全てp＜0.01）．栄養不良群では腰椎および全大腿骨近位部骨密度は有意に上昇していたが（全てp＜0.01），大腿骨頸部骨密度は上昇していなかった．デノスマブは栄養不良患者においても骨密度上昇効果を示すが，大腿骨頸部においては治療効果が減弱する可能性がある．骨粗鬆症診療においては早期に栄養状態の評価を行い，栄養指導も含めた治療介入が有用と考える．","subitem_description_type":"Abstract"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"昭和大学学士会"}]},"item_10002_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"10.14930/jshowaunivsoc.79.28"}}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2187-719X"}]},"item_10002_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"谷, 聡二"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"石川, 紘司"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"土谷, 弘樹"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"白旗, 敏之"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"工藤, 理史"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大下, 優介"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"黒田, 拓馬"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"八木, 敏雄"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岡村, 博輝"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"永井, 隆士"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"豊根, 知明"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"稲垣, 克記"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-27"}],"displaytype":"detail","filename":"79_28.pdf","filesize":[{"value":"536.3 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"79_28.pdf","url":"https://showa.repo.nii.ac.jp/record/3001/files/79_28.pdf"},"version_id":"668782c3-eab9-40da-9d0d-6335f440bc8f"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper"}]},"item_title":"患者栄養状態が抗RANKLモノクローナル抗体の治療成績に及ぼす影響—CONUT変法を用いた後ろ向きコホート研究—","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"患者栄養状態が抗RANKLモノクローナル抗体の治療成績に及ぼす影響—CONUT変法を用いた後ろ向きコホート研究—"}]},"item_type_id":"10002","owner":"1","path":["245"],"pubdate":{"attribute_name":"公開日","attribute_value":"2019-08-27"},"publish_date":"2019-08-27","publish_status":"0","recid":"3001","relation_version_is_last":true,"title":["患者栄養状態が抗RANKLモノクローナル抗体の治療成績に及ぼす影響—CONUT変法を用いた後ろ向きコホート研究—"],"weko_creator_id":"1","weko_shared_id":-1},"updated":"2023-05-15T12:35:22.847812+00:00"}