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ホームIMICライブラリMMWR抄訳2017年(Vol.66)バイタルサイン:医師により診断された関節炎の有病率・・・

MMWR抄訳

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2017/03/10Vol. 66 / No. 9

MMWR66(9):246-253
Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation — United States, 2013–2015

バイタルサイン:医師により診断された関節炎の有病率と関節炎による活動制限― アメリカ、2013年~2015年

2013年~2015年のNational Health Interview Surveyデータの分析では、アメリカ成人の22.7% (5,440万人、年齢補正有病率:21.0%)の成人が医師により関節炎と診断された。そのうち49.6%(2,220万人)が65歳以上の高齢者であり、18~44歳が7.1%(800万人)、45~64歳が29.3%(2,420万人)であった。年齢補正有病率は女性(23.5%)が男性(18.1%)に比べて有意に高く、人種別ではヒスパニック系(15.4%)やアジア系(11.8%)に比べて、非ヒスパニック系白人(22.6%)にて有意に高かった。学歴別では大卒以上(17.9%)に比べ、高卒未満(21.2%)にて有意に有病率が高かった。就業状態別では失業者にて43.9%と高く、身体活動別では推奨される身体活動を満たす人(18.1%)に比べ、不十分な人(23.1%)、活動しない人(23.6%)にて高かった。また、健康状態別では普通/不健康で40.5%、良好/非常に良好で15.4%であった。肥満、心臓病、糖尿病患者における関節炎の有病率はそれぞれ30.6%、49.3%、47.1%(年齢補正有病率:27.7%、36.4%、33.7%)であり、それぞれの基礎疾患を持たない人比比べ11.3倍、17.3倍、13.9倍高値であった。関節炎による活動制限は2,370万人(43.5%、年齢補正有病率:41.7%)に認められ、女性:43.8%、男性:38.5%と女性にて高く、人種別では非ヒスパニック系黒人:48.6%、ヒスパニック系:44.3%、非ヒスパニック系他民族:50.5%、非ヒスパニック系白人:40.1%であった。学歴別では高卒未満にて52.1%と高卒以上(32.1~43.6%)に比べ高かった。就業状態別では労働不可能者:80%、失業者(48.4%)にて就業者(28.3%)に比べ高く、身体活動別では活動しない人(54.0%)にて推奨される身体活動を満たす人(30.1%)に比べ高かった。また、健康状態別では普通/不健康が70.6%、良好/非常に良好が23.2%であり、肥満、心臓病、糖尿病患者ではそれぞれ45.2%、54.8%、52.5%であった。以上、関節炎は心疾患、糖尿病、肥満などの合併症のある成人にて有病率が高く、関節炎による活動制限があることから、疼痛軽減、身体機能やQOLの改善のため、自己管理に関する教育的介入の必要性が示唆された。

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