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脂質・脂肪酸フォーラム

脂質・脂肪酸フォーラム

<情報は以下にリンクします> (*記事の内容によっては後日修正される場合もあります)

これ以前の(Previous) #1 ~ #49 は、別室に移動しました(moved)。

50. OPERA Does Not Sing Praises for Fish Oil in AF. MedScape news より[LINK]。Short-term administration of fish oil to patients undergoing heart surgery did not reduce the incidence of postoperative atrial fibrillation (AF), a new study has shown. In OPERA, a double-blind,placebo-controlled, randomized clinical trial, a total of 1516 patients scheduled for cardiac surgery in 28 centers in Italy, Argentina, and the US were enrolled between August 2010 and June 2012. There was no difference in the primary end point between those who got fish oil, 30.0% of whom developed postoperative AF, and those who got placebo, of whom 30.7%developed it (p=0.74). 手術後に起こる心房細動は魚油で防げないAHA2012 Science session より。/2012.11.13

51. Lipid Profiles: Fasting Not Necessary,Concludes Large Study:Fasting Time and Lipid Levels in a Community-Based Population. Arch Intern Med. 2012;():1-4[LINK]. doi: 10.1001/archinternmed.2012.3708, Conclusion Fasting times showed little association with lipid subclass levels in a community-based population, which suggests that fasting for routine lipid levels is largely unnecessary. The mean triglyceride levels showed variations of up to 20%. 臨床検査で,空腹時の血中脂質(特にコレステロール)を測ることにあまり意味が無い。ただ,トリグリセリドに関しては空腹時とそうでない時の測定とでは20%の違いがある。 /2012.11.15

52. Low Levels of Omega-3 May Increase Postpartum Depression Risk. The literature shows that there could be a link between pregnancy, omega-3, and the chemical reaction that enables serotonin, a mood regulator, to be released into our brains. And many women could bring their omega-3 intake to recommended levels. CanJPsychiatry 2012;57(11):704--712[LINK]
産後のうつ症状とセロトニントランスポータのゲノタイプとω3脂肪酸のレベルは関係がある。 /2012.11.27

53. Babies' Vision Improves With Fatty Acid Formula Supplements. Pediatrics[LINK]誌。
Analyzing data from 19 studies involving 1949 infants,Ahmad Qawasmi, MD, from the Department of Pediatrics at the Children's Hospital of Michigan in Detroit, and colleagues found that long-chain polyunsaturated fatty acid (LCPUFA) supplementation started within 1 month of birth significantly improved infants' visual acuity at 2, 4, and 12 months of age, as assessed using visual evoked potential (VEP), and at 2 months when measured using behavioral methods (BM). 乳児の高度不飽和脂肪酸の補充栄養はやはり視力の改善に有効である。(以前は効果がないという報告があったが) /2012.12.20

54. Novel Cancer Hypothesis Suggests Antioxidants Are Harmful.Dr. Watson (二重らせんの!)が,栄養成分としての抗酸化物質(Vit.E,カロテンなど)はがんと戦う上では悪い作用をする,という提案を発表[LINK]。For years, such supplements have been widely hyped for cancer prevention and/or treatment, as has encouragement to eat colorful fruit and berries, which contain antioxidants. However, Dr. Watson warns that recent data strongly hint that much of the untreatability of late-stage cancer might be the result of "its possession of too many antioxidants, [so] the time has come to seriously ask whether antioxidant use more likely causes than prevents cancer." Many nutritional intervention trials have shown no obvious effectiveness in preventing gastrointestinal cancer or in lengthening mortality, he writes. "In fact, they seem to slightly shorten the lives of those who take them." しかしながら別の専門家は次のように話しています。Maurie Markman,MD, national director for medical oncology at the Cancer Treatment Centers of America:"The importance of the critical relationship between oxidating activity and antioxidants in the normal functioning of cells has been recognized by many investigators, and it is not surprising that this process would be quite relevant in cancer. However, it must be emphasized that this is a very complex process and the balance between these powerful influences at the cellular level is certain to be very carefully controlled. Further,it should be noted that antioxidants are components of our normal diets.Finally, while a provocative concept, it is most unlikely that a simple approach to somehow removing antioxidants from the body will be a useful strategy in cancer management,".

確かにバランスが大事という話ではある。癌になる前は抗酸化物質は予防的に良いように働くが,一旦癌ができてしまうと,癌細胞にとっては嫌な活性酸素ROS(癌細胞を自殺に追いやる)が抗酸化物質で無くなってしまうと癌細胞は生き延びやすくなる,という説は納得できる。抗酸化物質は両刃の剣,使うタイミングが重要であろう。少なくともがん患者に抗癌剤投与と抗酸化物質投与を一緒にやるのはよくない。 /2013.01.18

55. 新聞記事「DHAがアルツハイマー抑制…京大iPS研究所」:http://www.yomiuri.co.jp/science/news/20130222-OYT1T00092.htm?from=blist[LINK]
元の論文は,Cell Stem Cell誌で,ここから[LINK]読める。(著者数43名!)Summaryだけ引用。(DHAに関するところだけを太字で)
Oligomeric forms of amyloid-β peptide (Aβ) are thought to play a pivotal role in the pathogenesis of Alzheimer’s disease (AD), but the mechanism involved is still unclear. Here, we generated induced pluripotent stem cells (iPSCs) from familial and sporadic AD patients and differentiated them into neural cells. Aβ oligomers accumulated in iPSC-derived neurons and astrocytes in cells from patients with a familial amyloid precursor protein (APP)-E693Δ mutation and sporadic AD, leading to endoplasmic reticulum (ER)and oxidative stress. The accumulated Aβoligomers were not proteolytically resistant, and docosahexaenoic acid (DHA) treatment alleviated the stress responses in the AD neural cells.Differential manifestation of ER stress and DHA responsiveness may help explain variable clinical results obtained with the use of DHA treatment and suggests that DHA may in fact be effective for a subset of patients. It also illustrates how patient-specific iPSCs can be useful for analyzing AD pathogenesis and evaluating drugs. DHAは1〜15μM使って効果があったようです。 /2013.02.22

56. 動脈硬化学会が「栄養成分表示」に関して声明を発表。
http://www.j-athero.org/outline/eiyouseibun.html[LINK]
ここでは、「脂質」の表示に加え、動脈硬化性疾患発症のリスクとなる「コレステロール」、「飽和脂肪酸」、「トランス脂肪酸」の栄養表示をただちに行う必要性がある、としている。 /2013.04.04

57. 血中のω3不飽和脂肪酸量が多いと死亡率は少ない・・・米国内科学会誌の報告。Annals of Internal Medicine. 2013 Apr;158(7):515-525.[LINK] Plasma Phospholipid Long-Chain ω-3 Fatty Acids and Total and Cause-Specific Mortality in Older Adults:
A Cohort Study. Results: During 30 829 person-years, 1625 deaths (including 570 cardiovascular deaths), 359 fatal and 371 nonfatal CHD events, and 130 fatal and 276 nonfatal strokes occurred. After adjustment, higher plasma levels of ω3-PUFA biomarkers were associated with lower total mortality, with extreme-quintile hazard ratios of 0.83 for EPA (95% CI, 0.71 to 0.98; P for trend = 0.005), 0.77 for DPA (CI, 0.66 to 0.90; P for trend = 0.008), 0.80 for DHA (CI, 0.67 to 0.94; P for trend = 0.006), and 0.73 for total ω3-PUFAs (CI, 0.61 to 0.86; P for trend < 0.001). Lower risk was largely attributable to fewer cardiovascular than noncardiovascular deaths. Individuals in the highest quintile of phospholipid ω3-PUFA level lived an average of 2.22 more years (CI, 0.75 to 3.13 years) after age 65 years than did those in the lowest quintile.
Limitation: Temporal changes in fatty acid levels and misclassification of causes of death may have resulted in underestimated associations, and unmeasured or imperfectly measured covariates may have caused residual confounding.
Conclusion: Higher circulating individual and total ω3-PUFA levels are associated with lower total mortality,especially CHD death, in older adults. /2013.04.25

58. αリノレン酸と前立腺がんとの関係は?BMJ Open.[LINK] 2013 May 14;3(5). pii: e002280. doi:10.1136/bmjopen-2012-002280.[LINK]
CONCLUSIONS: This analysis failed to confirm an association between dietary ALA intake and prostate cancer risk. Larger and longer observational and interventional studies are needed to define the role of ALA and prostate cancer. メタ解析の結果、αリノレン酸ALAの摂取と前立腺がんリスクとの間には有意な関係は見いだせなかった。これまで前立腺組織中のALAと前立腺がんリスクには正の相関があるという報告が多い(例えばPLoS One.[LINK] 2012;7(12):e53104. doi: 10.1371/journal.pone.0053104.[LINK] )が、これは前立腺のがんが発症した結果、前立腺組織にALAが集まってきたからである、という解釈もあり得るのではないか(単に特異的な輸送系が活性化したことにより?)。 /2013.06.07

59. N-3脂肪酸と心血管リスク。 n-3 fatty acids in patients with multiple cardiovascular risk factors.N Engl J Med. 2013; 368(19):1800-8[LINK] (May 30, 2013: ISSN: 1533-4406)
Conclusions: In a large general-practice cohort of patients with multiple cardiovascular risk factors, daily treatment with n−3 fatty acids did not reduce cardiovascular mortality and morbidity. オリーブ油のプラセボとn−3脂肪酸(1g/日)の摂取では5 年では差がない。逆にこれくらいで、もし差が出ていたらすごいこと。 /2013.06.11

60. 米国CBNテレビで放送されたThe 700 Clubの中で「Forget Cholesterol, Inflammation's the Real Enemy」という15分の特集が組まれました(2013年2月4日)。YouTubeで見ることができます。ここからリンク。[LINK]

61. 精神障害の超高リスク群で赤血球膜のネルボン酸(NA;C24:1n-9)が減少していたMol Psychiatry 2012; 17: 1150-1152[LINK] As NA is a major constituent of the myelin sheath, decreased levels of NA could reflect suboptimal myelin status in those ultra-high risk individuals who develop a psychotic disorder. This should be further investigated in imaging studies. The present data also suggest that these affected myelin pathways may in particular contribute to the negative symptoms of schizophrenia. /2013.06.24

62. 魚油の摂取と乳がんリスクBMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3706[LINK] The consumption of higher levels of dietary marine n-3 polyunsaturated fatty acids (PUFAs)is associated with a 14% lower risk for breast cancer than lower levels of consumption, according to a meta-analysis of 26 studies from Asia, Europe, and the United States. The results, however, could have a geographic limitation. Subgroup analyses indicated that the protective effect of marine n-3 PUFAs was more evident in Asian countries (RR, 0.69) than in Western countries (RR, 0.89). /2013.06.28

63. アルツハイマー病を減らすための食事ガイドラインの発表A special report[LINK] from the Physicians Committee for Responsible Medicine The seven dietary principles to reduce the risk of Alzheimer’s disease were prepared for presentation at the International Conference on Nutrition and the Brain in Washington on July 19 and 20,2013. /2013.07.26

64. N-3脂肪酸と前立腺がんリスク。Plasma Phospholipid Fatty Acids and Prostate Cancer Risk in the SELECT Trial, J Natl Cancer Inst (2013) doi:10.1093/jnci/djt174, [LINK]Conflicting Data Fish oil supplements were associated with a lower risk for breast cancer in postmenopausal women in the Vitamins and Lifestyle (VITAL) cohort study (Cancer Epidemiol Biomarkers Prev. 2010;19:1696-1708); Another study found that in men with a genetic predisposition to prostate cancer, the consumption of a diet rich in omega-3 fatty acids can lower the risk for disease (J Clin Invest. 2007;117:1866-1875). However, "this is an observational study, and these studies usually generate rather than confirm hypotheses," he explained. "For observational data, they came to a fairly strong conclusion. It is a little puzzling, interesting, and provocative. It raises questions but is a long way from being definitive." 上記の#58の記事と比較すると、観察的研究では前立腺がん患者では血中のN-3脂肪酸が有意に増えているらしいが、摂取量との関係はあまりない、ということ。今回のJNCIの論文でも「there was no dose response.」とある。もともと、前立腺や精子にはN-3脂肪酸が(脳と同様に)豊富に存在している。そこががん化するとN-3脂肪酸がそこでは使われなくなって余分に血中に出てきているのではないか、という解釈も成り立つ。原因と結果がまだ明確ではないので、早急な判断はすべきではないが、今後十分に検討すべき課題ではある。/2013.07.26

65. 魚油はアルコール性認知障害を抑制する。Fish Oil May Protect Against Alcohol-Related Dementia[LINK]. Results showed that the cell cultures that were also exposed to omega-3 docosahexanenoic acid (DHA) showed approximately 90% less neuroinflammation and 90% less neuronal brain cell death compared with the cells that were not exposed to the fish oil compound. The 14th Congress of the European Society for Biomedical Research on Alcoholism.Abstract 01.2, presented September 8, 2013. /2013.09.25

66. オメガ3脂肪酸の認知機能保護効果は?Omega-3 (Fish Oil) Does Not Help Cognitive Decline[LINK] Because of the number of cognitive domains included as endpoints, researchers usedP = .01 as the critical value for statistical significance.The study found that participants in the high DHA+EPA tertile exhibited better fine motor speed, verbal knowledge, and verbal fluency, but after full adjustment for factors such as age, race, income,body mass index, physical activity, smoking, and daily caloric intake, these associations were no longer statistically significant (fine motor ability, P = .04; verbal knowledge, P =.14; verbal fluency, P = .07). The study found that participants in the high DHA+EPA tertile exhibited better fine motor speed,verbal knowledge, and verbal fluency. 有意性のレベルを0.01 に厳しくすると、ω3脂肪酸の認知機能保護効果はない、と報告している。しかし、通常のレベル(p=0.05)にすると、細かい運動機能の保護効果は一応あると言っても良い結果である(p=0.04)。この群でのω3脂肪酸の摂取レベルの問題もある。この著者たちは、「people taking higher levels of omega-3s all their adult life may have a very different outcome.」とも述べている。 /2013.09.30

67. 低炭水化物食(糖質制限食; LCD)の心血管障害のリスク因子への影響(メタ解析)obesity reviews (2012) 13, 1048--1066.[LINK] LCD to be associated with significant decreases in body weight (-7.04 kg ), body mass index (-2.09 kg m-2), abdominal circumference (-5.74 cm ), systolic blood pressure(-4.81 mm Hg), diastolic blood pressure (-3.10 mm Hg), plasma triglycerides (-29.71 mg dL-1), fasting plasma glucose (-1.05 mg dL-1 ), glycated haemoglobin (-0.21%), plasma insulin (-2.24 microIU mL-1 ) and plasma C-reactive protein, as well as an increase in high-density lipoprotein cholesterol (HDL-C; 1.73 mg dL-1 ). Low-density lipoprotein cholesterol(LDL-C) and creatinine did not change significantly. この本文中に次のような記述がある。「LCDs often have a higher saturated fat composition, which has been shown to increase LDL-cholesterol (62).The lack of increase in LDL-cholesterol may reflect the weight loss during the diet or that the LCD is also higher in unsaturated fatty acids,which lower LDL-C. 以前、糖尿病学会はLCDで飽和脂肪酸の摂取が増えLDL-Cが増えるので、LCDは推奨できない、と声明を出したが、そうではないことが示された。英国医学会の声明[PDF] (2013年、BMJ[LINK])でも言われていたが、昔から言われていた栄養指導(飽和脂肪酸をへらしリノール酸をふやす、という指導)は間違えていた、ということが、LCDで飽和脂肪酸が増えてもLDL-Cには影響しないという今回のメタ解析によってさらに証明された。/2013.10.18

68. 米FDA、トランス脂肪酸の安全性否定へ転換―禁止に向かう公算 という記事がWSJ から[LINK]
もとのFDAの発表資料は、ここから[LINK]。(PDFファイル) 各業界の意見を求めている。1970年代までは動物性飽和脂肪酸が健康に悪いということでより健康的な(という認識で)不飽和(リノール酸)とトランス脂肪酸を含むマーガリン等が推奨されてきた経緯がある。この状況がようやく米国でも否定されつつある。/2013.11.08

69. New Cholesterol Guidelines Abandon LDL Targets

リンクはMedScapeサイト[LINK]。New guidelines from the American College of Cardiology (ACC) and American Heart Association (AHA), developed in conjunction with the National Heart, Lung, and Blood Institute (NHLBI),are now available online in both the Journal of the American College of Cardiology and Circulation [1[LINK]](PDF free).9年ぶりにコレステロールガイドライン(ATP3)の改訂版がCirculation誌に発表された。ここでは、LDLコレステロールやnon-HDLコレステロールを標的(減らすのを治療目的)にすることを止めた。Gone are the recommended LDL- and non-HDL--cholesterol targets,specifically those that ask physicians to treat patients with cardiovascular disease to less than 100 mg/dL or the optional goal of less than 70 mg/dL. According to the expert panel, there is simply no evidence from randomized, controlled clinical trials to support treatment to a specific target. As a result, the new guidelines make no recommendations for specific LDL-cholesterol or non-HDL targets for the primary and secondary prevention of atherosclerotic cardiovascular disease. そのかわり、患者を4つのグループに分けてCVDイベントを減らす方向に注力すべきである、とした。しかし、
In an article published November 18, 2013 in the New York Times[LINK], two physicians testing the accuracy of the new risk calculator developed by the American College of Cardiology (ACC) andAmerican Heart Association (AHA) found that it vastly overestimated patient risk.

70. 植物ステロール(Campesterolなど)が多いと動脈硬化やCHDのリスクとなる(RCT 試験;オランダ2011年1月発表[LINK]);この研究を受けてEUでは2014年2月から植物ステロール入りの油脂の不必要な摂取はしないようにとの警告を表示すべきと法制化された。[LINK]
Atherosclerosis,Volume 214, Issue 1, January 2011, Pages 225--230.
[LINK] "We concluded that the positive correlation between the increases in serum campesterol concentrations and increases in retinal venular diameter (RVD) -- which was independent from changes in serum LDL cholesterol concentrations -- may be an explanation for the suggested adverse effects of plant sterols on vascular function."RVD(網膜小静脈の直径) は、動脈硬化やCHDの進行度合いのマーカーと考えられている。植物ステロールはLDL-Cを下げるとされているが、動脈硬化を促進する作用があるとのRCT試験の結果である。(日本でも植物ステロール入りの油はたくさん売られている) /2013.12.17

71. ω3系脂肪酸は脳あるいは海馬組織の体積の増大と関係がある (Omega-3 Fatty Acids Linked to Brain Volume):Total normal brain and hippocampus volumes were directly associated with levels of omega-3 fatty acids in a study of more than 1000 postmenopausal women.The study, published online[LINK] in Neurology on January 22. The women in the lowest omega-3 quartile had an omega-3 index of 3.4% compared with 7% for those in the highest quartile. "For reference, Japanese people, who generally eat a lot of fish, have an omega-3 index of around 10%," Dr. Harris noted. "It would be possible to move from an index of 3% to one of 7% by taking about 1000 mg of EPA + DHA every day or by eating a small portion of salmon or sardines every day. So it's not difficult to do." /2014.01.27[LINK]

72. 心血管系のリスクと飽和脂肪酸の関係:CV Risk and Saturated Fats: The Debate Roils On[LINK]: "We found essentially null associations between total saturated fatty acids [SFA] and coronary risk" in studies looking at dietary fat intake and those focusing on circulating fatty-acid levels, according to the authors, led by Dr Rajiv Chowdhury.(Paper; Ann Intern Med 2014; 160; 398-460[LINK].)

脂質の食事摂取量と体内循環量とではリスクに差が出る。(飽和脂肪酸の摂取量は心血管疾患のリスクを上げない。トランス脂肪酸の摂取はリスクを上げるが体内循環量はリスクとは無関係。オメガ3脂肪酸の体内循環量はリスクを下げるが、摂取量自体はあまり関係がない。など)これは、これらの脂肪酸の代謝力が心疾患に重要な意味を持つことを示唆していると思われる。
Relative Risk (95% CI) for Coronary Events, Top vs Bottom Third of Total DietaryFatty-AcidIntake Levels in Prospective Cohort Studies*

Fatty-Acid TypeRR (95% CI)
Saturated 1.02 (0.97--1.07)
Monosaturated0.99 (0.89--1.09)
Long-chain omega-3 0.93 (0.84--1.02)
Omega-6 1.01 (0.96--1.07)
Trans1.16 (1.06--1.27)

*32 studies, 530 525 participants, mean follow-up 5--23 years. All adjusted for age, sex, smoking, diabetes, and blood pressure, and other influences on CV risk

Relative Risk (95% CI) for Coronary Events, Top vs Bottom Third of Circulating Fatty-Acid Levels in Prospective Cohort Studies*

Fatty-Acid TypeRR (95% CI)
Saturated 1.06 (0.86--1.30)
Monosaturated1.06 (0.97--1.17)
Long-chain omega-3 0.84 (0.63--1.11)
Omega-6 0.94 (0.84--1.06)
Trans1.05 (0.76--1.44)

*19 studies, 32 307 participants, mean follow-up 1.3--30.7 years
(/2014.03.20)

73. 脂質栄養関連企業の動向にも影響する「食品の新たな機能性表示制度に関する検討会」(消費者庁)の対応方針案が公開。(5月2日)消費者庁のホームページから[LINK]。この検討会の委員には、座長が松澤佑次氏(阪大名誉教授)、副座長が寺本民生(帝京大学)氏がなっている。対応の重要なポイントは、「新制度においては、(企業の責任において)表示しようとする機能性について、(1)最終製品を用いたヒト試験による実証、(2)適切な研究レビューによる実証のいずれかを行うことを必須とする。」というところ。脂質栄養学会の活動も影響すると思われる。

74. Resveratrol Does Not Reduce CVD Risk,Prolong Life. JAMA Intern Med. Published online May 12, 2014. doi:10.1001/jamainternmed.2014.1582[LINK] 赤ワインの成分であるレスベラトロールには健康効果はないらしい。Resveratrol levels achieved with a Western diet did not have a substantial influence on health status and mortality risk of the population in this study.
これに関連して、2012年1月にレスベラトロールの研究者(コネチカット大、Dr. Das)の論文不正が明らかになっていた[LINK]。またPhotoshopによる画像の加工によるものだそうです。これは、上の#73に述べた健康食品の機能性表示制度にも関係して、「適切な研究レビューによる実証」があれば表示してよい、ということになった場合、もしその研究の論文が不正であることが後でわかった場合、どうなるのか、という問題を突き付けています。

75. 英国でスタチン処方を増やそうとするガイドライン(National Institute for Health and Care Excellence (NICE) )が出され、新聞各社(7社)が反論のキャンペーンを張った(6月初旬〜中旬)。The Independent[LINK]紙では、「guidance on statins could do more harm than good」などとした。まとめた資料はここからリンク[PDF] 。(from Dr. Okuyama)このガイドラインによれば、10年リスクが10%を超える人は健常者であってもスタチンを飲むべき、ということが言われていて、500万人もの人に無用な処方がなされる恐れがある、とされる。(/2014.06.24)

76. New Study Finds Diabetes Risk Rises With Statin Adherence The study, involving a healthcare utilization database of 115,709 statin-using patients with an average 6.4 years of follow-up per patient, "extends earlier findings of an increased risk of diabetes with statin therapy by providing evidence of a clear-cut association between adherence to statin therapy and risk of new-onset diabetes in a real-world setting. Diabetes Care June 26, 2014[LINK] (/2014.07.04)

77. Fish Oil May Guard Against Alcohol-Related Brain Damage PloS one (July 16, 2014)[LINK]. An omega-3 compound found in fish oil may lower the risk for brain damage caused by long-term alcohol use, new research suggests. A study of rat brain cultures exposed to alcohol levels equivalent to 4 times the legal driving limit showed that animals also exposed to omega-3 docosahexanenoic acid (DHA) had 90% less "neuronal death" and 90%less neuroinflammation than those not exposed to DHA. (/2014.07.30)

78. More Evidence Fish Protects the Aging Brain American Journal of Preventive Medicine[LINK].(July 29, 2014) In cognitively healthy older adults who were followed long term, weekly consumption of baked or broiled fish was positively associated with increased gray matter volumes in the hippocampus, precuneus, posterior cingulate, and orbital frontal cortex. (/2014.08.20)

79, Heart Disease Risk: Low-Carb Diet Trumps Low-Fat Option. 低炭水化物食と低脂肪食、どちらが肥満と心臓病リスクの減少に効果的か?Annals of Internal Medicine[LINK]Conclusion: The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors (HDL-cholesterol, and triglyceride).. (/2014.09.09)

80. 医学部のカリキュラムで栄養学を!Teaching Nutrition and Physical Activity in Medical School: Training Doctors for Prevention-Oriented Care (White Paper)[LINK]:Doctors Need to Learn About Nutrition(MedScape)[LINK] : (Devries S, Dalen JE,Eisenberg DM, et al. A deficiency of nutrition education in medical training.[LINK]Am J Med.2014 Apr 19. [Epub ahead of print] ): Dr. Devries: It struck me as a peculiar paradox that clinical practice guidelines highlight the primary importance of nutrition and lifestyle, yet the physicians who are expected to implement these guidelines receive absolutely no education in these areas during their residency and subspecialty training. 栄養学にはまだ相反する議論が多いが、それも踏まえて医学科のカリキュラムに取り入れた方が(基礎医学の一部に;栄養と人体運動学をチュートリアルで)役に立つと思う。日本の医学部でちゃんと栄養学を教えているところはどれくらいあるのだろうか、徳島大学医学部の医科栄養学科[LINK]ぐらいか(東大医学部は健康総合科学科の保健栄養学教室でしかない)?(/2014.09.10)

81. Data Reanalysis Changes 35% of Trial Conclusions 信頼できるはずのRCT試験を再解析してみると35%の結論は変わってしまう!? When researchers reanalyze patient-level data from randomized controlled trials (RCTs), the trial outcomes change in approximately 1 of 3 cases, according to a study published[LINK] in the September 10 issue of JAMA. The new study provides more fuel for an already heated debate on access to clinical trial data.この論文の結論: Conclusions and Relevance A small number of reanalyses of RCTs have been published to date. Only a few were conducted by entirely independent authors. Thirty-five percent of published reanalyses led to changes in findings that implied conclusions different from those of the original article about the types and number of patients who should be treated.RCT試験のデータの解析は完全に別の独立したグループが行うべきなのか。(/2014.09.12)

82. 低コレステロール、スタチンとパーキンソン病Serum Cholesterol, Statin, and Parkinson’s Risk in the Atherosclerosis Risk in Communities (ARIC) Study (S17.006)Neurology April 8, 2014 vol. 82 no.10 Supplement S17.006[LINK]CONCLUSIONS:In this community-based study, higher serum total-cholesterol is associated with a lower, and statin use with a higher, risk of PD. These results do not support the hypothesis that statins are neuroprotective for PD. 血清コレステロール(LDL-C でも同様)が高い方がパーキンソン病にはなり難い。スタチンを使うとパーキンソン病のリスクが高まる(OR=2.09)。一方、相反するデータも出ていて、2013年に、Am J Manag Care. 2013;19(8):626-632[LINK] に報告されたものは、「 Statin use was associated with a significant decrease in the incidence of PD (odds ratio, 0.73,95% confidence interval, 0.60-0.88; P =.001).」 というものである(この報告では、LDL-CのレベルとPDは関係ないとされている)。後者は、イスラエルの45歳以上の男女94308人でのcohort調 査(2000年〜2007年)で、前者は米国の4つの地域の15792人(45~64歳)を対象とした調査(cohort/community surveillances)。なぜこうも違うのか不明。(/2014.09)

83. スタチンが軟骨無形成症患者のiPS細胞から作った軟骨細胞の軟骨形成を回復したNature published online 17 Sept., 2014[LINK]. Statin treatment rescues FGFR3 skeletal dysplasia phenotypes. Yamashita A,et al. Discussion: The precise mechanism(s) by which statin treatment can rescue the chondrocyte abnormalities associated with FGFR3 diseases remain to be elucidated,although we have obtained some insights into the statin-induced promotion of FGFR3 degradation, which is inhibited in cases with mutant FGFR3.スタチンはFGFR3蛋白質(骨形成と維持に重要)の分解を促進加速することで効果を発揮するらしい。スタチンは糖尿病者の冠動脈の石灰化を促進することが知られているが(#39の記事、2012.09.03)、この血管の石灰化と軟骨形成とはどんな関係があるのだろうか?(/2014.10.1)

84. 魚油は抗うつ薬があまり効かない患者の投薬効果を上げる紹介記事(Nature World News)[LINK] According to lead researcher Roel Mocking, he and his colleagues took a closer look at "two apparently unrelated measures," the metabolism of fatty acids and the regulation of stress hormones - what is often unbalanced in people suffering from chronic depression. 元の論文は、http://www.europeanneuropsychopharmacology.com/article/S0924-977X%2814%2970632-7/abstract[LINK] にある(Eurpean Neuropsychopharmacology 誌)。 (/2014.10.23)

85. 米国で評判の本「The Big Fat Surprise」(Nina Teicholz 著:Simon&Schuster 出版) New York Times紙ベストセラー、紹介サイトも開設。http://www.thebigfatsurprise.com/[LINK] *Kindleから44% off で買えます。Amazon での紹介文[LINK]の一部:For decades, we have been told that the best possible diet involves cutting back on fat, especially saturated fat, and that if we are not getting healthier or thinner it must be because we are not trying hard enough. But what if the low-fat diet is itself the problem? What if the very foods we’ve been denying ourselves―the creamy cheeses, the sizzling steaks―are themselves the key to reversing the epidemics of obesity, diabetes, and heart disease? 飽和脂肪酸悪者論への反撃!(/2014.10.26)

86. 飽和脂肪酸の摂取は血中の飽和脂肪酸の量を増やさない――Study[LINK]: High saturated fat intake doesn't raise fat levels in blood :A controlled diet high in saturated fat and low in carbohydrates resulted in lower blood levels of saturated fat in metabolic syndrome patients during a recent study. Meanwhile, increased intake of carbohydrates led to higher blood levels of palmitoleic acid, according to the Ohio State University study[LINK]. "When you consume a very low-carb diet your body preferentially burns saturated fat," said senior author Jeff Volek.
(http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0113605[LINK])
上記の#85の本の内容を補強する論文。糖質制限食の方が「脂肪を燃やせる」。 (/2014.11.27)

87. 米国の「無駄な医療」削減キャンペーン 71の学会が参加 250ぐらいの医療が対象に2011年より――「Choosing Wisely」 - AMDA[LINK], の関与しているところ-- List 1. Don't insert percutaneous feeding tubes in individuals with advanced dementia. Instead, offer oral assisted feedings. 2. Don't use sliding scale insulin (SSI) for long-term diabetes management for individuals residing in the nursing home. 3. Don't obtain a urine culture unless there are clear signs and symptoms that localize to the urinary tract. 4. Don't prescribe antipsychotic medications for behavioral and psychological symptoms of dementia (BPSD) in individuals with dementia without ansessment for an underlying cause of the behavior. 5. Don't routinely prescribe lipid-lowering medications in individuals with a limited life expectancy. この中のコレステロール低下医療に関する「無駄な医療」について:There is no evidence that hypercholesterolemia, or low HDL-C, is an important risk factor for all-cause mortality, coronary heart disease mortality, hospitalization for myocardial infarction or unstable angina in persons older than 70 years. In fact, studies show that elderly patients with the lowest cholesterol have the highest mortality after adjusting other risk factors. In addition, a less favorable risk-benefit ratio may be seen for patients older than 85, where benefits may be more diminished and risks from statin drugs more increased (cognitive impairment, falls, neuropathy and muscle damage). / 元々はABIM[PDF] が起点。Consumer Reports[PDF] でも。日本でも紹介[LINK]。 (/2014.11.28)

88. 抗糖尿病効果、抗炎症作用を持つ新しい脂肪酸の発見 FAHFAs 飽和脂肪酸-ヒドロキシ脂肪酸縮合体 Cell 誌 http://www.sciencedirect.com/science/article/pii/S0092867414012239[LINK]Nature 誌[LINK]でも紹介 図で説明[LINK] (/2014.12.04)

89. Evidence-Based Medicine (EBM)のデータベースサイトの紹介 The NNT[LINK] NNT=the “Number-Needed-to-Treat”; ●心疾患に罹ったことのない人に対するスタチン処方→ (心疾患予防には)効果なし[LINK]; ●心疾患予防には地中海ダイエット[LINK]は→ 効果あり[LINK]; ●前立腺癌のスクリーニングのためのPSA検査→ 効果なし[LINK](害のみ;疑陽性のバイオプシー) : 他多数のエビデンスのサマリーが紹介されている。 (/2014.12.08)

90. Lipids誌が最近の「最も話題になった論文」と「最も引用された論文」を発表。

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(/2015.01.09)

91. スタチンに関するReviewがPublishされました。「Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms」 Expert Review of Clinical Pharmacology 誌。
http://informahealthcare.com/doi/abs/10.1586/17512433.2015.1011125[LINK]) (/2015.02.09)

92. Omega-3 脂肪酸は前立腺がんの増殖を抑制する、という論文が発表された。
The Journal of Pharmacology and Experimental Therapeutics[LINK] 誌にリン ク。FFA4というGPCRを介して抑制するらしい。(/2015.03.26)

93. Karger から総説「Towards a Paradigm Shift in Cholesterol Treatment - A re-examination of the cholesterol issue in Japan」(Hamazaki T. et al.) が出版されました。Ann Nutr Metab 2015; 66(suppl 4) (DOI:10.1159/000381635)[LINK] FreeでPDFがダウンロードできます。(/2015.05.08)

94. コレステロール低下薬=スタチン薬は女性でAggression(攻撃性)を上昇させるという論文が発表された(2015/06/01)。USCDのRCT試験。PLoS One誌。[LINK] : Golomb (author) explained that low cholesterol levels have been linked with aggression and to violent death/non-illness mortality, such as deaths from suicide, homicide, and accidents, in multiple observational studies. (MedScape) (/2015.07.07)