{"id":1318,"date":"2017-05-19T10:13:30","date_gmt":"2017-05-19T01:13:30","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1318"},"modified":"2017-05-19T10:13:30","modified_gmt":"2017-05-19T01:13:30","slug":"%e9%ab%98%e9%bd%a2%e8%80%85%e3%81%ae%e6%bd%9c%e5%9c%a8%e6%80%a7%e7%94%b2%e7%8a%b6%e8%85%ba%e6%a9%9f%e8%83%bd%e4%bd%8e%e4%b8%8b%e7%97%87","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1318","title":{"rendered":"\u9ad8\u9f62\u8005\u306e\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7"},"content":{"rendered":"

\u2015\u6587\u732e\u540d\u2015
\nD. J. Stott, et al. Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism. NEJM. April 3, 2017<\/p>\n

\u2015\u8981\u7d04\u2015
\nIntroduction<\/strong>
\n\u300065\u6b73\u4ee5\u4e0a\u306e\u6210\u4eba\u306e8\uff5e18%\u306f\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306e\u72b6\u614b\u306b\u3042\u308a\u3001\u7537\u6027\u3088\u308a\u3082\u5973\u6027\u306b\u591a\u3044\u50be\u5411\u306b\u3042\u308b\u3002\u9ad8\u9f62\u8005\u306b\u304a\u3051\u308b\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306f\u3001\u591a\u304f\u306e\u554f\u984c\u306b\u304b\u304b\u308f\u3063\u3066\u3044\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u3001\u7532\u72b6\u817a\u30db\u30eb\u30e2\u30f3\u306f\u3001\u5fc3\u8840\u7ba1\u7cfb\u3001\u8a8d\u77e5\u6a5f\u80fd\u3092\u542b\u3080\u8133\u795e\u7d4c\u7cfb\u3001\u9aa8\u3084\u7b4b\u9aa8\u683c\u7cfb\u306a\u3069\u591a\u5f69\u306a\u5f71\u97ff\u3092\u53ca\u307c\u3059\u3002\u75b2\u52b4\u611f\u306f\u3001\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306e\u91cd\u8981\u306a\u75c7\u72b6\u306e\u4e00\u3064\u3067\u3042\u308b\u304c\u3001\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306e\u60a3\u8005\u306f\u3001\u7121\u75c7\u72b6\u3001\u307e\u305f\u306f\u975e\u7279\u7570\u7684\u306a\u75c7\u72b6\u3092\u5448\u3059\u308b\u3002
\n\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306e\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6295\u4e0e\u306b\u3088\u308b\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u306f\u3001\u904e\u53bb\u306b\u884c\u308f\u308c\u3066\u3044\u308b\u304c\u3001\u898f\u6a21\u304c\u5c0f\u3055\u304f\u9650\u3089\u308c\u305f\u30a8\u30d3\u30c7\u30f3\u30b9\u3057\u304b\u793a\u3055\u308c\u3066\u304a\u3089\u305a\u3001\u305d\u306e\u52b9\u679c\u3084\u30ea\u30b9\u30af\u306b\u306f\u8b70\u8ad6\u306e\u4f59\u5730\u304c\u3042\u308b\u3002\u305d\u3053\u3067\u3001\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306e\u9ad8\u9f62\u8005\u306b\u5bfe\u3059\u308b\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6295\u4e0e\u306e\u81e8\u5e8a\u7684\u306a\u610f\u7fa9\u3092\u660e\u3089\u304b\u306b\u3059\u308b\u305f\u3081\u306b\u7814\u7a76\u3092\u884c\u3063\u305f\u3002<\/p>\n

Methods<\/strong>
\n\u3000\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u306f\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6295\u4e0e\u7fa4\u3068\u30d7\u30e9\u30bb\u30dc\u7fa4\u306b\u3088\u308b\u4e8c\u91cd\u76f2\u691c\u5316\u30e9\u30f3\u30c0\u30e0\u6bd4\u8f03\u8a66\u9a13\u3067\u3001\u5c11\u306a\u304f\u3068\u308265\u6b73\u4ee5\u4e0a\u3067\u3001\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\uff08TSH\u5024 4.60\uff5e19.99mIU\/L\u3001\u904a\u96e2\u30c1\u30ed\u30ad\u30b7\u30f3\u306f\u57fa\u6e96\u5024\u7bc4\u56f2\u5185\u306e\u3082\u306e\uff09\u306e\u72b6\u614b\u306b\u3042\u308b737\u4eba\u306e\u6210\u4eba\u3092\u5bfe\u8c61\u306b\u884c\u3063\u305f\u3002368\u4eba\u304c\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6295\u4e0e\uff08\u958b\u59cb\u7528\u91cf50\u03bcg\/day\u3001\u4f53\u91cd50kg\u672a\u6e80\u306e\u5834\u5408\u306f25\u03bcg\/day\uff09\u3092\u53d7\u3051\u3001TSH\u5024\u306b\u5fdc\u3058\u3066\u8abf\u6574\u3055\u308c\u305f\u3002369\u4eba\u306f\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u306b\u5272\u308a\u5f53\u3066\u3089\u308c\u3066\u7591\u4f3c\u7684\u306a\u7528\u91cf\u306e\u6295\u4e0e\u3092\u53d7\u3051\u305f\u30022\u3064\u306e\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u30011\u5e74\u9593\u306b\u304a\u3051\u308b\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u30b9\u30b3\u30a2\u3068\u3001\u7532\u72b6\u817a\u95a2\u9023QOL\u8cea\u554f\u7d19\u306b\u3088\u308b\u75b2\u52b4\u30b9\u30b3\u30a2\uff08\u3044\u305a\u308c\u30820\uff5e100\u70b9\u3067\u3001\u70b9\u6570\u304c\u9ad8\u3044\u307b\u3069\u75c7\u72b6\u3084\u75b2\u52b4\u304c\u5f37\u3044\u3053\u3068\u3092\u793a\u3057\u3001\u81e8\u5e8a\u7684\u306b\u91cd\u8981\u306a\u6700\u5c0f\u306e\u5dee\u306f9\u70b9\u3068\u3055\u308c\u308b\uff09\u3068\u3057\u305f\u3002<\/p>\n

Results<\/strong>
\n\u3000\u60a3\u8005\u5e74\u9f62\u306e\u5e73\u5747\u5024\u306f\u300174.4\u6b73\u3067\u3001396\u4eba\uff0853.7%\uff09\u306f\u5973\u6027\u3060\u3063\u305f\u3002TSH\u5024\u306e\u5e73\u5747\u5024\uff08\u00b1SD\uff09\u306f\u30016.40\u00b12.01\uff4dIU\/L\u3060\u3063\u305f\u30021\u5e74\u9593\u3067\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6295\u4e0e\u7fa4\u306f\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u306e\u4e2d\u592e\u502450\u03bcg\u306e\u6295\u4e0e\u306b\u304a\u3044\u3066\u30013.63mIU\/L\u306b\u4f4e\u4e0b\u3057\u305f\u306e\u306b\u5bfe\u3057\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f\u30011\u5e74\u9593\u30675.48mIU\/L\u3078\u3068\u4f4e\u4e0b\uff08P<0.001\uff09\u3057\u305f\u3002
\n1\u5e74\u9593\u306e\u5909\u5316\u3068\u3057\u3066\u3001\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u30b9\u30b3\u30a2\u306e\u6709\u610f\u306a\u5909\u5316\u306f\u8a8d\u3081\u306a\u304b\u3063\u305f\u3002\uff08\u30d7\u30e9\u30bb\u30dc\u7fa40.2\u00b115.3\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6295\u4e0e\u7fa40.2\u00b114.4\uff09\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6295\u4e0e\u306b\u3088\u308b\u526f\u6b21\u7684\u306a\u30a2\u30a6\u30c8\u30ab\u30e0\uff08QOL\u30b9\u30b3\u30a2\u3001\u63e1\u529b\u3001\u8840\u5727\u3001BMI\u3001\u8179\u56f2\uff09\u306b\u3064\u3044\u3066\u3082\u6709\u76ca\u306a\u5dee\u306f\u307f\u3089\u308c\u306a\u304b\u3063\u305f\u3002\u307e\u305f\u3001\u4e8b\u524d\u306b\u60f3\u5b9a\u3055\u308c\u305f\u91cd\u5927\u306a\u6709\u5bb3\u4e8b\u8c61\u306b\u3064\u3044\u3066\u3082\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f\u3002<\/p>\n

Discussion<\/strong>
\n\u3000\u4eca\u56de\u306e\u8a66\u9a13\u306f\u3001\u7d71\u8a08\u7684\u306b\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u3092\u8a55\u4fa1\u3059\u308b\u306b\u306f\u5341\u5206\u306a\u75c7\u4f8b\u6570\u3060\u3063\u305f\u3068\u8003\u3048\u3089\u308c\u308b\u3002\u5c0f\u3055\u306a\u898f\u6a21\u306e\u89b3\u5bdf\u7814\u7a76\u306a\u3069\u3067\u306f\u3001\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u30b9\u30b3\u30a2\u3084\u75b2\u52b4\u30b9\u30b3\u30a2\u306e\u5909\u5316\u3092\u793a\u3057\u3066\u3044\u305f\u304c\u3001\u3044\u305a\u308c\u3082\u77ed\u3044\u89b3\u5bdf\u671f\u9593\u306b\u304a\u3051\u308b\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6295\u4e0e\u306b\u3088\u308b\u6cbb\u7642\u52b9\u679c\u306e\u6bd4\u8f03\u3060\u3063\u305f\u3002\u904e\u53bb\u306b\u306f\u3001\u9ad8\u9f62\u8005\u3092\u5bfe\u8c61\u3068\u3057\u305f\u8cea\u306e\u9ad8\u3044\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u306f\u884c\u308f\u308c\u3066\u3044\u305f\u304c\u3001\u75c7\u4f8b\u6570\u304c120\u4eba\u4ee5\u4e0b\u3067\u3001\u5341\u5206\u306a\u898f\u6a21\u3068\u306f\u8a00\u3048\u306a\u304b\u3063\u305f\u3002\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u3067\u306f\u3001\u60c5\u5831\u51e6\u7406\u80fd\u529b\u304c\u4f4e\u4e0b\u3059\u308b\u3068\u793a\u5506\u3055\u308c\u3066\u3044\u308b\u304c\u3001\u4eca\u56de\u306e\u8a66\u9a13\u3067\u884c\u3063\u305f\u6587\u5b57\u30b3\u30fc\u30c9\u30c6\u30b9\u30c8\u306e\u7d50\u679c\u304b\u3089\u306f\u3001\u660e\u3089\u304b\u306a\u5dee\u306f\u793a\u3055\u308c\u306a\u304b\u3063\u305f\u3002\u540c\u69d8\u306b\u8840\u5727\u3001\u4f53\u91cd\u3001\u8179\u56f2\u3001BMI\u3001ADL\uff08Barthel Index\uff09\u3001IADL\u3067\u3082\u6cbb\u7642\u52b9\u679c\u306e\u5dee\u306f\u8a8d\u3081\u306a\u304b\u3063\u305f\u3002\u307e\u305f\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6295\u4e0e\u7fa4\u306b\u304a\u3051\u308b\u6709\u5bb3\u306a\u7532\u72b6\u817a\u6a5f\u80fd\u4ea2\u9032\u75c7\u306e\u767a\u73fe\u306f\u8a8d\u3081\u305a\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u306b\u304a\u3044\u3066\u3082\u3001\u5fc3\u623f\u7d30\u52d5\u3001\u5fc3\u4e0d\u5168\u3001\u9aa8\u6298\u3001\u9aa8\u7c97\u9b06\u75c7\u306a\u3069\u60f3\u5b9a\u3055\u308c\u3066\u3044\u305f\u6709\u5bb3\u4e8b\u8c61\u306b\u3064\u3044\u3066\u306f\u8a8d\u3081\u306a\u304b\u3063\u305f\u3002\u904e\u53bb\u306e\u89b3\u5bdf\u7814\u7a76\u306b\u304a\u3044\u3066\u3082\u3001\u6cbb\u7642\u306b\u3088\u308b\u6709\u5bb3\u4e8b\u8c61\u306e\u30ea\u30b9\u30af\u4e0a\u6607\u306f\u793a\u3055\u308c\u3066\u3044\u306a\u3044\u3002
\n\u4eca\u56de\u306e\u7814\u7a76\u306e\u9650\u754c\u3068\u3057\u3066\u306f\u3001\u6cbb\u7642\u76ee\u6a19\u3092\u4e00\u90e8\u306e\u6a29\u5a01\u8005\u304c\u793a\u3057\u3066\u3044\u308bTSH\u5024\uff080.40\uff5e2.50mIU\/L\uff09\u3067\u306f\u306a\u304f\u3001\u6700\u8fd1\u306e\u9ad8\u9f62\u8005\u306b\u5bfe\u3059\u308b\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6cbb\u7642\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u793a\u3055\u308c\u3066\u3044\u308bTSH\u5024\uff080.40\uff5e4.60mIU\/L\uff09\u3092\u63a1\u7528\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u6319\u3052\u3089\u308c\u308b\u3002\u9650\u754c\u306e2\u3064\u76ee\u3068\u3057\u3066\u306f\u3001TSH\u5024\u304c10mIU\/L\u3092\u8d85\u3048\u3066\u3044\u305f\u5c11\u6570\u306e\u5bfe\u8c61\u8005\u306b\u3064\u3044\u3066\u306f\u3001\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u89e3\u6790\u304c\u5341\u5206\u306b\u3067\u304d\u3066\u304a\u3089\u305a\u3001\u6cbb\u7642\u52b9\u679c\u306e\u30e1\u30ea\u30c3\u30c8\u306b\u3064\u3044\u3066\u306f\u660e\u3089\u304b\u306b\u3067\u304d\u306a\u304b\u3063\u305f\u3002\u9650\u754c\u306e3\u3064\u76ee\u3068\u3057\u3066\u306f\u3001\u5bfe\u8c61\u8005\u306e\u75c7\u72b6\u306e\u7a0b\u5ea6\u304c\u8efd\u304f\u3001\u3088\u308a\u75c7\u72b6\u306e\u5f37\u3044\u5834\u5408\u306e\u53ef\u80fd\u6027\u306b\u3064\u3044\u3066\u306f\u9664\u5916\u3067\u304d\u3066\u3044\u306a\u3044\u30024\u3064\u76ee\u3068\u3057\u3066\u306f\u3001\u7532\u72b6\u817a\u306e\u6297\u4f53\u5024\u3092\u6e2c\u5b9a\u3057\u3066\u3044\u306a\u3044\u305f\u3081\u3001\u6297\u4f53\u306e\u6709\u7121\u306b\u3088\u308b\u5dee\u3068\u3001\u6297\u4f53\u3092\u6709\u3057\u3066\u3044\u308b\u5834\u5408\u306b\u9577\u671f\u9593\u306e\u6cbb\u7642\u3067\u5dee\u304c\u751f\u3058\u305f\u53ef\u80fd\u6027\u306f\u8a55\u4fa1\u3067\u304d\u3066\u3044\u306a\u3044\u3002\u6700\u5f8c\u306b\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u3084\u6b7b\u4ea1\u7387\u306b\u53ca\u307c\u3059\u52b9\u679c\u3092\u8a55\u4fa1\u3059\u308b\u306b\u306f\u81f3\u3063\u3066\u304a\u3089\u305a\u3001\u6cbb\u7642\u306b\u3088\u308b\u5fc3\u8840\u7ba1\u7cfb\u3078\u306e\u4fdd\u8b77\u4f5c\u7528\u3084\u6709\u5bb3\u6027\u306e\u53ef\u80fd\u6027\u306f\u3001\u9664\u5916\u3067\u304d\u3066\u3044\u306a\u3044\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n\u30002017\u5e745\u670817\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u2015\u6587\u732e\u540d\u2015 D. J. Stott, et al. Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism. NEJM. Apri … \u7d9a\u304d\u3092\u8aad\u3080 \u9ad8\u9f62\u8005\u306e\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-1318","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1318","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1318"}],"version-history":[{"count":2,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1318\/revisions"}],"predecessor-version":[{"id":1320,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1318\/revisions\/1320"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1318"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1318"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}