{"id":1919,"date":"2020-06-29T11:12:10","date_gmt":"2020-06-29T02:12:10","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1919"},"modified":"2020-06-29T11:27:32","modified_gmt":"2020-06-29T02:27:32","slug":"%e3%83%ac%e3%83%9c%e3%83%81%e3%83%ad%e3%82%ad%e3%82%b7%e3%83%b3%e3%81%af80%e6%ad%b3%e4%bb%a5%e4%b8%8a%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","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1919","title":{"rendered":"\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u306f80\u6b73\u4ee5\u4e0a\u306e\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306eQOL\u3092\u6539\u5584\u3057\u306a\u3044"},"content":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat’s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002<\/p>\n

\uff0d\u6587\u732e\u540d\uff0d
\nAssociation Between Levothyroxine Treatment and Thyroid-Related Symptoms Among Adults Aged 80 Years and Older With Subclinical Hypothyroidism.
\nJAMA. 2019;322(20):1977-1986. doi:10.1001\/jama.2019.17274<\/p>\n

\uff0d\u8981\u7d04\uff0d
\nIntroduction\uff1a
\n\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306e\u60a3\u8005\u306e\u4e00\u90e8\u304b\u3089\u3001\u4fbf\u79d8\u30fb\u7cbe\u795e\u9045\u6ede\u30fb\u75b2\u52b4\u30fb\u6291\u3046\u3064\u75c7\u72b6\u306a\u3069\u306e\u75c7\u72b6\u306e\u5831\u544a\u304c\u3042\u308b\u3002\u307e\u305f\u3001\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306f\u5fc3\u8840\u7ba1\u75be\u60a3\u306e\u30ea\u30b9\u30af\u306e\u5897\u52a0\u3068\u95a2\u9023\u3057\u3066\u3044\u308b\u3068\u3044\u3046\u5831\u544a\u3082\u3042\u308b\u300265\u6b73\u4ee5\u4e0a\u306e\u60a3\u8005\u3092\u5bfe\u8c61\u3068\u3057\u305f2017\u5e74\u306eRCT\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6cbb\u7642\u306b\u3088\u308b\u7532\u72b6\u817a\u95a2\u9023QOL\u306e\u6539\u5584\u306f\u793a\u3055\u308c\u306a\u304b\u3063\u305f\u3002
\n\u3057\u304b\u3057\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6cbb\u7642\u304c80\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306e\u6f5c\u5728\u6027\u7532\u72b6\u817a\u4f4e\u4e0b\u75c7\u306b\u91cd\u8981\u306a\u5229\u76ca\u304c\u3042\u308b\u304b\u3069\u3046\u304b\u306f\u4e0d\u660e\u3067\u3042\u3063\u305f\u3002\u4eca\u56de\u306e\u8abf\u67fb\u3067\u306f\u3001\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306b\u5bfe\u3059\u308b\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6cbb\u7642\u3068\u300180\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306eQOL\u306e\u95a2\u9023\u3092\u6c7a\u5b9a\u3059\u308b\u3002<\/p>\n

Method\uff1a
\n80\u6b73\u4ee5\u4e0a\u306e\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u304c\u95a2\u4e0e\u3059\u308b\u30c7\u30fc\u30bf\u306e\u7d44\u307f\u5408\u308f\u305b\u5206\u6790\u3092\u8a08\u753b\u3057\u3001\uff12\u3064\u306eRCT\u306780\u6b73\u4ee5\u4e0a\u306e\u53c2\u52a0\u8005\u306e\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u3068\u7d44\u307f\u5408\u308f\u305b\u305f\u3002\u6700\u521d\u306e\u8a66\u9a13\u3067\u306f\u30aa\u30e9\u30f3\u30c0\u30fb\u30b9\u30a4\u30b9\u30672014\u5e745\u6708\u304b\u30892017\u5e745\u6708\u30012\u3064\u76ee\u306e\u8a66\u9a13\u306f\u30aa\u30e9\u30f3\u30c0\u3002\u30b9\u30a4\u30b9\u3002\u30a2\u30a4\u30eb\u30e9\u30f3\u30c9\u30fb\u30a4\u30ae\u30ea\u30b9\u30672013\u5e744\u6708\u304b\u30892018\u5e745\u6708\u306e\u9593\u306b\u884c\u308f\u308c\u305f\u3002\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u306f\u6700\u77ed\u3067\uff11\uff12\u30f6\u6708\u3001\u6700\u9577\u3067\uff13\uff16\u30f6\u6708\u8ffd\u8de1\u3057\u305f\u3002\u53c2\u52a0\u8005\u306f\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\uff08112\u4eba\u3002\u6700\u521d\u306e\u8a66\u9a13\u304b\u308952\u4eba\u3001\uff12\u56de\u76ee\u306e\u8a66\u9a13\u304b\u308960\u4eba\uff09\u307e\u305f\u306f\u30d7\u30e9\u30bb\u30dc\u7fa4\uff08139\u4eba\u3002\u6700\u521d\u306e\u8a66\u9a13\u304b\u308953\u4eba\u3001\uff12\u56de\u76ee\u306e\u8a66\u9a13\u304b\u308986\u4eba\uff09\u306b\u30e9\u30f3\u30c0\u30e0\u306b\u5272\u308a\u5f53\u3066\u3089\u308c\u305f\u3002
\n\u6cbb\u9a13\u85ac\u306f\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u30ca\u30c8\u30ea\u30a6\u30e0\u30bf\u30d6\u30ec\u30c3\u30c8\u30681\u65e51\u56de\u7d4c\u53e3\u6442\u53d6\u3055\u308c\u308b\u5bfe\u5fdc\u3059\u308b\u30d7\u30e9\u30bb\u30dc\u30bf\u30d6\u30ec\u30c3\u30c8\u3092\u4f7f\u7528\u3002\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\u306f1\u65e550 \u00b5g\uff08\u4f53\u91cd\u304c50 kg\u672a\u6e80\u306e\u53c2\u52a0\u8005\u307e\u305f\u306f\u51a0\u72b6\u52d5\u8108\u6027\u5fc3\u81d3\u75c5\u306e\u75c5\u6b74\u304c\u3042\u308b\u5834\u5408\u306f25 \u00b5g\uff09\u3067\u958b\u59cb\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u306f6\u301c8\u9031\u9593\u3001\u4e00\u81f4\u3059\u308b\u30d7\u30e9\u30bb\u30dc\u3067\u958b\u59cb\u3057\u305f\u3002\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u306e\u6295\u4e0e\u91cf\u306f\u3001\u4ecb\u5165\u958b\u59cb\u5f8c6\u301c8\u9031\u9593\u3001\u5404\u6295\u4e0e\u91cf\u8abf\u6574\u5f8c6\u301c8\u9031\u9593\u3001\u304a\u3088\u3073\u76ee\u6a19\u9054\u6210\u306e\u305f\u3081\u306e12\u304b\u6708\u304a\u3088\u307324\u304b\u6708\u306e\u8ffd\u8de1\u8abf\u67fb\u3067\u6e2c\u5b9a\u3002TSH\u306b\u5fdc\u3058\u306625 \u00b5g\u305a\u3064\u5897\u52a0\u3057\u3066\u8abf\u6574\u3057\u305f\u3002<\/p>\n

\"JC\u5927\u897f\uff11\"<\/a><\/p>\n

\uff1c\u9664\u5916\u57fa\u6e96\uff1e
\n\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u3001\u6297\u7532\u72b6\u817a\u85ac\u3001\u30a2\u30df\u30aa\u30c0\u30ed\u30f3\u3001
\n\u30ea\u30c1\u30a6\u30e0\u306e\u4f7f\u7528\u3002
\n\u6700\u8fd1\u306e\u7532\u72b6\u817a\u624b\u8853\u3001\u653e\u5c04\u6027\u30e8\u30a6\u7d20\u7642\u6cd5\u3001NYHAclass4\u306e\u5fc3\u4e0d\u5168\u3001\u8a8d\u77e5\u75c7\u3001\u6700\u8fd1\u306e\u5165\u9662\u3001ACS\u3001\u5fc3\u7b4b\u708e\u3001\u7d42\u672b\u671f\u75be\u60a3\u3002<\/p>\n

\"JC\u5927\u897f\uff12\"<\/a><\/p>\n

\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u865a\u8840\u6027\u5fc3\u75be\u60a3\u304c27.3%(vs20.5%)
\nTSH\u306f\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa46.4\u3067\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u30676.3\u3002<\/p>\n

Results\uff1a
\n\u30d7\u30e9\u30a4\u30de\u30ea\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\uff11\u5e74\u9593\u306e\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u72b6\u3068\u75b2\u52b4\u611f\u3092\u30a2\u30f3\u30b1\u30fc\u30c8\u30b9\u30b3\u30a2\u3067\u3068\u3063\u305f\u7532\u72b6\u817a\u95a2\u9023\u306eQOL\u3068\u3057\u305f\u3002251\u4eba\u306e\u53c2\u52a0\u8005\uff08\u5e73\u5747\u5e74\u9f6285\u6b73\u300147\uff05\u304c\u5973\u6027\uff09\u306e\u3046\u3061\u3001105\u4eba\u306f\u6700\u521d\u306e\u8a66\u9a13\u306b\u542b\u307e\u308c\u3001146\u4eba\u306f\uff12\u56de\u76ee\u306e\u8a66\u9a13\u3067\u542b\u307e\u308c\u305f\u3002
\n\u8a08212\u4eba\u306e\u53c2\u52a0\u8005\uff0884%\uff09\u304c\u8abf\u67fb\u3092\u5b8c\u4e86\u3002\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u72b6\u30b9\u30b3\u30a2\u306f\uff11\uff12\u30f6\u6708\u306e\u6642\u70b9\u3067\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\u3067\u306f\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e21.7\u304b\u308919.3\u306b\u6e1b\u91cf\u3057\u305f\u306e\u306b\u5bfe\u3057\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f19.8\u304b\u308917.4\u306b\u6e1b\u5c11\u3057\u305f\uff08\u30b0\u30eb\u30fc\u30d7\u9593\u8abf\u6574 1.3 [95\uff05CI\u3001-2.7\u301c5.2] ; P \u2009= .53\uff09\u3002\u75b2\u52b4\u30b9\u30b3\u30a2\u306f\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\u306e\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u3067\u306e25.5\u304b\u308928.2\u306b\u5897\u52a0\u3057\u305f\u306e\u306b\u5bfe\u3057\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u3067\u306e25.1\u304b\u308928.7\u306b\u5897\u52a0\u3057\u305f\uff08\u30b0\u30eb\u30fc\u30d7\u9593\u8abf\u6574 \u22120.1 [95% CI, \u22124.5 to 4.3]; P\u2009=\u2009.96\uff09\u3002<\/p>\n

\"JC\u5927\u897f\uff13\"<\/a><\/p>\n

12\u304b\u6708\u5f8c\u306e\u5909\u5316\u3068\u306f\u6709\u610f\u306b\u95a2\u9023\u3057\u3066\u3044\u306a\u304b\u3063\u305f\u3002<\/strong>
\n\u30fb\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6cbb\u7642\u306f\u3001\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u304b\u3089EuroQol-5D\u30a4\u30f3\u30c7\u30c3\u30af\u30b9\u3067\u6e2c\u5b9a\u3055\u308c\u305f\u4e00\u822c\u7684\u306aQOL\u306e\uff08\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\uff1a0.785\u21920.754\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\uff1a0.811\u21920.785\u3002-0.012 [ 95\uff05CI\u3001\u22120.063 to 0.039]\uff09\u3002
\n\u30fb12\u304b\u6708\u306e\u63e1\u529b\u3067\u6e2c\u5b9a\u3057\u305f\u8eab\u4f53\u6a5f\u80fd\uff08\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\uff1a25.4 kg\u219223.4 kg\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u306e24.7 kg\u219223.0 kg\u3002\u22120.27 kg [95\uff05CI\u3001-1.79 to 1.25]\uff09
\n\u30fbBMI\uff080.38 [95\uff05CI\u30010.08-0.68]; P \u2009= .01\uff09
\n\u30fb\u8179\u56f2\uff081.52 cm [95 \uff05CI\u30010.09-2.95]; P \u2009= .04\uff09<\/p>\n

\"JC\u5927\u897f\uff14\"<\/a><\/p>\n

\u7532\u72b6\u817a\u7279\u7570\u7684\u307e\u305f\u306f\u5168\u4f53\u7684\u306aQOL\u3068\u6709\u610f\u306b\u95a2\u9023\u3057\u3066\u3044\u306a\u304b\u3063\u305f\u3002<\/strong>
\n\u30d0\u30fc\u30b5\u30eb\u30a4\u30f3\u30c7\u30c3\u30af\u30b9\u3092\u7528\u3044\u3066\u6e2c\u5b9a\u3057\u305f\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6cbb\u7642\u3068ADL\u3068\u306e\u6709\u610f\u306a\u95a2\u9023\u306f\u306a\u304b\u3063\u305f\uff08\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\uff1a19.3\u219219.0\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\uff1a19.4\u219219.1\u30020.09 [95\uff05CI\u3001-0.33\u301c0.52]\uff09
\n\u8abf\u67fb\u7d42\u4e86\u6642\u306b\u6587\u5b57\u6570\u5b57\u30b3\u30fc\u30c7\u30a3\u30f3\u30b0\u30c6\u30b9\u30c8\u3067\u6e2c\u5b9a\u3055\u308c\u305f\u5b9f\u884c\u8a8d\u77e5\u6a5f\u80fd\uff081.24 [95\uff05CI\u3001-0.30\u301c2.78]\uff09<\/p>\n

\"JC\u5927\u897f\uff15\"<\/a><\/p>\n

80\u6b73\u4ee5\u4e0a\u306e\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306b\u304a\u3051\u308b
\n\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6cbb\u7642\u3068\u7532\u72b6\u817a\u95a2\u9023\u75c7\u72b6\u306e\u95a2\u9023\u306e\u53c2\u52a0\u8005\u306eTSH\u5024<\/p>\n

\"JC\u5927\u897f\uff16\"<\/a><\/p>\n

\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u306f\u3001\u81f4\u547d\u7684\u307e\u305f\u306f\u975e\u81f4\u547d\u7684\u306a\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306e\u767a\u751f\u7387\u306e\u5897\u52a0\u3068\u95a2\u9023\u3057\u3066\u3044\u306a\u304b\u3063\u305f\uff080.61 [95\uff05CI\u30010.24-1.50]\uff09\u3002<\/strong>
\n17\u304b\u6708\u306e\u5e73\u5747\u8ffd\u8de1\u671f\u9593\uff08\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u5024\u300113\u304b\u6708\uff09\u4e2d\u306b\u30019\u4eba\u306e\u53c2\u52a0\u8005\uff083.6\uff05\uff09\u304c\u6b7b\u4ea1\uff081\u4eba\u306e\u5fc3\u8840\u7ba1\u6b7b\uff09\u3002100\u4eba\u5e74\u3042\u305f\u308a\u306e\u30a4\u30d9\u30f3\u30c8\u7387\u306f\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\uff1a4.2\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\uff1a7.64\uff09\u3002
\n\u5168\u6b7b\u4ea1\u7387\uff081.39 [95\uff05CI\u30010.37-5.19]\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\uff1a2.99\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\uff1a2.02\uff09\u3002
\n\u5c11\u306a\u304f\u3068\u30821\u3064\u306e\u6709\u5bb3\u4e8b\u8c61\u304c\u3001\u5408\u8a0873\u4eba\uff1a\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\u306e33\u4eba\uff0829.5\uff05\uff09\u30d7\u30e9\u30bb\u30dc\u7fa4\u306e40\u4eba\uff0828.8\uff05\uff09\u306b\u767a\u751f\u3057\u305f\u3002<\/strong>
\n\u6709\u5bb3\u4e8b\u8c61\u306f\u3001\u65b0\u898f\u767a\u75c7\u5fc3\u623f\u7d30\u52d510\u4eba\uff084.5\uff05\uff09\u3001\u5fc3\u4e0d\u51689\u4eba\uff084.1\uff05\uff09\u3001\u9aa8\u62989\u4eba \uff084.1\uff05\uff09\u304c\u542b\u307e\u308c\u3066\u3044\u305f\u3002\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306f\u3001\u53c2\u52a0\u8005\u306e\u3044\u305a\u308c\u306b\u3082\u767a\u751f\u3057\u306a\u304b\u3063\u305f\u3002\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u7fa4\u3067\u3001\u6700\u3082\u4e00\u822c\u7684\u306a\u6709\u5bb3\u4e8b\u8c61\u306f\u3001\u8133\u5352\u4e2d3\u4eba\uff082.2\uff05\uff09\u3001\u8ca7\u88402\u4eba\uff081.4\uff05\uff09\u3001\u304a\u3088\u3073\u80ba\u708e2\u4eba\uff081.4\uff05\uff09\u3067\u3042\u3063\u305f\u3002
\n\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f\u3001\u6700\u3082\u4e00\u822c\u7684\u306a\u6709\u5bb3\u4e8b\u8c61\u306f\u80ba\u708e4\u4eba\uff083.6\uff05\uff09\u3001\u5fc3\u4e0d\u51682\u4eba\uff081.8\uff05\uff09\u3001\u304a\u3088\u3073\u547c\u5438\u4e0d\u51682\u4eba\uff081.8\uff05\uff09\u3067\u3042\u3063\u305f\u3002\u7814\u7a76\u306e\u7d42\u308f\u308a\u306b\u3001\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u4e2d\u306b81\u4eba\uff0832\uff05\uff09\u3067\u6cbb\u7642\u306e\u4e2d\u6b62\u304c\u767a\u751f\u3057\u305f\u306e\u306b\u5bfe\u3057\u3001\u7814\u7a76\u306e\u7dcf\u4e2d\u6b62\u306f19\u4eba\uff088\uff05\uff09\u3067\u3042\u3063\u305f\u3002<\/p>\n

\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306e\u3042\u308b80\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u3092\u5bfe\u8c61\u3068\u3057\u30662\u3064\u306e\u81e8\u5e8a\u8a66\u9a13\u304b\u3089\u306e\u3053\u306e\u524d\u5411\u304d\u306b\u8a08\u753b\u3055\u308c\u305f\u30c7\u30fc\u30bf\u5206\u6790\u3067\u306f\u3001\u30d7\u30e9\u30bb\u30dc\u3068\u6bd4\u8f03\u3057\u305f\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u3067\u306e\u6cbb\u7642\u306f\u3001\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306e\u75b2\u52b4\u306e\u6539\u5584\u3068\u6709\u610f\u306b\u95a2\u9023\u3057\u3066\u3044\u306a\u304b\u3063\u305f\u3002\u3053\u308c\u3089\u306e\u8abf\u67fb\u7d50\u679c\u306f\u300180\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306b\u304a\u3051\u308b\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u306e\u6cbb\u7642\u306e\u305f\u3081\u306e\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u306e\u65e5\u5e38\u7684\u306a\u6295\u85ac\u306f\u652f\u6301\u3057\u306a\u304b\u3063\u305f\u3002<\/p>\n

Discussion\uff1a
\nBMI\u3068\u8179\u56f2\u3092\u306e\u305e\u3044\u3066\u6709\u5bb3\u4e8b\u8c61\u307e\u305f\u306f\u4e8c\u6b21\u8ee2\u5e30\u306e\u30ea\u30b9\u30af\u3068\u306e\u95a2\u9023\u306f\u306a\u304b\u3063\u305f\u304c\u3001\u6bd4\u8f03\u306e\u6570\u304c\u591a\u3044\u3053\u3068\u304b\u3089\u5076\u7136\u306b\u3088\u308b\u3068\u601d\u308f\u308c\u308b\u3002\u6cbb\u7642\u7fa4\u9593\u306b\u5dee\u306f\u306a\u304f\u3001\u5076\u7136\u306b\u3088\u308b\u3068\u601d\u308f\u308c\u308b\u3002\u6cbb\u7642\u7fa4\u9593\u3067\u306e\u8131\u843d\u7387\u306b\u5dee\u306f\u306a\u304f\u3001\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6cbb\u7642\u304c\u6709\u5bb3\u4e8b\u8c61\u306b\u95a2\u9023\u3057\u3066\u3044\u306a\u304b\u3063\u305f\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u308b\u3002\u4eca\u56de\u306e\u8a66\u9a13\u3067\u5831\u544a\u3055\u308c\u305f\u7d50\u679c\u306f\u3001\u30e8\u30fc\u30ed\u30c3\u30d1\u3068\u7c73\u56fd\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u3042\u308b\u300c\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306e\uff18\uff10\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306b\u5bfe\u3059\u308b\u6cbb\u7642\u3092\u63a8\u5968\u3057\u306a\u3044\u300d\u3068\u4e00\u81f4\u3057\u3066\u3044\u308b\u3002\u3044\u305a\u308c\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3082TSH\u304c10mIU\/L\u3092\u8d85\u3048\u305f\u3089\u6cbb\u7642\u3059\u308b\u3053\u3068\u304c\u63a8\u5968\u3055\u308c\u3066\u3044\u308b\uff08\u5e74\u9f62\u306f\u8a18\u8f09\u3055\u308c\u3066\u3044\u306a\u3044\uff09\u3002\u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u6cbb\u7642\u306f\u3001\u7532\u72b6\u817a\u95a2\u9023\u306e\u75c7\u72b6\u3001QOL\u3001\u8a8d\u77e5\u6a5f\u80fd\u3001\u8eab\u4f53\u6a5f\u80fd\u306b\u6709\u76ca\u306a\u5f71\u97ff\u3092\u53ca\u307c\u3055\u306a\u3044\u3053\u3068\u304c\u5224\u660e\u3057\u3066\u3044\u305f65\u6b73\u4ee5\u4e0a\u306e\u6210\u4eba\u3092\u5bfe\u8c61\u3068\u3057\u305f\u8a66\u9a13\u306e\u7d50\u679c\u3068\u4e00\u81f4\u3057\u3066\u304a\u308a\u3001\u65e5\u5e38\u751f\u6d3b\u30b9\u30b3\u30a2\u3084\u6709\u5bb3\u4e8b\u8c61\u306e\u5897\u52a0\u306f\u306a\u304b\u3063\u305f\u3002\u3053\u306e\u7814\u7a76\u306b\u306f\u3044\u304f\u3064\u304b\u306e\u5236\u9650\u304c\u3042\u308b\u3002\u7b2c\u4e00\u306b\u3001\u4ea4\u611f\u795e\u7d4c\u7cfb\u306e\u8ca0\u62c5\u304c\u9ad8\u3044\u304b\u3001\u307e\u305f\u306f\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u6642\u306eTSH\u5024\u304c\u9ad8\u3044\u53c2\u52a0\u8005\u306b\u3064\u3044\u3066\u306f\u3001\u4e8b\u524d\u306b\u8a08\u753b\u3055\u308c\u305f\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u89e3\u6790\u304c\u884c\u308f\u308c\u3066\u3044\u306a\u3044\u3002\u7d50\u679c\u306f\u3053\u308c\u3089\u306e\u53c2\u52a0\u8005\u306b\u306f\u9069\u7528\u3055\u308c\u306a\u3044\u304b\u3082\u3057\u308c\u306a\u3044\u3002\u7b2c\u4e8c\u306b\u3001\u660e\u3089\u304b\u306a\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u3078\u306e\u9032\u884c\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u4eba\u3092\u8b58\u5225\u3059\u308b\u53ef\u80fd\u6027\u306e\u3042\u308b\u6297\u7532\u72b6\u817a\u6297\u4f53\u306e\u72b6\u614b\u306f\u5229\u7528\u3067\u304d\u306a\u304b\u3063\u305f\u3002\u7b2c\u4e09\u306b\u3001\u7814\u7a76\u96c6\u56e3\u306f\u540c\u7a2e\u306e\u4eba\u7a2e\u3067\u3042\u3063\u305f\u3002\u7b2c\u56db\u306b\u3001\u6cbb\u7642\u3092\u7d99\u7d9a\u3057\u306a\u304b\u3063\u305f\u53c2\u52a0\u8005\uff0832\uff05\uff09\u304c\u304a\u308a\u3001\u3053\u308c\u304c\u7d50\u679c\u306b\u504f\u308a\u3092\u4e0e\u3048\u3066\u3044\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002\u3057\u304b\u3057\u3001\u6cbb\u7642\u3092\u4e2d\u6b62\u3057\u305f\u8005\u306e\u6570\u3068\u305d\u306e\u7406\u7531\u306f\u6cbb\u7642\u7fa4\u9593\u3067\u540c\u7a0b\u5ea6\u3067\u3042\u3063\u305f\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u30112020\u5e746\u670810\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat’s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002 \uff0d\u6587\u732e\u540d\uff0d Association Between Levothyro … \u7d9a\u304d\u3092\u8aad\u3080 \u30ec\u30dc\u30c1\u30ed\u30ad\u30b7\u30f3\u306f80\u6b73\u4ee5\u4e0a\u306e\u6f5c\u5728\u6027\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u306eQOL\u3092\u6539\u5584\u3057\u306a\u3044<\/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":[33,17],"tags":[],"class_list":["post-1919","post","type-post","status-publish","format-standard","hentry","category-whats-new","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1919","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=1919"}],"version-history":[{"count":5,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1919\/revisions"}],"predecessor-version":[{"id":1933,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1919\/revisions\/1933"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1919"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1919"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1919"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}