JP2006043360A - Method for grasping whole picture in quality and quantity of fat - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To support health management by providing the whole situation of fat in a form to allow not an expert but a patient or a physical examination receiver to understand it. <P>SOLUTION: The inspection result of the quality and quantity of the fat is expressed at a time by a radar chart. Accordingly, the whole situation of the fat is made to be understood so as to synthetically grasp the risk of arteriosclerosis or myocardial infarction at a glance. A plurality of cases are determined, where the fat is highly risky in quality but normal in quantity or, on the contrary, the fat is a little risky in quantity but not abnormal in quality, etc. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

Fields related to notation methods such as reports on clinical test results at hospitals, health check centers, and registered hygiene laboratories.

Conventionally, radar charts have been widely used as a method of expressing information in an easy-to-understand manner, like line graphs, pie charts, and bar graphs.
Also in the medical field, it is used daily in conference presentations and reports as a statistical expression of various clinical findings and test results. However, these reports were supposed to be reported to specialists who are doctors, and the list of test results was generally sufficient. Also, in the case of personal checkup results reports for individuals, most of the test results of many measurement items are listed as numerical values.

Recently, hypertension, diabetes, and hyperlipidemia have become established as lifestyle-related diseases.
With regard to high blood pressure and diabetes, it has become possible for individuals to self-examine blood pressure monitors, urine sugar or blood glucose tests. However, as for hyperlipidemia, it is not known whether it is hyperlipidemia unless a blood test is performed at a hospital or a medical examination.

Hyperlipidemia is written mainly on the amount of lipid as far as medical examination results and medical commentary books that are generally available on the market are examined. In the special article of the non-patent document 1 June 1997 issue of Nikkei Medical, the purpose of hyperlipidemia treatment is to prevent arteriosclerosis and prevent myocardial infarction. It is described that not only the amount of lipid but also examination of lipid quality is important.

In hyperlipidemia, only a small number of specialized doctors use both the amount and quality of lipids for medical care. This method of examining the quality of lipids is troublesome and time consuming, and has the problem that it can only be judged by a few specialists, and these have not been particularly popular in the medical examination area.

The turbidity of serum is generally called milk serum or milk plasma, and a method of visually expressing turbidity +1 or +2 has been adopted in clinical laboratories such as hospitals.

Reference Non-Patent Document 1 Curvature of Hyperlipidemia Treatment, Nikkei Medical, June 1997, 60-69
Non-Patent Literature 2 Tashiro Satoshi et al .: Significance of Midband in Familial Hypercholesterolemia, Arteriosclerosis, Vol. 15, no. 8,1561-1564, 1988
Non-patent document 3 Yasuo Mishima et al .: Effects of administration of bezafibrate sustained-release tablets on serum lipids and lipoprotein electrophoresis, Therapeutic Research, vol, 14, no. 10, 4489-4497, 1993
Non-Patent Document 4 Yasuo Mishima et al .: Estimation of LDL particle size using a simple PAG electrophoresis kit, arteriosclerosis, vol. 25, no. 1, 2, 67-70, 1997
Non-Patent Document 5 Tsutomu Hirano: New Small, dense LDL quantification method, Journal of Japanese Society for Clinical Laboratory Automation, Vol. 29, No. 2, 81-87, July 26, 2004 Patent Document 1 Japanese Patent Application No. 2003-387226

Means for solving the problem

The present invention provides a method for making it easy to grasp the overall image of an individual lipid by expressing the quality and quantity of the lipid together on one radar chart. For the examination of lipid quality, analysis results of polyacrylamide gel disk electrophoresis images as described in Non-Patent Documents 1, 2, and 3 are used, and IDL called VLDL, LDL, HDL, which is a lipoprotein particle, or midband. Or Small LDL called small particle LDL. As the lipid amount test, total cholesterol, LDL cholesterol, HDL cholesterol, neutral fat and the like which are routinely used as a general test are used. Diabetes is strongly related to lipid metabolism, and blood glucose levels and hemoglobin A1C can also be used as related tests. This method for measuring the amount of lipids and sugars is omitted here because it is well known among hospital inspection personnel and experts.

Regarding the degree of obesity, BMI (standard body weight, body mass index, Japanese Society of Obesity), which is the most common index among doctors examining obesity, is used. BMI is expressed as body weight / (height × height), and normal is less than 18.5 to 25, and 25 or more is obese. Conversely, less than 18.5 is said to be thin.

The method of expressing the turbidity of serum is generally expressed as +1 or +2 by visual inspection by a laboratory technician. Since there are too many personal sensory parts, the present invention uses formazine turbidity, which is an index of turbidity in JIS K-0400-9-10. I can write.

Until now, these conventional lipid quality and quantity tests have been used independently, but in the present invention, by using a radar chart associated with them, not only specialists but also arteriosclerosis and hyperlipidemia. Even ordinary people interested in the disease can easily know the status of their lipid quality and quantity.

Radar chart is a multivariate data analysis method, and is widely used in statistics as a graph directly connected to interpretation of results.
Using this radar chart to analyze the quality and quantity of lipids has a great impact on understanding the overall picture of lipids, which has been vague until now.

In the present invention, in addition to the lipid quality test results and quantity test results, milky values, which are obesity levels and turbidity levels of blood, are selected as variables, and a radar chart is constructed.
As a lipid quality test, information on the lipoprotein midband (also referred to as IDL) and small particle LDL (also referred to as Small LDL) is selected as a variable axis from the results of polyacrylamide gel disk electrophoresis. The lipoprotein precipitation method according to Non-Patent Document 5 recently published as a quality inspection method may be incorporated as a variable. In addition, since there are lipid abnormalities in VLDL, LDL, and HDL, the existence ratios of which are different from normal lipids, it is possible to take them on the variable axis.

For testing the amount of lipid, commonly used total cholesterol level, LDL cholesterol level, HDL cholesterol level, and neutral fat level are selected as variables. It is safe to take several types of apoproteins as one of the variables as a method for testing the amount of lipid. Further, a quantitative value of an enzyme such as LDL lipase related to lipid metabolism, and a blood sugar level and a carbohydrate test such as hemoglobin A1C may be added as a related test.

As a method of taking the criteria for each variable, first, the value shown by the Arteriosclerosis Society as a diagnostic criterion for the amount of lipid is used as the upper limit of the healthy value. For example, the total cholesterol value is 220 mg / dL, the LDL cholesterol value is 140 mg / dL, and the neutral fat value is 150 mg / dL. The lower limit of the HDL cholesterol value is 40 mg / dL.
The degree of obesity is generally 25, which is generally recommended among specialists, and the upper limit of health is less than 18.5. This number itself may change with the trend of the times.
For the amount of milk powder, the formazine concentration that has been determined visually until now is used as the turbidity standard in JIS. The values +1, +2, and +3 of the visual judgment based on the subjectivity of the conventional inspection engineer may be used. As clinical tests for lipids, it is said that blood collection after fasting for about 12 hours is desirable for normal blood collection, and serum or plasma of normal lipid subjects is said to be transparent and free from turbidity. Therefore, there is no data below the normal reference wheel in the radar chart.

Regarding the method for determining lipid quality, it is normal that a normal lipid person usually has no abnormality in lipid quality, and the appearance of a qualitative abnormality is not normal. This determination of abnormal appearance is described in detail in Non-Patent Document 4. The median MI index of the so-called mid-band (also referred to as IDL, sometimes referred to as large particle LDL) indicates a group of 0.2, and the median MI index of small particles indicates a group of 0.41. A radar chart is constructed by plotting the existence% value on the variable axis.
Since it has been pointed out that there is a possibility of small particles when the median MI index of small particles LDL is 0.35 or more, the 0.2 or 0.41 values described here are not necessarily fixed. .

The name of the MI index is slightly different depending on the doctor who reported it. An Rm value or Rf value that has been used by experts for a long time as an electrophoretic charge amount or size may be used.

There are two ways of taking individual measurement values with respect to the normal reference wheel of the radar chart. Here, a method is adopted in which the convex part of the reference wheel is abnormal. A radar chart in which a concave portion is abnormal inside the reference wheel can be assumed.

Lipid metabolism is also closely related to blood glucose metabolism, and there are many patients with diabetes in hyperlipidemia. In order to get an overall picture of lipids of diabetic patients, it is also possible to add blood glucose and hemoglobin A1C and quantitative values of 1.5 AG or fructosamine to the radar chart and use them for diabetes management.

In the radar chart of lipid quality and quantity, for example, in the case of FIG. 1, even if the quantity of lipid of (1) to (5) partially exceeds the normal reference wheel (9), the quality of lipid (6 ) To (8) are normal, it can be judged that the risk of myocardial infarction is low, and conversely, even if the amount of lipid in (1) to (5) is within the normal reference ring (9), When the lipid quality (6) to (8) is abnormal, the risk of myocardial infarction cannot be denied.

FIG. 1 shows a radar chart having eight variable axes. Upper level is obesity level (1), clockwise total cholesterol (2), then LDL cholesterol (3), (4) HDL cholesterol, (5) neutral fat, (6) milk content Small particles LDL were selected for (7) and midband (also referred to as IDL) for (8). The wavy ring (9) in the center is a so-called normal reference ring, which is an overview of lipids of normal subjects.
(2) to (6) represent the amount of lipid, and (7) and (8) represent the quality of the lipid. The milk amount of (6), the small particle LDL of (7), and the midband (also referred to as IDL) of (8) are the portions that do not appear in normal subjects and are indicated by hatching (10). The fatal practice of (11) is an example of a lipid radar chart of a health checkup patient A, who has a slightly higher total cholesterol (1) and LDL cholesterol (2), but a small particle LDL (7) that is of lipid quality. And the mid band (8) is normal, indicating that the risk of myocardial infarction is low.

FIG. 2 shows a radar chart having six variable axes. Total cholesterol (12) was selected at the top, LDL cholesterol (13), (14) HDL cholesterol, (15) neutral fat, (16) small LDL, and (17) midband. (18) is a normal reference wheel. . (12) to (15) represent the amount of lipid, and (16) and (17) represent the quality of the lipid.
(19) is the analysis result of the medical examination patient B by the radar chart, and the amount of lipid is normal, but the mid band (also referred to as IDL) of (17) is a little, indicating that there is a risk of arteriosclerosis. .

FIG. 3 shows a radar chart having eight variable axes. Total cholesterol (20) at the top, then LDL cholesterol (21), (22) HDL cholesterol, (23) neutral fat, (24) blood glucose, (25) hemoglobin A1C, (26) Small particle LDL was selected for (2) and midband was selected for (27).
(28) is a normal reference ring for lipids and carbohydrates. (20) to (25) represent the amount of lipid and carbohydrate, and (26) and (27) represent the lipid quality.
(29) is the analysis result of the medical examination patient C by the radar chart, and it is clear that the lipid, the amount, and the diabetes index are higher than those of normal persons and the risk is high.

FIG. 4 shows a radar chart with six variable axes for lipid quality. In the upper part, VLDL (30) was taken clockwise, and midband or IDL (31), LDL (32), small particle LDL or Small LDL (33), HDL (34), and milk (35) were taken. Since IDL (31), Small LDL (33), and milk (35) have no test results in normal subjects, the inside of the normal reference ring of (36) is filled with diagonal lines (37).
(38) is the analysis result by the radar chart of the medical examination patient D, and shows abnormality over the whole quality of lipid. However, this is a case without milky milk (35), which is an indicator of blood turbidity.

The invention's effect

The invention of the present application states in Non-Patent Document 1 that “the greatest purpose of treating hyperlipidemia is prevention of coronary disease. It's been a long time since the feature article was published, "Isn't the result as expected?" Even now, even experts have such a question, there is a question whether it can be said that there is no worry about myocardial infarction only by screening mainly on the measurement result of general lipid content.

It is clear that fat does not dissolve in water, and it is always present as a part of particulate lipoprotein constituents in blood. Examining the existence form of the lipoprotein, that is, the particle state, is a so-called lipid quality test. It is said that these lipoprotein particles cause qualitative abnormalities due to poor metabolism or excessive state, and eventually cause arteriosclerosis and hyperlipidemia. Of course, not only the quality of lipid but also quantitative abnormalities are well known as bad and good cholesterol, and there is no room for objection to being an important indicator.

This important lipid quality and quantity is worth seeing at the same time, and some experts are now using this fact in their practice. The reason why only some specialists are useful in medical care is because lipid quality tests are not yet widely used.
Recently, the self-responsibility era of self-responsibility has come, and knowing the truth about the individual's health status, even as a result of screening, will surely prevent arteriosclerosis. In the future, the present invention will provide one of the tools that patients should pay more attention to maintaining their health.

There has never been a comparison of lipid quality and quantity test results, and there is no qualitative abnormality even if it is abnormal in quantity, or it is qualitative even if it is healthy in quantity. There may be abnormalities. With the widespread use of the “method for grasping the overall picture of the quality and quantity of lipid” of the present invention, hyperlipidemia is better understood and health awareness is increased.
In other words, with the spread of the present invention, it will be possible to break down the incomplete common sense of bad or good by looking at only the quantitative abnormality of lipids currently being carried out, and patients and ordinary people also recognize these truths As a result, it is possible to receive appropriate hyperlipidemia treatment, prevent an increase in medical expenses, and contribute to maintaining health.

  Lipid radar chart with 8 variable axes   Lipid radar chart with 6 variable axes   Lipid and carbohydrate radar chart with 8 variable axes   Lipid quality radar chart with 6 variable axes

Explanation of symbols

(1) Obesity level (2) Total cholesterol level (3) LDL cholesterol level (4) HDL cholesterol level (5) Triglyceride level (6) Milky level (7) Small particle LDL
(8) Midband (IDL)
(9) Normal reference wheel (10) Portion not appearing in normal person (11) Results of medical examination patient A (12) Total cholesterol level (13) LDL cholesterol level (14) HDL cholesterol level (15) Triglyceride level ( 16) Small particle LDL
(17) Midband (18) Normal reference wheel (19) Results of medical examination patient B (20) Total cholesterol level (21) LDL cholesterol level (22) HDL cholesterol level (23) Triglyceride level (24) Blood glucose level (25) Hemoglobin A1C
(26) Small particle LDL
(27) Midband (IDL)
(28) Normal reference wheel (29) Results of medical examination patient C (30) VLDL
(31) IDL
(32) LDL
(33) Small LDL
(34) HDL
(35) Milk pin (36) Normal reference wheel (37) Part where patient test result does not exist (37) Result of medical examination patient D

Claims (6)

A method for grasping the overall picture of the quality and quantity of lipids, which features the quality and quantity of lipids on a single radar chart so that the status of the whole lipid can be understood at a glance. 2. The radar chart includes at least two types of VLDL, midband, LDL, small particle LDL, and HDL, which are analysis results of lipoprotein electrophoresis, as lipid quality test results. To understand the overall picture of lipid quality and quantity Claims characterized in that at least two or more of total cholesterol, LDL cholesterol, HDL cholesterol, neutral fat, blood sugar level, and hemoglobin A1C measurement values are incorporated into the radar chart as a test result of the amount of lipid or carbohydrate. Method of grasping the whole picture of the quality and quantity of lipid of Item 1 The method for grasping the overall picture of the quality and quantity of lipid according to claim 1, wherein obesity level, which is one expression of lipid metabolism, is incorporated in a radar chart. The method of grasping the whole picture of the quality and quantity of lipid according to claim 1, wherein the amount of milk milk, which is turbidity due to lipids in blood, is visually determined or expressed by a formazine concentration and incorporated in a radar chart. The method for grasping the overall picture of the quality and amount of lipid according to claim 1, wherein the amount of oxidized LDL or the amount of oxidized HDL is taken into the radar chart as the quality of lipid.

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