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献血ノススメ
❖ Seiichi Domyo����
道明 ����誠ー��
自転車で痩せて、マラソンに目覚めた人
❖ 脂肪肝[’98-’06]
❖ 自転車で20kg痩せた[’07]
❖ 帰宅難民で発心[’11]
❖ フルマラソン[’12]
❖ ウルトラトレイル[’16]
❖ 糖尿病が、潜在的脅威と思う��
なぜ献血するのか
❖ 情け(献血)は人の為ならず
❖ (健康診断との)合わせ技一本�����
情けは人の為ならず
❖ 献血は、50歳以上の抗ガン治療で使われている
❖�血液は、もうしばらくは人工的に作れない
❖�ガンになったら、自分も献血の血液を使うはず
合わせ技一本
❖ 献血には、血液検査がサービスでついている
❖�健康診断で足りない検査項目を、献血で補う
❖�定期的な血液検査で、生活習慣を見直す
合わせ技一本
❖�糖尿病の予兆監視
❖ HbA1c(ヘモグロビン・エイワンシー)
❖ GA(グリコ・アルブミン)
❖�脂肪肝の再発予防
❖�ALT(アラニンアミノ基転移酵素)
糖尿病の予兆監視
❖�背景
❖�夜中にトイレにいく回数の増加
❖�食後の異常な眠気
❖�目的
❖�加齢か糖尿病か(一般論ではなくて)、���
自分の数値で納得したい
健康診断でのHbA1c 推移
2011年以前の値はNGSPに換算
4.5
5
5.5
6
6.5
2002年 2005年 2009年 2013年 2016年
健康診断で予兆監視は十分?
❖�健康診断でのコメントの例
❖�”日常生活に注意”
❖�”年1回経過をみてください”
❖�自己努力で何をすべきか[’13]
❖�何を注意すべきか/医者任せで良いのか?
❖�年1回の検査で良いのか?
血液検査と予兆監視
❖�血液検査での糖尿病の指標
❖�空腹時血糖値
❖ HbA1c(ヘモグロビン・エイワンシー)
❖ GA(グリコ・アルブミン)
糖尿病の指標となる血液検査の項目
検査項目 検査目的 検査機会
空腹時血糖
10時間以上絶食の血糖値
空腹時の血糖値が分かる?
健康診断
HbA1C
1〜2月前の血糖値
長期的な血糖値が分かる?
健康診断
GA
2週間前の血糖値
食後の高血糖が分かる?
献血
糖尿病の予兆監視
https://www.tokyo.bc.jrc.or.jp/news-topics/2009/0315_55.html
❖�年2、3回行っていた献血で、検査できるならうれしい
献血でのGA推移
12
13
14
15
16
2009年 2011年 2013年 2015年 2017年
糖尿病の予兆監視のマトメ
❖ 献血で、ふだんの血糖値(食後)を知りたい
❖�検査回数を年1回から年2、3回に増やした
❖ 2週間前の生活から、改善の気づきを得らえる
❖�健康診断のセカンドオピニオンとして利用
❖�HbA1c(6.5%未満)� �良
❖�GA(15.6%未満) 優
合わせ技一本
❖�糖尿病の予兆監視
❖ HbA1c(ヘモグロビン・エイワンシー)
❖ GA(グリコ・アルブミン)
❖�脂肪肝の再発予防
❖�ALT(アラニンアミノ基転移酵素)
有効
脂肪肝の再発予防
❖�背景
❖�脂肪肝(デブ)は1日にしてならず
❖�痩せていても、脂肪肝になるらしい
❖�目的
❖過食による肝臓への負担把握�
❖体重(BMI)や腹回り以外で分かる
私の指標は何か[’08]
再発予防のPDCA
❖�Plan:
❖(過食x運動不足の)予兆を検知し、再発予防
❖�Do:
❖健康診断をもとに、脂肪肝との相関係数を求める
❖�Check:
❖�私の脂肪肝は、BMI、HDL、ALT、HbA1cと相関有
❖�Act:
❖ ALTは、(健康診断以外に)献血で測れる
○健康診断でのALT推移
10
30
50
70
1996年 2001年 2006年 2011年 2017年
10
30
50
70
1996年 2001年 2006年 2011年 2017年
○健康診断でのALT推移
脂肪肝(デブ)
基準値
+献血
脂肪肝再発予防のマトメ
❖ 献血で、ふだんのALTを知りたい
❖�検査回数を年1回から年2、3回に増やした
❖ 健康診断以外の記録を併用し、再発予防
❖�健康診断のセカンドオピニオンとしての検査
❖�ALT(30程度)� �良
A.Iによる健康診断が始まる?
❖東大とNTT、AIで糖尿病患者の通院中断を
推定:日経新聞[’17]
❖ 日本IBM: 糖尿病分析�電子カルテで病状把
握へ[’16]
❖ 経済産業省:糖尿病改善と予防へ、AIで助
言…運動量や食事[’16]
合わせ技一本
❖�糖尿病の予兆監視
❖ HbA1c(ヘモグロビン・エイワンシー)
❖ GA(グリコ・アルブミン)
❖�脂肪肝の再発予防
❖�ALT(アラニンアミノ基転移酵素)
有効
有効
健康診断と献血の併用で、低コストで気づきを
自ら得るのは、数年分のデータがあれば可能
付録A:“脱”脂肪肝(デブ)なら献血可
❖�ALT�100以下ならば、血液廃棄にならず
http://www.mhlw.go.jp/file/05-Shingikai-11121000-Iyakushokuhinkyoku-Soumuka/0000116211.pdf
10
30
50
70
1996年 2001年 2006年 2011年 2017年
異常?
+献血
○健康診断でのALT推移
付録B:激しい運動は、ALTを一時的に上げる
❖�前の週末に、24時間、75km
レースに参加→ダメージ有り
❖�Wuの研究: ALTは、平常値
へ戻るまで9日以上*
❖�後日、30以下に戻った
❖�B、C型肝炎検査済[’05]
* Effects of 24h ultra-marathon on biochemical and hematological parameters[’04]

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