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		<h1 class="title">そうだったんだ！脂肪酸（電子版のみ）<span class="version"></span></h1>
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">PUFAあるいは脂肪酸といってもピンとこない方のために，本書は，PUFAに関する知識の乏しい初心者向けに，その作用機序から最近のエビデンスに至るまで，その分野のエキスパートが，わかりやすく記述することにより，医療従事者のPUFAに対する理解を深めることを目的とした．<br>☆図版143点，表組30点，カラー写真9点，モノクロ写真1点</section><section class="preface">序　文<br>　動脈硬化をはじめとする慢性疾患の発症には食事と運動などの生活習慣が大きく関与することが知られています．ところが，医師の関心はもっぱら薬物療法に向けられており，ガイドラインで提示されている血圧，血糖そしてLDLコレステロールの目標レベルをどう達成するかが患者管理のポイントになっているのではないでしょうか．しかし，それでは，完全なリスクマネージメントができるのでしょうか．動脈硬化などの生活習慣病を扱ううえで，食事はとても重要です．食事が疾病構造を決定しているといっても良いくらいです．それは，食文化の異なる国ごとに疾病構造が異なり，食が時代とともに変化すると疾病構造が変化していくことからも理解できるでしょう．<br>　欧米人は，日本人の冠動脈疾患が少ないのは日本人が魚介類を多く摂取しているからだと考えています．ところがその日本人が食習慣のメリットを忘れ，魚食中心の和食から肉食や植物油の多い西欧食に急激に変化してきたことが，近年の動脈硬化性疾患の増加に寄与していることは間違いありません．そのような中で注目されているのが多価不飽和脂肪酸（PUFA）です．PUFAの中でもエイコサペンタエン酸（EPA）やドコサヘキサエン酸（DHA）は魚に特有で，我々の生命維持に必要な必須脂肪酸です．<br>　近年，EPAやDHAに関して新たな知見が続々と出てきており，古くて新しい話題になっています．魚食による動脈硬化性疾患の予防という疫学調査や介入試験に加え，魚から抽出された薬剤であるEPAあるいはEPA＋DHAで心血管事故が予防されることが数々の大規模試験で証明されています．さらに，EPAやDHAには脂質異常の改善効果，抗炎症作用，血管保護効果，糖代謝改善効果，抗不整脈作用，そして心不全に対する予防効果があることが証明されており，その機序も最近の研究から明らかにされつつあります．このようなPUFAのエビデンスを循環器診療に活かすことにより，より有効な一次予防，二次予防が可能となり，健康寿命を延ばすことができると期待されています．<br>　しかし，PUFAあるいは脂肪酸といってもピンとこない方が多いのではないでしょうか．本書は，PUFAの作用機序から最近のエビデンスに至るまで，その分野のエキスパートにわかりやすく記述していただくことにより，医療従事者のPUFAに関する理解を深めることを目的としました．<br>　本書が先生方の日常診療のお役に立てば幸いです．<br><br>　2013年2月<br>　岡山大学大学院医歯薬学総合研究科循環器内科学<br>　伊藤　浩</section><section class="indexes">［1］beyond LDL，なぜ今脂肪酸？<br>　　1．beyond LDL，なぜ今脂肪酸？<br>［2］脂肪酸をわかりやすく説明しましょう<br>　　1．脂肪酸の種類を説明しましょう<br>　　2．脂肪酸の主な働き<br>　　3．必須多価不飽和脂肪酸とはどのようなものか<br>［3］脂肪酸からみた循環器疾患の疫学<br>　　1．魚を食べると心筋梗塞が減る？─疫学的根拠─<br>　　2．脂肪酸のバランスが崩れてきている現代人<br>　　　One Point Advice　知ってほしいトランス脂肪酸のリスク<br>　　　One Point Advice　EPA/AAとは何？その正常値は？<br>［4］脂肪酸の持つ薬理学的効果<br>　　1．血小板凝集を抑制します<br>　　　Controversy　抗血小板療法にはアスピリンそれともEPA？<br>　　2．脂質異常症を是正します─n-3系多価不飽和脂肪酸の効果─<br>　　3．降圧効果が認められます<br>　　4．血管機能を改善する効果があります<br>　　　One Point Advice　多価不飽和脂肪酸は血液レオロジーを改善する<br>　　5．血管の弾性を改善します─動脈スティフネスと脂肪酸─<br>　　6．動脈硬化を抑制する効果があります<br>　　　One Point Advice　今注目されている中鎖脂肪酸とは<br>　　7．組織の炎症を抑制します<br>　　8．不整脈を抑制する効果があります<br>［5］脂肪酸の循環器疾患予防効果<br>　　1．冠動脈疾患を予防します<br>　　　Controversy　どの指標が最適？─EPA濃度，EPA/AA比またはOmega-3 index─<br>　　2．心臓突然死や心房細動を減らすかもしれない<br>　　3．心不全を予防し，心機能を改善するかもしれない<br>　　4．脳血管疾患を予防します<br>　　5．末梢動脈疾患の症状と予後の改善に貢献する<br>　　6．慢性腎臓病の血管を守ります<br>　　7．高リスク患者の一次予防に有効です<br>［6］脂肪酸の知識を循環器診療に活かす<br>　　1．どのようにEPA，DHA摂取を指導したらよいか<br>　　　One Point Advice　α-リノレン酸を摂取するとEPA，DHAが増加するか？<br>　　　One Point Advice　魚の調理法と多価不飽和脂肪酸バランス<br>　　2．どのような症例にEPA製剤で治療介入すべきか？<br>　　　Controversy　治療効果はEPA投与量，血中濃度のどちらに依存するか？<br>［7］注目されている脂肪酸のトピックス<br>　　1．糖尿病に効くかもしれない<br>　　2．自律神経に良い影響を与えるらしい<br>　　3．慢性炎症を積極的に抑制するらしい<br>　　4．血管新生抑制作用─加齢黄斑変性モデルでの検討─<br>　　5．抗うつ効果があるかもしれない<br>　　　One Point Advice　多価不飽和脂肪酸は認知症を抑制するらしい<br>索引</section></article>
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