我が国の国民健康保険加入者の定期健診受診と糖尿病および透析リスクに関する新たな研究知見

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2025-04-21 国立循環器病研究センター,合同会社 H.U.グループ中央研究所

国立循環器病研究センターの研究によると、国民健康保険加入者の定期健診受診は、将来的な糖尿病および人工透析リスクの抑制に重要であることが明らかになった。約32万人のデータを分析した結果、定期健診を継続的に受けている人は、受診していない人に比べて糖尿病の新規発症率が23%、透析導入率が46%も低いことが判明した。特に40〜74歳の層で顕著な傾向が見られ、定期健診の重要性と予防医療の強化が強調されている。

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国民健康保険加入者における毎年の健康診断頻度に基づく糖尿病有病率と透析リスクの検討 Prevalence of diabetes mellitus and dialysis risk based on annual health checkup frequency among National Health Insurance citizens in Japan

Iori Nakamura,Satoshi Kato,Akari Suda,Eri Kiyoshige,Kiyomasa Nakatsuka,Yuriko Nakaoku,Kanako Teramoto,Yusuke Yoshikawa,Misa Takegami,Soshiro Ogata,Akihito Hagihara & Kunihiro Nishimura
BMC Public Health  Published:14 April 2025
DOI:https://doi.org/10.1186/s12889-025-22403-1

我が国の国民健康保険加入者の定期健診受診と糖尿病および透析リスクに関する新たな研究知見

Abstract

Background
In Japan, type 2 diabetes mellitus (T2DM) is a major health concern due to its increasing prevalence and associated complications, including diabetic nephropathy and dialysis. Although the positive relationship between annual health checkups and health outcomes is well-documented, the impact of skipping health checkups on T2DM and its progression to dialysis remains unclear. This study aimed to explore the association between the frequency of annual health checkups and DM-related indices and the potential impact of early intervention in preventing dialysis.

Methods
The study included citizens aged ≥ 40 years from Nobeoka City, Japan (n = 22,094). Health checkup data from 2021 were analyzed, and participants were categorized into four groups based on their health checkup attendance between 2018 and 2020. Logistic regression analyses evaluated the association between health checkup frequency and DM-related indices, such as hemoglobin A1c and estimated glomerular filtration rate. These indices are used to diagnose DM and evaluate its severity. The time to dialysis for citizens without health checkups was estimated under untreated and treated scenarios using a previously published model.

Results
Among the 3,472 participants who underwent health checkups in 2021, 2,098 (60.4%) were women, and 1,374 (39.6%) were men. Citizens who missed health checkups for 3 consecutive years had a higher risk of T2DM than those who had annual checkups (odds ratio = 4.69, 95% confidence interval: 2.78–7.94). No significant difference was observed in T2DM rates between those who attended once or twice and those who attended annually. Simulations for high-risk citizens showed that 32 of 39 individuals may require dialysis during their lifetime; however, early intervention could prevent dialysis in 31 of them.

Conclusions
Citizens who skipped health checkups for 3 consecutive years or longer had a higher risk of T2DM, highlighting the need for targeted public interventions to prevent DM in this population.

医療・健康
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