コロナ禍の行動制限とその解除が体組成と血糖管理に与える長期的影響を解明

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2026-04-10 京都大学

京都大学の研究チームは、新型コロナによる行動制限とその解除が、耐糖能異常患者の血糖管理と体組成に与える長期的影響を検証した。外来患者221名を対象に2019年、2020~21年、2023年を比較した結果、制限解除後もHbA1cは有意に高値を示し、血糖管理の悪化が持続していた。一方で体重・体脂肪は減少したが、骨格筋量は一貫して低下していた。特に、行動制限期に身体活動低下や間食増加が見られた群では、その後も血糖悪化が続く傾向が確認された。これにより、感染対策終了後も生活習慣の変化を踏まえた継続的な個別支援の重要性が示された。

コロナ禍の行動制限とその解除が体組成と血糖管理に与える長期的影響を解明

<関連情報>

日本における耐糖能異常を有する人への新型コロナウイルス感染症(COVID-19)に伴う行動制限および制限緩和が、体組成と血糖コントロールに及ぼした影響:単施設観察研究 Impact of COVID-19 restrictions and their relaxation on body composition and glycemic control in individuals with glucose intolerance in Japan: A single-center observational study

Ami Kobayashi, Yamato Keidai, Takaaki Murakami, Ryo Tsukaguchi, Miharu Fujita, Keiko Wada, Daisuke Yabe
Journal of Diabetes Investigation  Published: 09 April 2026
DOI:https://doi.org/10.1111/jdi.70307

ABSTRACT

Aims/Introduction

During the coronavirus disease 2019 (COVID-19) pandemic, Japan imposed voluntary-based restrictions under a state of emergency (SOE) from 2020 to 2021, and nationwide behavioral restrictions ended with its category 5 status in May 2023. The long-term metabolic impact and their behavioral adaptations of these restrictions and relaxation remain unclear in individuals with glucose intolerance (GI). This single-center observational study assessed changes in glycemic control, body composition, and lifestyle changes across the pre-SOE (2019), SOE (2020–2021), and post-SOE (2023) periods in outpatients.

Materials and Methods

We included 221 outpatients with GI who had complete data for glycated hemoglobin (HbA1c) and body composition in all three periods. Lifestyle changes were evaluated using a questionnaire at post-SOE period.

Results

HbA1c levels gradually increased, with a significant elevation post-SOE compared to pre-SOE. While body weight and BMI remained stable during the SOE, both decreased post-SOE. Fat mass increased during the SOE and thereafter decreased, whereas skeletal muscle mass decreased progressively. Among 68 individuals whose HbA1c worsened during the SOE, 25 experienced further deterioration post-SOE, whereas 43 showed improvements in both glycemic control and body composition. Clustering analysis of questionnaire responses in this subgroup identified two behavioral patterns. One cluster, marked by the combination of persistent reductions in physical activity and increased snacking, showed greater post-SOE HbA1c increases.

Conclusions

This study clarified long-term metabolic effects of COVID-19 restrictions with glycemic deterioration in individuals with GI. In exploratory analysis of those with HbA1c worsening during SOE, behavioral patterns were associated with post-SOE HbA1c changes.

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