学位の種別: 課程博士審査委員会委員 : (主査)東京大学教授 水口 雅, 東京大学教授 神馬 征峰, 東京大学教授 矢冨 裕, 東京大学准教授 近藤 尚己, 東京大学准教授 西浦 博University of Tokyo(東京大学

INOUE YOSUKE

井上 陽介

UTokyo Repository

論文の内容の要旨 
 
論文題目 The association between economic development, lifestyle 
differentiation and C-reactive protein concentrations within 
rural communities in Hainan Island, China 
（中国海南省農村部コミュニティにおける経済発展と 
C反応性タンパク質濃度に関する研究） 
 
井 上 陽 介 
 
 
Objectives: Previous research in lower income countries has suggested that there might 
be an increase in cardiovascular disease risk in response to the adoption of more 
“modern” lifestyles in the course of economic development. The designation of Hainan 
Island, China as a special economic zone in the late 1980s was accompanied by 
dramatic lifestyle changes among local residents. Importantly, a series of earlier 
fieldwork studies in rural Hainan communities witnessed increasing differences 
emerging in socioeconomic status and lifestyles within each community in terms of 
inter-individual variation. It is possible that these variations might have stratified 
residents into sub-populations with different health attributes; to explore this issue, this 
study examined the associations between C-reactive protein (CRP) concentration, a 
biomarker of future cardiovascular events, and personal lifestyle parameters and 
whether it differs according to the degree of community-level economic development 
among rural communities. 
 
Methods: Fieldwork was undertaken in 19 rural communities in 5 regions in Hainan 
Island which differed in terms of the extent of their economic development. 
Convenience sampling was used to collect dried blood spot samples to measure 
high-sensitivity CRP concentration, anthropometric data and information on residents’ 
lifestyles from 1744 individuals aged 15 years old and above during the period from 
November to December, 2010. Duplicated samples were assayed for CRP with a 
high-sensitivity sandwich enzyme immunoassay (EIA). Logistic regression analyses 
were conducted to identify factors which contributed to an elevated CRP concentration 
(i.e., serum equivalent concentration of 3 – 10 mg/L) among the participants. 
 
Results: A positive association was found between CRP concentrations and markers of 
individual-level lifestyle in rural Hainan Island, China. CRP concentration was 
positively associated with the weekly consumption frequency of poultry (odds ratio 
[OR] = 1.36, p = 0.049) and experience of migratory work in the previous year (OR = 
1.79, p = 0.006). CRP concentration was also positively associated with the degree of 
community-level economic development, indexed as maximum income reported in each 
community, a proxy of community income inequality (OR = 1.01, p = 0.012), after 
adjusting for socio-demographic and lifestyle variables. These associations were more 
pronounced among the female participants. Statistically significant interactions between 
sex and the degree of community-level economic development suggest that the 
associations between CRP concentration and sex were modulated by the extent of 
community-level economic development. 
 
Conclusions: The health impact of economic development may be easily observed 
among those who were previously isolated from market exposure, e.g., female residents. 
In contrast to male residents, who had had opportunities to go outside of their own 
communities and be exposed to “modern” lifestyles, female residents seemed to have 
been especially isolated from such lifestyles. This conclusion is supported by the fact 
that the impact of higher mobility, as indicated by the experience of migratory work in 
the previous year, on elevated CRP concentration was also more apparent among 
females. This study also suggests that within these rural communities that once used to 
be homogenous economic development might have stratified people into differing 
population subgroups with different health attributes. 


中国海南省農村部コミュニティにおける経済発展とC反応性タンパク質濃度に関する研究

https://repository.dl.itc.u-tokyo.ac.jp/?action=repository_action_common_download&item_id=7937&item_no=1&attribute_id=14&file_no=2

中国海南省農村部コミュニティにおける経済発展とC反応性タンパク質濃度に関する研究

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