杉原 誉明^{1, 2}, 木原 琢也¹, 兼村 恵美子¹, 星野 由樹¹, 永原 天和¹, 磯本 一¹, 服部 博明³

Takaaki SUGIHARA^{1, 2}, Takuya KIHARA¹, Emiko KANEMURA¹, Yoshiki HOSHINO¹, Takakazu NAGAHARA¹, Hajime ISOMOTO¹, Hiroaki HATTORI³

¹鳥取大学医学部附属病院消化器内科, ²鳥取大学医学部保健学科検査技術科学専攻病態検査学講座, ³はしもとクリニック内科・呼吸器科

¹Department of Gastroenterology, Tottori University, ²Division of Pathobiological Science and Technology, Major in Clinical Laboratory Science, School of Health Science, Faculty of Medicine, Tottori University, ³Hashimoto Clinic, Internal Medicine and Respiratory Medicine

キーワード : POCUS, screening for steatotic liver, community health, preventive medicine, hepatorenal echo contrast

【目的】脂肪肝疾患（Steatotic Liver Disease：SLD）は，肝疾患のみならず2型糖尿病や心血管疾患と関連が指摘されており，早期発見が重要である．本研究では，地域住民を対象とした健康啓発活動の一環として，Point-of-Care Ultrasound（POCUS） を活用した脂肪肝チェックの有用性を検討した．【対象と方法】2023年10月～2024年3月の期間に，市民対象イベント計3回でブースを設営し，携帯型超音波装置を用いたPOCUS脂肪肝スクリーニングを実施した．脂肪肝の判定は，超音波検査士および超音波専門医が肝腎コントラストを基準に評価した．さらに，被検者には聞き取り形式のアンケート調査を行った．【結果と考察】検査対象123例（男性75例，女性48例）のうち，脂肪肝は43例（35％）であった．脂肪肝群はBMIが有意に高く（25.3 vs 21.2 kg/m²，p ‹ 0.001），運動習慣のない割合も高い傾向があった（66.7％ vs 44.3％，p = 0.065）．また，53例（43.1％）は超音波検査を初めて受ける症例であった．【結論】POCUS脂肪肝スクリーニングは，一般市民を対象とした健康啓発活動において，超音波検査未経験者への機会提供と脂肪肝の発見に有用と示された．今後，地域医療や予防医学の分野において，POCUSの活用が期待される．

Purpose: Steatotic liver disease （SLD） is associated with both liver-related and cardiovascular risks, necessitating early detection. This study assessed the effectiveness of a simplified screening method for SLD using point-of-care ultrasound （POCUS） as part of a community-based health awareness initiative. Subjects and Methods: Between October 2023 and March 2024, fatty liver screenings were conducted at three community events with dedicated examination booths. Handheld ultrasound devices were used, and SLD was diagnosed based on hepatorenal echo contrast, evaluated by certified sonographers and ultrasound specialists. An interview-based questionnaire collected data on medical history, body measurements, and exercise habits. Results and Discussion: A total 123 participants （75 men, 48 women） underwent screening, with 43 （35％） diagnosed with SLD. The SLD group had a significantly higher BMI （25.3 vs. 21.2 kg/m², p ‹ 0.001） and a relatively higher prevalence of no exercise habits （66.7％ vs. 44.3％, p = 0.065）. No significant difference in SLD prevalence was found based on medical history （38.1％ vs. 31.2％, p = 0.445）. Additionally, 53 participants （43.1％） underwent ultrasound screening for the first time. The study demonstrated that POCUS-based screening for SLD was highly efficient, requiring only three minutes per case, and was comparable to routine health checkups in detection rate. Conclusion: POCUS-based screening for SLD proved an effective and efficient tool for community health initiatives. Its implementation in non-hospital settings may enhance early detection and preventive interventions, expanding the role of POCUS in public health and primary care.