Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, New York, NY 10032, USA.
Am J Prev Med. 2010 Feb;38(2):138-44. doi: 10.1016/j.amepre.2009.09.043.
Quality-adjusted life-years (QALYs) use preference-based measurements of health-related quality-of-life (HRQOL) to provide an assessment of the overall burden of disease using a single number.
This study estimated QALYs lost contributed by smoking and obesity for U.S. adults from 1993 to 2008.
Population HRQOL data were from the 1993-2008 Behavioral Risk Factor Surveillance System. The QALYs lost contributed by a risk factor is the sum of QALYs lost due to morbidity in the current year and future QALYs lost in expected life-years due to premature deaths (mortality). Premature deaths were estimated from the National Health Interview Survey Linked Mortality Files and mortality statistics.
From 1993 to 2008, the proportion of smokers among U.S. adults declined 18.5% whereas the proportion of obese people increased 85%. The smoking-related QALYs lost were relatively stable at 0.0438 QALYs lost per population. In 1993 the QALYs lost were much smaller for obesity compared to smoking, with obesity contributing about 0.0204 QALYs lost. However, as a result of the increasing prevalence of obesity, the contribution of obesity-related QALYs lost increased consistently and had increased by 127% in 2008 when obesity resulted in 0.0464 QALYs lost, slightly more than smoking did. Smoking had a bigger impact on mortality than morbidity, whereas obesity had a bigger impact on morbidity than mortality.
This study estimated the overall burden of smoking and obesity over time and results indicate that because of the marked increase in the proportion of obese people, obesity has become an equal, if not greater, contributor to the burden of disease than smoking. Such data are essential in setting targets for reducing modifiable health risks and eliminating health disparities.
质量调整生命年（QALYs）使用基于偏好的健康相关生活质量（HRQOL）测量来提供对疾病总体负担的评估，使用单个数字。
本研究估计了 1993 年至 2008 年美国成年人因吸烟和肥胖导致的 QALYs 损失。
人群 HRQOL 数据来自 1993-2008 年行为风险因素监测系统。一个危险因素导致的 QALYs 损失是当年因疾病导致的 QALYs 损失和由于过早死亡（死亡率）导致的预期寿命内未来 QALYs 损失的总和。过早死亡是根据国家健康访谈调查链接死亡率文件和死亡率统计数据估算的。
1993 年至 2008 年，美国成年人中吸烟者的比例下降了 18.5%，而肥胖者的比例增加了 85%。与吸烟相关的 QALYs 损失相对稳定，为每人口 0.0438 QALYs 损失。1993 年，肥胖导致的 QALYs 损失明显小于吸烟，肥胖导致的 QALYs 损失约为 0.0204。然而，由于肥胖患病率的不断增加，肥胖导致的 QALYs 损失的贡献持续增加，2008 年增加了 127%，当时肥胖导致的 QALYs 损失为 0.0464，略高于吸烟。吸烟对死亡率的影响大于发病率，而肥胖对发病率的影响大于死亡率。
本研究估计了吸烟和肥胖随时间的总体负担，结果表明，由于肥胖人口比例的显著增加，肥胖已成为与吸烟同等甚至更大的疾病负担因素。此类数据对于制定减少可改变健康风险和消除健康差距的目标至关重要。
