Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, New York, New York 10032, USA.
Am J Prev Med. 2010 Sep;39(3):220-7. doi: 10.1016/j.amepre.2010.03.026.
Although trends in the prevalence of obesity and obesity-attributable deaths have been examined, little is known about the resultant burden of disease associated with obesity.
This study examined trends in the burden of obesity by estimating the obesity-related quality-adjusted life years (QALYs) lost-defined as the sum of QALYs lost due to morbidity and future QALYs lost in expected life years due to premature deaths-among U.S. adults along with differences by gender, race/ethnicity, and state.
Health-related quality-of-life data were taken from the 1993-2008 Behavioral Risk Factor Surveillance System to calculate QALYs lost due to morbidity. Age-specific mortality data were used to calculate QALYs lost due to mortality.
QALYs lost due to obesity in U.S. adults have more than doubled from 1993 to 2008. Black women had the most QALYs lost due to obesity, at 0.0676 per person in 2008. This number was 31% higher than the QALYs lost in black men and about 50% higher than the QALYs lost in white women and white men. A strong and positive relationship between obesity-related QALYs lost and the percentage of the population reporting no leisure-time physical activity at the state level (r=0.71) also was found.
This analysis enables the overall impact of obesity on both morbidity and mortality to be examined using a single value. The overall health burden of obesity has increased since 1993 and such increases were observed in all gender-by-race subgroups and in all 50 states and the District of Columbia.
尽管已经研究了肥胖症和肥胖相关死亡的流行趋势，但对于肥胖相关疾病的负担知之甚少。
本研究通过估计肥胖相关的质量调整生命年（QALYs）损失，来评估肥胖的负担趋势，这些损失定义为由于发病率导致的 QALYs 损失和由于过早死亡导致的预期寿命内未来 QALYs 损失的总和，同时还考虑了性别、种族和州的差异。
使用来自 1993-2008 年行为风险因素监测系统的健康相关生活质量数据来计算由于发病率导致的 QALYs 损失。使用特定年龄的死亡率数据来计算由于死亡率导致的 QALYs 损失。
1993 年至 2008 年，美国成年人因肥胖导致的 QALYs 损失增加了一倍多。黑人女性因肥胖导致的 QALYs 损失最多，2008 年每人损失 0.0676 个 QALYs。这一数字比黑人男性高出 31%，比白人女性和白人男性高出约 50%。还发现肥胖相关 QALYs 损失与州一级无休闲时间体力活动的人口百分比之间存在强烈的正相关关系（r=0.71）。
这项分析使我们能够使用单一数值来检查肥胖症对发病率和死亡率的整体影响。自 1993 年以来，肥胖症对健康的整体负担有所增加，并且在所有性别-种族亚组以及 50 个州和哥伦比亚特区都观察到了这种增加。
